Public health reviews
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Public health reviews · Jan 2003
Review Historical ArticleThe impact of "ancient pathogen" studies on the practice of public health.
A new field of "ancient pathogens" is making an impact on our concepts of the evolution of infectious diseases, and it will eventually alter the practice of public health in their control. It has begun to answer important questions regarding past epidemics of influenza and tuberculosis by recovering the genetic sequences of the ancient causative agents. Vaccination strategics will have to study these microbial variants in order to develop tomorrow's vaccines. ⋯ Signal molecules are being identified which alter the virulence of the microbe. Focussing on these mechanisms without attempting to kill the pathogen may in some cases drive it into a benign state. These and other aspects of the evolution of pathogens are discussed which may lead to innovative approaches to the control of infectious diseases.
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Public health reviews · Jan 1998
ReviewClinical manifestations and management of scorpion envenomation.
The most venomous scorpion species are Buthotus tamulus of India, the Leiurus quinquestriatus and Androctonus crassicauda of North Africa and the Middle East, the Tityus serrulatus of Brazil, and the Centruroides suffussus of Mexico. The severity of scorpion envenomation varies with the scorpion's species, age, and size, and is much greater in children. Systemic intoxication reflects the overstimulation of the CNS, the sympathetic and parasympathetic nervous system. ⋯ Antiarrhythmics such as lidocaine, may be required. There is increasing evidence for the efficacy of specific antivenom. The advance in supportive care and antivenom efficacy has markedly improved the outcome of patients with scorpion envenomation.
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Ten species of venomous snakes belonging to three families occur in Israel and in Jordan, some of which may pose a serious threat to humans. Specific, local antivenins are available against only two of the species, while against others regional or European preparations are used. It is suggested that in addition to the monospecific anti-Vipera palaestinae, a polyspecific antivenin be prepared against the clinically most important venomous snakes of the region, namely, Echis coloratus, Pseudocerastes fieldi, Cerastes cerastes, Walterinnesia aegyptia, and Atractaspis engaddensis.