The second half of the 20th century saw stunning success in the war on microbial disease. Widespread availability of antibiotics and the development of vaccines against smallpox, polio, and other illnesses heralded a new era in which many believed we might close the book on infectious disease. Almost a decade into the 21st century, however, the eradication of infectious disease remains elusive. Existing pathogens have adapted, and new, sometimes virulent, organisms have emerged. Infectious disease continues to pose a major public health challenge worldwide, and constitutes a leading cause of death in many countries.
The World Health Organization (WHO) has identified infectious disease as the world’s number one killer of children and young adults, accounting for more than 13 million deaths per year. In all countries, infectious disease causes a substantial health and economic burden, with developing countries at particular risk. Impure food and drinking water and poor living conditions in many less developed countries contribute to the spread of communicable diseases, which can be exacerbated by political instability and refugee migration. Moreover, the convenience of modern travel facilitates the rapid and often global spread of contagion.
Patient care is complicated by the abundance, diversity, and resilience of infectious pathogens. Parasites continue to exact a high toll on health and flourish in areas with limited access to clean food and water. Diseases such as cholera and dengue are resurging, while resistant strains of once treatable diseases, such as tuberculosis, have evolved. Human immunodeficiency virus/acquired immunodeficiency syndrome (HIV / AIDS) presents a universal challenge and continues to devastate sub-Saharan Africa, where it is one of the leading causes of death and is responsible for millions of orphans. Highly resistant strains of bacteria have emerged that cause infections for which there are limited therapeutic options.
The ramifications of infectious disease often extend far beyond the initial infection. Viruses such as herpes or cytomegalovirus (CMV), and parasitic infections such as toxoplasmosis, can cause birth defects and stillbirth. Left untreated, syphilis can affect the central nervous system, leading to mental and neurological disorders. Viruses such as human papilloma virus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Epstein–Barr virus (EBV) have been linked to cancer. Many infections such as HBV, HCV, and HIV can progress from an acute to a chronic phase, increasing morbidity and mortality. While vaccines for pathogens such as smallpox, measles, HBV, and rabies have been used successfully to control disease, many infectious organisms such as HIV and HCV lack an effective vaccine.
Despite ongoing improvements in antiviral therapy and vaccines, viral strains continue to adapt and become resistant, often rendering existing therapies ineffective. Widespread and often inappropriate use of antibiotics has led to a dramatic rise in resistant bacteria in both hospital and community settings. Resistance has also been identified in fungal and parasitic disease. The appearance of resistant strains raises concerns as to regional and global pandemics.
The continuing emergence of new diseases and the evolution of existing organisms are a challenge not only to treatment, but to diagnosis and patient monitoring. In light of these challenges, effective patient care requires access to, and an understanding of, a comprehensive menu of complex laboratory tests.
Siemens Healthcare Diagnostics is dedicated to providing a broad range of diagnostic solutions to meet these demands and is committed to providing educational support for healthcare professionals.