Medical Microbiology

GeneralEpidemiology 31

TheFightagainstInfectiousDiseases

Legislation

Confrontingandpreventinginfectiousdiseasescansometimesinvolvesub-

stantialincursionsintotheprivatesphereofthoseinvolvedaswellaseco-

nomicconsequences.Forthesereasons,suchmeasuresmustbebasedonef-

fectivediseasecontrollegislation.Inprinciple,theselawsaresimilarinmost

countries,althoughthedetailsvary.

Thecenterpieceofeverydiseasepreventionsystemisprovisionforre-

portingoutbreaks.Basically,reportingisinitiatedattheperiphery(individual

patients)andmovestowardthecenterofthesystem.Urgencylevelclassifi-

cationsofinfectionsandlaboratoryfindingsaredecidedonbyregional

healthcenters,whichareinturnrequiredtoreportsomediseasestothe

WHOtoobtainaglobalpicturewithintheshortestpossibletime.

Concretecountermeasuresinthefaceofanepidemictaketheformofpro-

phylacticmeasuresaimedatinterruptingthechainofinfection.

ExposureProphylaxis

Exposureprophylaxisbeginswithisolationofthesourceofinfection,inpar-

ticularofinfectedpersons,asrequiredforthediseaseathand.Quarantine

referstoaspecialformofisolationofhealthyfirst-degreecontactpersons.

Thesearepersonswhohavebeenincontactwithasourceofinfection.

Thequarantineperiodisequivalenttotheincubationperiodoftheinfectious

diseaseinquestion(seeInternationalHealthRegulations,www.who.int/en/).

Furthermeasuresofexposureprophylaxisincludedisinfectionandsteri-

lization,useofinsecticidesandpesticides,anderadicationofanimalcarriers.

ImmunizationProphylaxis

Activeimmunization.Inactiveimmunization,theimmunesystemisstimu-

latedbyadministrationofvaccinestodevelopadisease-specificimmunity.

Table 1. 12 liststhevaccinegroupsusedinactiveimmunization.Table 1. 13

showsasanexamplethevaccinationschedulerecommendedbytheAdvisory

CommitteeonImmunizationPracticesoftheUSA(www.cdc.gov/nip).Re-

commendedadultimmunizationschedulesbyagegroupandbymedical

conditionsarealsoavailableintheNationalImmunizationProgramWebsite

mentionedabove.Thevaccinationcalendarsusedinothercountriesdeviate

fromtheseproposalsinsomedetails.Forinstance,routinevaricellaand

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Kayser, Medical Microbiology © 2005 Thieme