MMWR Recomm Rep. 1998 Sep 11;47(RR-15):1-14.
Societal, technological, and environmental factors continue to have a dramatic effect on infectious diseases worldwide, facilitating the emergence of new diseases and the reemergence of old ones, sometimes in drug-resistant forms. Modern demographic and ecologic conditions that favor the spread of infectious diseases include rapid population growth; increasing poverty and urban migration; more frequent movement across international boundaries by tourists, workers, immigrants, and refugees; alterations in the habitats of animals and arthropods that transmit disease; increasing numbers of persons with impaired host defenses; and changes in the way that food is processed and distributed. Several recent health events underscore the need for a public health system ready to address whatever disease problems that might arise. For example, in 1997, an avian strain of influenza that had never before infected humans began to kill previously healthy persons in Hong Kong, and strains of Sta phylococcus aureus with diminished susceptibility to the antibiotic vancomycin were reported in Japan and the United States. In addition, researchers recently discovered that a strain of the virus that causes acquired immunodeficiency syndrome (AIDS) had been infecting humans for at least 20 years before AIDS emerged as a worldwide epidemic. Preventing Emerging Infectious Diseases: A Strategy for the 21st Century describes CDC's plan to combat today's infectious diseases and prevent those of tomorrow. It represents the second phase of the effort launched in 1994 with the publication of CDC's Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States. This overview of the updated plan outlines specific objectives under four major goals: a) surveillance and response, b) applied research, c) infrastructure and training, and d) prevention and control. Achieving these objectives will enhance understanding of infectious diseases and bolster their detection, control, and prevention. The plan also targets nine categories of problems that cause human suffering and place a burden on society. The aim of this plan is to build a stronger, more flexible U.S. public health system that is well-prepared to respond to known disease problems, as well as to address the unexpected, whether it be an influenza pandemic, a disease caused by an unknown organism, or a bioterrorist attack. The implementation of this plan will require the dedicated efforts of many partners, including state and local health departments, other federal agencies, professional societies, universities, research institutes, health-care providers and organizations, the World Health Organization, and many other domestic and international organizations and groups.
社会、技术和环境因素继续对全球传染病产生巨大影响,促使新疾病出现以及旧疾病再度出现,有时还以耐药形式出现。有利于传染病传播的现代人口和生态条件包括人口快速增长;贫困加剧和城市人口迁移;游客、工人、移民和难民更频繁地跨越国界流动;传播疾病的动物和节肢动物栖息地的改变;宿主防御功能受损的人数增加;以及食品加工和分销方式的变化。最近的几起卫生事件凸显了建立一个随时准备应对可能出现的任何疾病问题的公共卫生系统的必要性。例如,1997年,一种从未感染过人类的禽流感毒株开始在香港导致原本健康的人死亡,并且在日本和美国报告了对抗生素万古霉素敏感性降低的金黄色葡萄球菌菌株。此外,研究人员最近发现,导致获得性免疫缺陷综合征(艾滋病)的一种病毒毒株在艾滋病成为全球流行病之前已经感染人类至少20年。《预防新出现的传染病:21世纪的战略》描述了美国疾病控制与预防中心(CDC)应对当今传染病并预防未来传染病的计划。它代表了1994年随着CDC发布《应对新出现的传染病威胁:美国的预防战略》而启动的努力的第二阶段。这份更新计划的概述在四个主要目标下列出了具体目标:a)监测与应对,b)应用研究,c)基础设施与培训,d)预防与控制。实现这些目标将增进对传染病的了解,并加强对它们的检测、控制和预防。该计划还针对导致人类痛苦并给社会带来负担的九类问题。该计划的目标是建立一个更强大、更灵活的美国公共卫生系统,做好充分准备应对已知的疾病问题,以及应对意外情况,无论是流感大流行、由未知病原体引起的疾病,还是生物恐怖袭击。该计划的实施将需要许多合作伙伴的共同努力,包括州和地方卫生部门、其他联邦机构、专业协会、大学、研究机构、医疗保健提供者和组织、世界卫生组织以及许多其他国内和国际组织与团体。