Control and prevention of infectious diseases of global significance

This chapter addresses the prevention and control of infectious diseases associated with the greatest burden of global morbidity and mortality. We begin by highlighting overall global progress toward infectious disease control. Subsequent sections focus on the critical role of cross-cutting interventions that decrease host susceptibility and exposure across many infectious diseases, including the optimization of nutritional status and environmental modification through the provision of clean water and improved sanitation. The remainder of the chapter is dedicated to prevention and control strategies for specific syndromes of global importance. The communicable disease sections of this book provide a comprehensive overview of the recommended treatments for specific infectious diseases; this chapter only includes these treatments if they are an essential element of control programs. Prevention of infectious diseases refers to the avoidance of infection in individuals, while control refers to reduction in the impact of disease across a population. Prevention and control of infectious diseases can be achieved through interventions designed to kill or inactivate a pathogen (such as mass drug administration, MDA), interventions to limit the spread of a vector or reservoir of the pathogen (such as bed net distribution), interventions to reduce underlying host susceptibility (such as management of malnutrition), or interventions targeting modification of the environment to reduce exposure (such as water and sanitation). Infectious disease prevention and control efforts can be viewed across a spectrum of four categories: control, elimination, eradication, and extinction. Control is defined as reducing the incidence, prevalence, morbidity, or mortality of a condition to locally acceptable levels. This is distinct from elimination (reduction in the incidence of infection to zero within a given geographical area), eradication (permanent reduction in worldwide incidence of an infection to zero), or extinction which implies complete removal of an infectious agent from nature, including no longer being present in any laboratory.