Sagot :
Answer:
1.Emerging Threats
A new variant of a fatal neurologic illness, Creutzfeldt-Jakob disease, appeared in the United Kingdom and was possibly transmitted by ingestion of beef from animals afflicted with bovine spongiform encephalopathy, also known as "mad cow disease." This disease might be caused by a newly recognized type of transmissible agent called a prion (18).
A new and virulent strain of influenza in Hong Kong raised fears of a global pandemic (13).
The United States had several multistate foodborne outbreaks, including outbreaks caused by Cyclospora parasites on fresh raspberries (19); hepatitis A virus on frozen strawberries (20); and Escherichia coli O157:H7 bacteria in apple cider, lettuce, alfalfa sprouts, and ground beef (21-22).
Staphylococcus aureus with reduced susceptibility to vancomycin
the only antibiotic that remains effective against some strains of this bacterium -- was reported for the first time in the United States and Japan (14).
A new strain of tuberculosis (strain W), which is multidrug-resistant and appears more frequently in persons with HIV infection, has become endemic in New York (23)
2.Scientific Findings
Scientists have found increasing evidence that certain infectious microbes cause or contribute to the development of some chronic diseases (24).
Many human genes have been discovered that influence a person's susceptibility to infection, severity of infection, and responsiveness to vaccination or treatment (25).
3.Tools and Technologies
Electronic communications are linking public health institutions in most areas of the world, providing a constant and enormous stream of information on infectious disease outbreaks and related health issues.
Innovations in biotechnology are making it easier to identify and track strains of infectious microbes and to determine the causes and sources of outbreaks as well as the routes of disease transmission.
4.Changes in Health-Care Delivery
Large numbers of Americans have switched from fee-for-service medical insurance to various types of managed care. The shift to managed care has created new challenges and opportunities for disease prevention, surveillance, control, and research. Because of their structures, managed care organizations are in a good position to conduct surveillance, answer clinical research questions, and effect changes in medical practice (e.g., implementation of guidelines).
Shortened hospital stays for some conditions have made it necessary to develop new ways to monitor certain patient outcomes, including hospital-acquired infections whose symptoms do not appear until after the patient has left the hospital.
Home health care has become the fastest growing sector of the U.S. health-care industry (26). New public health partnerships and new methods for assessment are needed to monitor the impact of treatments and to measure the occurrence of health-care- related infections in home health-care settings.
5.Public and Policy Issues
Many Americans have learned about new diseases like Ebola hemorrhagic fever through media reports, films and television movies, and books (27-29). In addition, they might know somebody who has suffered from an emerging infectious disease or an antibiotic-resistant infection.
In 1995, a policy report issued by the Committee on International Science, Engineering, and Technology (CISET) of the National Science and Technology Council recommended governmentwide action to combat emerging infectious diseases (30).
In 1996, a Presidential Decision Directive on emerging infectious diseases established a new national policy to address the growing health and national security threat posed by infectious diseases, including the potential threat of bioterrorism (31).
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