Infectious Disease Crisis Research Articles

Infectious Disease Management: Lessons from Cuba

Over the past decade in Canada, infectious disease outbreaks have repeatedly been in the public spotlight. The Escherichia coli outbreak in Walkerton, Ontario (1), the severe acute respiratory syndrome outbreak in Toronto, Ontario (2) and the Clostridium difficile hospital outbreak in Montreal, Quebec (3), have cost lives, grabbed headlines and stressed local health care systems. Each outbreak raised questions about our ability to prevent outbreaks, detect outbreaks early, and respond efficiently and effectively to infectious disease crises; these outbreaks also highlighted gaps in Canada′s preparedness for managing major infectious disease problems when multiple jurisdictions are involved (4). Canada′s poor track record of tuberculosis control in the north (5) raises the concern that this problem is not limited to crisis situations, but rather has deeper implications for the management of infectious diseases in Canada.

Implications of pandemic influenza for bioterrorism response.

The 1918-1919 influenza pandemic (Spanish flu) had catastrophic effects upon urban populations in the United States. Large numbers of frightened, critically ill people overwhelmed health care providers. Mortuaries and cemeteries were severely strained by rapid accumulation of corpses of flu victims. Understanding of the outbreak's extent and effectiveness of containment measures was obscured by the swiftness of the disease and an inadequate health reporting system. Epidemic controls such as closing public gathering places elicited both community support and resistance, and fear of contagion incited social and ethnic tensions. Review of this infamous outbreak is intended to advance discussions among health professionals and policymakers about an effective medical and public health response to bioterrorism, an infectious disease crisis of increasing likelihood. Elements of an adequate response include building capacity to care for mass casualties, providing emergency burials that respect social mores, properly characterizing the outbreak, earning public confidence in epidemic containment measures, protecting against social discrimination, and fairly allocating health resources.

Drug-resistant bacteria: responding to the infectious disease crisis

The 1990s have been a period of growing anxiety about the emergence of antibiotic-resistant bacteria. Public health, society and the research community must respond quickly to safeguard existing drugs and develop new ones to prevent resistance overwhelming healthcare systems worldwide.