Sexually transmitted diseases in the 1990s

Article Abstract:

In the November 7, 1991 issue of The New England Journal of Medicine, researchers reported confirming the effectiveness of a single oral dose of cefixime against gonorrhea, even when the gonorrhea bacteria were resistant to penicillin and tetracycline. Indeed, gonorrhea is the only sexually transmitted disease for which public health goals are being met. The rate of gonorrhea began to decline in the 1970s and continued to decline at an even faster rate in the 1980s. The success in dealing with bacterial sexually transmitted diseases, such as gonorrhea and syphilis, has rested largely on the ability to successfully treat these conditions. Treatment not only cures the individual, it eliminates a potential source of disease transmission. But what about the other forms of sexually transmitted disease? There is no treatment for genital herpes or for papillomavirus, the causative virus of genital warts. However, the most dangerous sexually transmitted disease is HIV infection, the cause of AIDS. Attempts to deal with the HIV/AIDS epidemic are likely to decrease the incidence of other sexually transmitted diseases as well. The AIDS epidemic is forcing public health officials, as well as many others, to promote programs designed to educate people about disease transmission and the adoption of safer sexual practices. Already, there has been a decline in the incidence of sexually transmitted diseases among homosexual men, indicating that educational programs can work and do have the desired effect. The development of even more effective programs to promote changes in sexual behavior is the hope for the 1990s, not only for the prevention of the spread of HIV infection, but for preventing sexually transmitted diseases in general. (Consumer Summary produced by Reliance Medical Information, Inc.)

Sexually transmitted diseases, Editorial, HIV (Viruses), HIV, Study and teaching, Disease transmission, Sexually transmitted disease prevention

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Patterns of transmission in measles outbreaks in the United States, 1985-1986

Article Abstract:

The incidence of measles virus infection has decreased to less than 2 percent of previous levels in the United States as a result of routine vaccination. Vaccination originally occurred at nine months of age, then was raised to 12 months and then to 15 months when it was observed that vaccination at a later age was more effective and that few measles cases occurred among the younger age group. It was projected that the disease would be eliminated by Oct 1982, but outbreaks are still occurring. An analysis of 152 outbreaks, each with 5 to 945 cases, indicated that outbreaks generally occur among preschool-age children under 5 years of age and school-age children between 5 and 19 years of age. Preschool-age children comprised 26 percent of the outbreaks. Fourteen percent of these children had been vaccinated, and of the remaining 86 percent, 45 percent of the cases were considered to be preventable according to current immunization standards. School-age children accounted for 67 percent of the total number of measles outbreaks, 60 percent of which occurred in vaccinated children. Twenty-seven percent of the measles cases in the 5-19 age group were considered to be preventable. The measles outbreaks in the preschool-age children reveal deficiencies in the national measles-elimination strategy. Institution of selective or universal revaccination in the school age group has been suggested even though it may be costly and difficult to accomplish, particularly in the inner city populations who may have difficulty complying with routine vaccination schedules. The benefits of such a program will eventually outway the costs in completing the elimination of measles infection.

Children, Demographic aspects, Measles, Communicable diseases, Vaccination of children, Vaccination

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AIDS and absolutism - the demand for perfection in prevention

Article Abstract:

Methods used to prevent the transmission of the HIV virus are not 100% effective. Since the onset of the AIDS epidemic, arguments have appeared in the scientific and lay press about which methods are most effective. The only infallible method for preventing the sexual transmission of HIV is abstinence, but this may be unrealistic for many people. Condoms are effective more than 90% of the time, and they may prevent or delay a significant number of infections. Confidential programs for notifying sexual partners of HIV-infected individuals may not reach every contact, but they do reach a significant number. The transmission of HIV among intravenous (IV) drug users may be decreased significantly by methadone maintenance programs and street outreach programs to supply bleach to (IV) drug users. Education and testing of IV drug users and prostitutes may also slow down the spread of HIV infection.

Column, AIDS (Disease), Methadone maintenance, Disease reporting

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