Although many experts predicted that the public
health significance of infectious diseases would
continue to wane in the United States, they remain major
sources for morbidity and mortality in this country. In
addition, the detection of new infectious agents and
diseases continues, and diseases considered to be under
control have reemerged in recent years. An example of an
emerging disease in the 1990s is a previously
unrecognizable hantavirus that caused an outbreak of
fatal respiratory illness in the American Southwest.
This agent has now been identified in more than half of
the States. Other examples include contamination of a
public water supply with the parasite Cryptosporidium,
resulting in the largest waterborne outbreak in U.S.
history; widespread outbreaks of foodborne illness due
to Escherichia coli O157:H7; and a subtype of
influenza A not previously associated with human illness
that produced an outbreak of disease in Hong Kong.
Compounding the problem of emerging infections,
antimicrobial resistance is evolving rapidly in a
variety of hospital- and community-acquired infections.
These trends provide timely reminders of the importance
and potential volatility of infectious diseases as the
new century approaches.
Between 1980 and 1992, data show that overall
mortality from infectious disease rose 58 percent in the
United States. A significant proportion of this increase
is accounted for by the increasing burden of
HIV-associated disease. However, even when
HIV-associated diagnoses are removed, mortality from
infectious diseases still increased 22 percent during
this time. Considered as a group, in 1992 infectious
diseases were the third leading cause of death in the
United States, the most recent year for which final data
were available and analyzed. The direct and indirect
economic costs of infectious diseases are significant.
For example, every hospital-acquired infection adds an
average of $2,100 to a hospital bill. Bloodstream
infections result in an average of $3,517 in additional
hospital charges per infected patient, and cause the
patient to stay in the hospital an average of 7
additional days. A typical case of Lyme disease
diagnosed in the early stages incurs about $174 in
direct medical treatment costs. However, delayed
diagnosis and treatment can result in complications that
cost from $2,228 to $6,724 per patient in direct medical
costs in the first year alone.
Because of their impact on society, a coordinated
strategy is necessary to understand, detect, control,
and ultimately prevent infectious diseases. Such a
strategy is needed to protect the gains achieved in life
expectancy over the 20th century, resulting from the
control and prevention of infectious diseases and to
ensure further improvements in the 21st century.
Taken from Healthy People 2010 Objectives
Local health departments are an important partner in
any coordinated strategy for disease control and
prevention. Data from NACCHO’s 1997 Profile of U.S.
Local Health Departments indicates that 91% of the 2,
292 LHDs respondents either provide, or contract to
provide, communicable disease control. Eighty-three
percent of LHD respondents perform epidemiology and
surveillance.
NACCHO’s projects relating to communicable disease
include:
Hepatitis C Project
HIV/AIDS Project
HIV and Hepatitis C Needs Assessment
See also
National Center for Infectious Disease
