THE TEN GREAT ACHIEVEMENTS OF PUBLIC HEALTHMODULE #2

Missouri Association of Local Boards of Health (MALBOH) Presents

TEN GREAT ACHIEVEMENTS OF PUBLIC HEALTH

(WHY WE DO THE THINGS WE DO)!

Modules developed by Ross McKinstry, MPH;

Sheila Guice, MPH; and Mahree Skala, MA

ACHIEVEMENT #2:Prevention and Control

of Infectious diseases

Prevention and Control of Infectious diseases

At the beginning of the 20th Century• Infectious diseases such as influenza,

smallpox, diphtheria and measles were prevalent

• They took many lives, especially among children

• Pneumonia, tuberculosis and diarrhea were the top 3 causes of death in 1900

• Very few prevention measures or treatments were available to control the spread of diseases

Prevention and Control of Infectious diseases

Control of infectious diseases has come from:

Clean drinking water Improved sanitation Vaccinations Animal control regulations and

services Improvements in laboratory testing Antibiotic treatments

Quarantine Sign of Yesterday...

Iron Lung

Pandemic Influenza -Worldwide Epidemics

• 1918 - Spanish Flu – at least 20 million died

• 1957 - Asian Flu - 70,000 died⁻ Took officials 6 months to detect

• 1968 - Hong Kong Flu - 34,000 died⁻ Took officials 3 months to detect

• 1977 - Russian Flu• 2009 – H1N1

World War I Soldiers - Home from the front

Spanish Flu

The Spanish Flu of 1918 killed more people in U.S. (675,000) than all the wars of the 20th century combined

Community - Mass Immunizations

PREVENTING COMMUNICABLE DISEASES….

• We must be vigilant to safeguard our water supplies through source protection, proper disinfection and filtration

• Outbreaks of E. Coli 0157 in the 1990’s were traced to contaminated ground water in New York and Wyoming, and such incidents continue

• The World Health Organization estimates 2,000,000 children worldwide die each year from diarrheal diseases due to contaminated water

Containing the waste

Where is our water supply located and how is it maintained?

Sewage draining to open ditch

Contaminated Ground Water

Chlorination Of Water Supplies for Communicable Disease Control…

• Began in New Jersey in 1908• Dramatically decreased the number

of water-borne diseases

Currently 98% of water treatment facilities in the US disinfect with chlorine

Water testing is important to monitor for diseases…

Achievements, 1900-1999

Sanitation and hygiene measures Vaccination Antibiotics Serologic (blood) testing Sophisticated laboratory testing

methods Surveillance (disease reporting) laws

and systemsALL THESE MEASURES HAVE GREATLY

REDUCED DISEASE TRANSMISSION

Achievements, 2001-2010

2001-2010• New Tuberculosis cases

⁻ Declined from 6.6 in 1998 to 4.2 2008• Hospital-acquired bloodstream infections from central

IV lines⁻ Declined from 5.5 in 1995-98 to 1.6 in 2009•Efforts to extend HIV testing⁻ Expand screening of persons aged 13--64 years

to enable earlier access to life-saving treatment• Implementation of new blood donor screening

⁻ Interdicted 3,000 potentially infected U.S. donations from blood supply

POLICY CHALLENGES

• State law is not strict enough to protect the public from contamination from onsite sewage systems. (Discharges to road ditches)

• Ground and surface water contamination continue to be sources of communicable disease

ACHIEVEMENT #3:Safer And Healthier Foods

Labeling Requirements and Food Service Training

Safer And Healthier Foods

• Today E. Coli 0157, Staphylococcus, Campylobacter, Listeria and Salmonella are the common food-borne diseases

• No longer are Trichinosis and Botulism the prevalent threats, thanks to advances in food production and processing

Safer And Healthier Foods

• Decreased microbial contamination and food-borne disease

• Improved food handling methods - refrigeration

• Improved nutritional value of foods, crops

• Identifying essential micronutrients and deficiency conditions

• Folic acid and other new disease- preventing functional food elements

Five-A-Day Programs

Safer And Healthier Foods

• Increase in nutritional content

• Establishment of food-fortification programs ⁻ (vitamin fortification, WIC, Summer Food,

etc)

• Close to eliminating major nutritional deficiency diseases in U.S.⁻ (e.g. Rickets, Beri-Beri, Goiter, Pellagra)

Safer And Healthier Foods

• Mistakes are made—LPHAs must maintain vigilance through inspections, food recall enforcement, disease surveillance

• Mass food production and distribution means more multi-state outbreaks and recalls

POLICY CHALLENGES

• Farm-to-Table programs to promote locally grown, healthy foods in schools and childcare

• Support for policies that help improve the nutritional content of food for children

• Improve access to label information that will help people make good choices

• Maintain food protection laws and rules already on the books!

References

Ten Great Achievements of Public Health in the 20th CenturyMorbidity and Mortality Weekly ReportApril 2, 1999 / 48 (12);241-243http://www.cdc.gov/mmwr/preview/mmwrhtml/00056796.htm

Update, May 20, 2011 / 60(19);619-623

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6019a5.htm

References, Continued

Achievements in Public Health, 1900-1999: Control of Infectious DiseasesMorbidity and Mortality Weekly ReportJuly 30, 1999 / 48 (29);621-629

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4829a1.htm

References, Continued

Achievements in Public Health, 1900-1999:

Safer and Healthier Foods Morbidity and Mortality Weekly

ReportOctober 15, 1999 / 48 (40);905-913

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm4840a1.htm

Thanks! Questions