Despite predictions earlier this century that infectious
diseases would soon be eliminated as a public health problem
(1), infectious diseases remain the major cause of death
worldwide and a leading cause of illness and death in the
United States. Since the early 1970s, the U.S. public health
system has been challenged by a myriad of newly identified
pathogens and syndromes (e.g., Escherichia coli O157:H7,
hepatitis C virus, human immunodeficiency virus, Legionnaires
disease, Lyme disease, and toxic shock syndrome). The
incidences of many diseases widely presumed to be under
control, such as cholera, malaria, and tuberculosis (TB), have
increased in many areas. Furthermore, control and prevention
of infectious diseases are undermined by drug resistance in
conditions such as gonorrhea, malaria, pneumococcal disease,
salmonellosis, shigellosis, TB, and staphylococcal infections
(2). Emerging infections place a disproportionate burden on
immunocompromised persons, those in institutional settings
(e.g., hospitals and child day care centers), and minority and
underserved populations. The substantial economic burden of
emerging infections on the U.S. health-care system could be
reduced by more effective surveillance systems and targeted
control and prevention programs (3).
This issue of MMWR introduces a new series, "Emerging
Infectious Diseases." Future articles will address these diseases,
as well as surveillance, control, and prevention efforts by
health-care providers and public health officials. This first
article updates the ongoing investigation of an outbreak of E.
coli O157:H7 in the western United States (4).
References
Burnet M. Natural history of infectious disease. Cambridge,
England: Cambridge University Press, 1963.
Kunin CM. Resistance to antimicrobial drugs -- a worldwide
calamity. Ann Intern Med 1993;118:557-61.
Lederberg J, Shope RE, Oaks SC Jr, eds. Emerging
infections: microbial threats to health in the United
States. Washington, DC: National Academy Press, 1992.
CDC. Preliminary report: foodborne outbreak of Escherichia
coli O157:H7 infections from hamburgers -- western United
States, 1993. MMWR 1993;42:85-6.
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