Deadly infections worldwide

The World Health Organisation in its 1996 report 8 estimated that the leading cause of approximately 50 million deaths in the world in 1995 was infectious diseases, which accounted for about one-third or 17 million deaths. Other figures included diseases of the circulatory system (15 million deaths including ischaemic heart disease—7.2 million—and stroke—4.6 million) and cancer 6.2 million deaths (approximately 12%).

The report indicated that nearly 50 000 people are dying every day from infectious diseases such as cholera, malaria and tuberculosis. At least 30 new infections have emerged in the past 20 years, and for many of them there is no treatment, cure or vaccine. These include rotavirus (which causes infant diarrhoea), Legionella pneumophila, Lyme borreliosis (Lyme disease), the Wantaan virus (which can cause a fatal haemorrhagic fever), HIV and hepatitis E and C.

The report also said that until recently the struggle for control over infectious diseases had seemed almost over, with smallpox eradicated and six other diseases, including polio, leprosy and guinea-worm disease, singled out for eradication within a few years. However, half the world's 5.72 billion were at risk of many infectious diseases since many that seemed under control such as tuberculosis and malaria were becoming more prevalent. Some such as yellow fever and cholera were striking in new regions. Other infections were resistant to drugs and virtually untreatable. The previously almost forgotten diseases such as yersinia (the plague) had re-emerged.

The deadly haemorrhagic fevers that have broken out in isolated endemics include the zoonotic African diseases—Ebola haemorrhagic fever, Marburg haemorrhagic fever and Lassa fever. These are caused by filoviruses and for most no specific treatment is available.

Another serious infection that emerged sporadically was the so called 'flesh eating' Streptococcus A infection, which was a particularly virulent strain causing localised destruction of soft tissue. The lessons to be learned include careful surveillance, attention to prevention especially with effective immunisation programs, rational antibiotic prescribing and care with travelling to developing tropical countries.

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Constipation Prescription

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