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The importance of parasitic zoonoses continues to increase on both local and global scales as interactions between people and animals become more frequent through global travel, intensification of agriculture, habitat devastation, and changes in world trade patterns. A current and real threat is the potential for a deliberate introduction of a zoonotic disease through the prospect of bioterrorism. Parasitic zoonoses represent significant problems in public health, animal agriculture and conservation, and the meat industry. There is an urgent need for integration of medical and veterinary services, continuous disease surveillance in both humans and animals, the teaching of zoonoses to medical doctors, and intensified research on zoonotic agents and diseases. The convergence of both public health and veterinary services currently represents a real challenge for managing zoonotic diseases.
The objective was to identify the main factors influencing micronutrient policies in the opinion of policy actors in ten European countries. Study was carried out during Jan-Nov 2010 in European countries: the Czech Republic, Denmark, England, Germany, Greece, Italy, the Netherlands, Norway, Poland and Spain. Semi-structured qualitative interviews were conducted with representatives of stakeholders involved in the vitamin D, folate and iodine policy making process. Fifty eight key informants representing mainly scientific advisory bodies (n=24) and governmental organisations (n=19) participated in the study. The remaining interviewees represented non-governmental organisations (n=6), industry (n=4) or were independent academic or health professional experts (n=5). Data were analysed by theoretical interpretative thematic analysis. Insights from interviewees on the development of micronutrient policies were grouped using the Public Health Nutrition Policy-making model. The main factors influencing the micronutrient policies were: systematic monitoring of nutrition and health, causal relationships between consumers' diet-related behaviours and health outcomes, scientific recommendations from national bodies (Science area); scientific recommendations from international authorities and experiences of other countries, EU legislation, cultural factors (Wider context) and political environment, national capacity to deal with the problem, national legislation, economics, stakeholder engagement, relationships between stakeholders (Policy and institutions area). The spectrum and weight of the factors influencing nutritional policy depends on nutrient, country and degree of its "advanced status" within nutrition policy, political environment, culture and socio-economic conditions as well as the point of view (who is expressing the opinion).
Background. Monitoring public health workforce is one of the essential functions of the public health system. Objective. The aim of the study was to identify the specialities for physicians and dentists related to public health in the years 1951-2013, and analyse of available data on physicians and dentists certified as public health specialists (PHS) in 2003-2015. Material and Methods. The historical analysis covers a relevant regulations of a minister in charge of health. The data on PHS were obtained from the Centre of Medical Exams and included: the number of specialists and their demographic characteristics, professional background, spatial distribution. Density was also calculated. Results. The public health specialty was introduced in 1999. Before there were specialties in disciplines related to public health. In the years of 2003-2015, 360 physicians and dentists were certified as PHS. The majority of them had former background in another discipline, mostly related to clinical medicine. The average age of specialists was 47.2. Currently, the average age of specialists is ca. 57.6 years, with a prevalence of people aged 61-70 years (36.9%). PHS tend to be older than specialists in other disciplines. Over three fourths of PHS were certified in 2004. With the exception of that year, the public health specialist title was annually obtained by an average of 9 persons. The density of PHS in Poland was 0.94 per 100 thousand inhabitants, ranging between 0.16 and 3.12 in a given voivodeship. Conclusions. The analysis has revealed numerous obstacles in estimation of the number of PHS and indicated a lack of relevant mechanisms aimed at workforce development. A relevant policy for developing public health workforce is urgently needed.
The aim of this study was to undertake a preliminary assessment of the groundwater quality of the West Thrace region. Forty groundwater samples collected from Edirne (Site 1) and Canakkale (Site 2) were assessed for their suitability for human consumption. Eight water samples (20%) had heterotropic plate counts exceeding the EU and Turkish Water Directive limit of 20 cfu/ml in drinking water and the maximum number of bacteria recorded as 44 cfu/ml. Total coliforms, thermotolerant coliforms, E. coli, Enterococcus spp., Salmonella sp., Staphylococcus spp. and Pseudomonas aeruginosa were detected in 25%, 17.5%, 15%, 47.5%, 15%, 27.5% and 15% of the groundwater samples, respectively. Eleven (27.5%) samples exceeded the EU Water Directive value of 50 mg/l for nitrate, but 13 (32.5%) samples violated the Turkish standard of 45 mg/l nitrate in drinking water. pH values of all samples were between 5.5-8.5 limits. Conductivity of all samples were below Turkish and EU Water Directive levels. Five samples (12.5%) exceeded the Turkish Water Directive for total dissolved solids (TDS) in water.
Shiga-like toxin-producing (SLTEC) Escherichia coli strains are one of the most important food borne emerging pathogens. One hundred and fifty-seven E. coli strains isolated from 39 children with diarrhea of unknown origin and one hundred and five E. coli strains from 20 healthy children were examined for Shiga-like toxin production in Vero cell line assay. The synthesis of Shiga-like toxin was observed on Vero cell line and confirmed by PCR for one of 262 E. coli strains tested. The shiga-like toxin II-positive E. coli strain was isolated from 2-years old healthy child with no symptoms of gastrointestinal tract infection.
Birth defects (BD) surveillance using international standards was introduced in Ukraine by a network of five BD centers located in northwestern, central and southern regions. BD centers provide resources to access current and comprehensive information and to nurture partnerships with physicians, administrators, parental support groups, educators, and humanitarian assistance organizations. One outcome was the vigorous and popular website International BD Information Systems (IBIS). The network is now incorporated as OMNI-Net Ukraine. The program has documented high prevalence rates of neural tube defects (NTD); fetal alcohol effects (FAE); and idiopathic developmental retardation among orphans that prompted prevention and amelioration initiatives. Further program objectives include: universal folic acid flour fortification, as recommended by the Ukrainian Academy of Medicine; continued research on methods to reduce FAE in collaboration with partners from California; opening other early infant stimulation centers funded by local authorities, modeled on those in Rivne and Lutsk; and linking BD prevention with bioethical considerations, which is a topic of interest in Ukraine in part enhanced by the effects of Chornobyl.
Geographical Information System (GIS) combines information from cartography sources (i.e. maps), earthbound surveys, remote sensing (i.e. aerial and satellite imagery) and creates overlapping layers that can be accessed, transformed, and manipulated interactively in one spatial structure. Thanks to the great flexibility of GIS, its possible applications are countless. For example, dynamic databases created by GIS can manage information from various sources and make spatial correlations with epidemiological data about temporal distribution of environmentally-related diseases. GIS has also been increasingly used to monitor, analyse and model pesticide migration in the environment. GIS analysis has proved to be a valuable tool in environmental and public health studies yielding important results that may ultimately help prevent excessive or uncontrolled exposure to xenobiotics, including pesticides. Despite its obvious advantages GIS technology is still not commonly used for such studies, particularly in the developing countries where the knowledge about GIS technology and its accessibility is limited. The presented review briefly explains the basic features of GIS and discusses exemplary studies where this technology has been successfully used for monitoring and analysing pesticide pollution and its impact on public health.
Animal by-products of category 3 after proper processing may be a valuable fertilizer for agricultural purposes. However, they can contain numerous bacterial and viral pathogens and, in cases of improper handling, may pose a health risk for people and animals. This study is aimed at monitoring the number of fecal streptococci introduced into carriers of different types imitating fragments of meat and bone wastes during composting process in a drum bio-reactor. Fecal streptococci are indicator microorganisms, and are known by their thermoresistant characteristics, so it was assumed that their elimination will also diminish the pathogenic microorganisms present in wastes. Three research cycles were carried out in a drum-type bio-reactor, and a different course of temperature was noted in each of them. In cycle 1, in which the temperature exceeded 60ºC, fecal streptococci died the fastest, 139.0-154.4 hours later (depending on carrier type). In cycles 2 and 3, maximum temperatures were similar (57.2ºC and 58.8ºC, respectively), but secondary multiplication of the streptococci in the 102nd hour of the processes was observed. In cycle 2 at this time their number was similar to the level of initial suspension. The type and size of the carriers were of no major importance to streptococci survival in the bio-reactor. Yet in each of the cycles analyzed, effective reduction was accomplished and the product obtained can be considered to be environmentally safe.
Brucellosis is a zoonosis with a worldwide distribution and remains a significant public health problem mainly in the developing world. In this study we evaluated the in vitro activities and synergistic effects of antibiotic combinations against blood culture isolates of Brucella spp. In vitro susceptibilities of 76 blood culture isolates of Brucella melitensis and one blood culture isolate of Brucella abortus to doxycycline, streptomycin, gentamicin, trimethoprim-sulfamethoxazole, moxifloxacin, rifampin, ciprofloxacin, and tigecycline were examined by Etest method. For 37 patients with Brucella spp. isolates (36 B. melitensis, 1 B. abortus), antibiotic combinations used for treatment were identified with those tested in vitro for synergy using Etest method. Trimethoprim-sulfamethoxazole and tigecycline were the most active of the compounds tested with MIC₉₀ value of 0.094 mg/1. Among antibiotic combinations only streptomycin-rifampin combination was synergistic for one Brucella spp. isolate. The other antibiotic combinations revealed antagonistic or indifferent activity. Complete clinical response was achieved in all patients. Further studies are required to determine the correlation between the antimicrobial susceptibility and synergy test results with the clinical course of patients. Brucellosis can be adequately treated with existing regimens in our region.
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