SYED A. SATTAR, Ph.D. DIRECTOR, CENTRE FOR RESEARCH ON ENVIRONMENTAL MICROBIOLOGY (CREM) UNIVERSITY...

SYED A. SATTAR, Ph.D.

DIRECTOR, CENTRE FOR RESEARCH ONENVIRONMENTAL MICROBIOLOGY (CREM)UNIVERSITY OF OTTAWA, OTTAWA, ON, CANADA

SYED A. SATTAR, Ph.D.

DIRECTOR, CENTRE FOR RESEARCH ONENVIRONMENTAL MICROBIOLOGY (CREM)UNIVERSITY OF OTTAWA, OTTAWA, ON, CANADA

THE ROLE OF THE ENVIRONMENT IN THE

TRANSMISSION OF BACTERIA AND VIRUSES

AMONGST CHILDREN

THE ROLE OF THE ENVIRONMENT IN THE

TRANSMISSION OF BACTERIA AND VIRUSES

AMONGST CHILDREN

CREM

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CRME

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DESIGNING ASAFER TOMORROW

POUR UN FUTURPLUS SAIN

DESIGNING ASAFER TOMORROW

POUR UN FUTURPLUS SAIN

SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., 2005SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., 2005 22

INTRODUCTIONINTRODUCTION

WHY THE EMPHASIS ON CHILDREN? WHY THE CONCERN WITH BACTERIAL & VIRAL

INFECTIONS? NEWER PATHOGENS & NEWER ROLES FOR THEM? LONGER-TERM IMPACTS OF INFECTIONS?

WHAT IS THE GLOBAL PICTURE? WHAT IS THE SITUATION IN CANADA & THE U.S.? HOW DO BACTERIA & VIRUSES SPREAD IN NATURE? WHAT ROLE DOES THE ENVIRONMENT PLAY? HOW CAN ENVIRONMENTAL SPREAD BE INTERRUPTED? WHAT DOES THE FUTURE HOLD?

WHY THE EMPHASIS ON CHILDREN? WHY THE CONCERN WITH BACTERIAL & VIRAL

INFECTIONS? NEWER PATHOGENS & NEWER ROLES FOR THEM? LONGER-TERM IMPACTS OF INFECTIONS?

WHAT IS THE GLOBAL PICTURE? WHAT IS THE SITUATION IN CANADA & THE U.S.? HOW DO BACTERIA & VIRUSES SPREAD IN NATURE? WHAT ROLE DOES THE ENVIRONMENT PLAY? HOW CAN ENVIRONMENTAL SPREAD BE INTERRUPTED? WHAT DOES THE FUTURE HOLD?


TERMS OF REFERENCETERMS OF REFERENCE

A CHILD: ANY PERSON UNDER 18 YEARS OF AGE

THE ENVIRONMENT: ANYTHING OUTSIDE THE BODY

OF THE HUMAN HOST

A CHILD: ANY PERSON UNDER 18 YEARS OF AGE

THE ENVIRONMENT: ANYTHING OUTSIDE THE BODY

OF THE HUMAN HOST


WHY THE EMPHASIS ON CHILDREN?WHY THE EMPHASIS ON CHILDREN?

MORE VULNERABLE TO INFECTION

GREATER EXPOSURE TO MICROBES

POTENTIAL FOR LONGER-TERM HEALTH IMPACT

DEPENDENCE ON CARE-GIVERS

LOWER LEVELS OF AWARENESS

INCREASING GROUPING IN DAYCARE CENTERS

POVERTY, MALNUTRITION & NEGLECT

MORE VULNERABLE TO INFECTION

GREATER EXPOSURE TO MICROBES

POTENTIAL FOR LONGER-TERM HEALTH IMPACT

DEPENDENCE ON CARE-GIVERS

LOWER LEVELS OF AWARENESS

INCREASING GROUPING IN DAYCARE CENTERS

POVERTY, MALNUTRITION & NEGLECT

SIMPLY PUT, A HEALTHY CHILD IS MORE LIKELY TO BE A HEALTHY ADULT

SIMPLY PUT, A HEALTHY CHILD IS MORE LIKELY TO BE A HEALTHY ADULT


WHY WORRY ABOUT THE GLOBAL PICTURE?WHY WORRY ABOUT THE GLOBAL PICTURE?

INFECTIONS CONTINUE TO BE A MAJOR KILLER

OF CHILDREN WORLDWIDE (GRAPHS)

INCREASING LEVELS OF POLLUTION POVERTY MALNUTRITION

IMPACT OF NATURAL DISASTERS IMPACT OF DISEASES SUCH AS AIDS OVC’S (ORPHANS & VULNERABLE CHILDREN)

INFECTIONS CONTINUE TO BE A MAJOR KILLER

OF CHILDREN WORLDWIDE (GRAPHS)

INCREASING LEVELS OF POLLUTION POVERTY MALNUTRITION

IMPACT OF NATURAL DISASTERS IMPACT OF DISEASES SUCH AS AIDS OVC’S (ORPHANS & VULNERABLE CHILDREN)

“NO ONE IS SAFE UNTIL EVERYONE IS SAFE”“NO ONE IS SAFE UNTIL EVERYONE IS SAFE”


CHILDREN AND BASIC DEPRIVATION FACTORS(UNICEF, STATE OF THE WORLD CHILDREN, 2005)

CHILDREN AND BASIC DEPRIVATION FACTORS(UNICEF, STATE OF THE WORLD CHILDREN, 2005)

FACTOR MILLIONS

NO ADEQUATE SHELTER 640

NO ACCESS TO SANITATION 500

NO ACCESS TO SAFE WATER 400

NO ACCESS TO INFORMATION 300

NO ACCESS TO HEALTH CARE SERVICES 270

HAVE NEVER BEEN TO SCHOOL 140

ARE SEVERELY FOOD-DEPRIVED 90

AIDS HAS CREATED 15 MILLION OVC’SAIDS HAS CREATED 15 MILLION OVC’S


DEMOGRAPHICS IN CANADA AND THE U.S. – 2003*(http://www.unicef.org/statistics/index_countrystats.html)

DEMOGRAPHICS IN CANADA AND THE U.S. – 2003*(http://www.unicef.org/statistics/index_countrystats.html)

*BASED ON UNICEF REPORT THE STATE OF WORLD’S CHILDREN, 2005*BASED ON UNICEF REPORT THE STATE OF WORLD’S CHILDREN, 2005

CANADA U.S.

TOTAL POPULATION 31,510,000 294,043,000

POPULATION UNDER AGE 18 6,942,000 75,893,000

POPULATION UNDER AGE 5 1,663,000 20,794,000

% OF CHILDREN LIVING IN POVERTY 14.9 21.9


MAIN CAUSES OF DEATH AMONG CHILDREN 0-4 YEARS (WORLD HEALTH ORGANIZATION, 1999)

MAIN CAUSES OF DEATH AMONG CHILDREN 0-4 YEARS (WORLD HEALTH ORGANIZATION, 1999)


CAUSES OF PREMATURE DEATH AMONGST 0-44 YEAR OLDS (WORLD HEALTH ORGANIZATION, 1999)

CAUSES OF PREMATURE DEATH AMONGST 0-44 YEAR OLDS (WORLD HEALTH ORGANIZATION, 1999)


BREAKDOWN OF KNOWN HUMAN PATHOGENS(TAYLOR ET AL. PHIL. TRANS. R. SOC. LOND. B. 2001; 356:983-989)

BREAKDOWN OF KNOWN HUMAN PATHOGENS(TAYLOR ET AL. PHIL. TRANS. R. SOC. LOND. B. 2001; 356:983-989)

OF THESE 1415 PATHOGENS,

THE MEANS OF SPREAD OF

>200 ARE NOT KNOWN!!

OF THESE 1415 PATHOGENS,

THE MEANS OF SPREAD OF

>200 ARE NOT KNOWN!!

287 HELMINTHS (20%)

66 PROTOZOA (5%)

307 FUNGI (22%)

217 VIRUSES & PRIONS (15%)

538 BACTERIA (38%)

BACTERIA & VIRUSES

TOGETHER CONSTITUTE

>50% OF KNOWN HUMAN

PATHOGENS

BACTERIA & VIRUSES

TOGETHER CONSTITUTE

>50% OF KNOWN HUMAN

PATHOGENS


HUMAN HEALTH IMPACT OF INFECTIOUS AGENTSHUMAN HEALTH IMPACT OF INFECTIOUS AGENTS

GLOBALLY, INFECTIONS DIRECT CAUSE OF >32% (18/56

MILLION) OF ALL DEATHS/YEAR; >45% IN DEVELOPING

COUNTRIES (WHO 2001)

40 NEW PATHOGENS FOUND IN PAST 30 YEARS ALONE

(DESSELBERGER, J. INFECT. 2000; 40:3-15)

INFECTIONS & DELAYED OUTCOMES, E.G., POST-POLIO &

GUILLAIN-BARRÉ SYNDROMES (WHO 2003)

VIRUSES (HBV, HCV, HPV) & BACTERIA (H. PYLORI)

CAUSING CANCERS (WHO 2003)

GLOBALLY, INFECTIONS DIRECT CAUSE OF >32% (18/56

MILLION) OF ALL DEATHS/YEAR; >45% IN DEVELOPING

COUNTRIES (WHO 2001)

40 NEW PATHOGENS FOUND IN PAST 30 YEARS ALONE

(DESSELBERGER, J. INFECT. 2000; 40:3-15)

INFECTIONS & DELAYED OUTCOMES, E.G., POST-POLIO &

GUILLAIN-BARRÉ SYNDROMES (WHO 2003)

VIRUSES (HBV, HCV, HPV) & BACTERIA (H. PYLORI)

CAUSING CANCERS (WHO 2003)


HEALTH IMPACT (CONT’D.)HEALTH IMPACT (CONT’D.)

CHRONIC CONDITIONS (ARTERIOSCLEROSIS, ARTHRITIS)

EXACERBATION OF ASTHMA

POLYMICROBIC DISEASES E.G., ~15% OF CASES OF ACUTE

OTITIS MEDIA DUE TO A MIXTURE OF VIRUSES & BACTERIA

(HEIKKINEN & CHONMAITREE. CLIN. MICROBIOL. REV. 2003; 16:230-241.)

VIRUSES & OBESITY – INFECTOBESITY (DHURANDHAR, J. NUTR.

2001; 131:2794S-2797S)

INFECTIONS & BEHAVIORAL CHANGES, E.G., TOXOPLASMA

GONDII (BERDOY ET AL. PROC R SOC LOND. B BIOL. SCI. 2000; 267:1591-1594)

LACK OF NEW VACCINES & DRUGS

DECREASING RATES OF CHILDHOOD VACCINATIONS

CHRONIC CONDITIONS (ARTERIOSCLEROSIS, ARTHRITIS)

EXACERBATION OF ASTHMA

POLYMICROBIC DISEASES E.G., ~15% OF CASES OF ACUTE

OTITIS MEDIA DUE TO A MIXTURE OF VIRUSES & BACTERIA

(HEIKKINEN & CHONMAITREE. CLIN. MICROBIOL. REV. 2003; 16:230-241.)

VIRUSES & OBESITY – INFECTOBESITY (DHURANDHAR, J. NUTR.

2001; 131:2794S-2797S)

INFECTIONS & BEHAVIORAL CHANGES, E.G., TOXOPLASMA

GONDII (BERDOY ET AL. PROC R SOC LOND. B BIOL. SCI. 2000; 267:1591-1594)

LACK OF NEW VACCINES & DRUGS

DECREASING RATES OF CHILDHOOD VACCINATIONS


GLOBAL HEALTH IMPACT OF ROTAVIRAL INFECTIONS - 1986-2000 (PARASHAR ET AL. EMERG. INFECT. DIS. 2003; 9: 565-572)

GLOBAL HEALTH IMPACT OF ROTAVIRAL INFECTIONS - 1986-2000 (PARASHAR ET AL. EMERG. INFECT. DIS. 2003; 9: 565-572)

SAFE & EFFECTIVE VACCINE STILL UNAVAILABLE PERSONAL & ENVIRONMENTAL HYGIENE EFFECTIVE IN

PREVENTING SPREAD OF ROTAVIRAL INFECTIONS RELATIVE IMPORTANCE OF VARIOUS VEHICLES REMAINS

UNCLEAR

SAFE & EFFECTIVE VACCINE STILL UNAVAILABLE PERSONAL & ENVIRONMENTAL HYGIENE EFFECTIVE IN

PREVENTING SPREAD OF ROTAVIRAL INFECTIONS RELATIVE IMPORTANCE OF VARIOUS VEHICLES REMAINS

UNCLEAR

EVENT (RISK)NUMBER/YEAR IN

MILLIONS

EPISODES OF DIARRHEA REQUIRING HOME CARE (1:1) 111

VISITS TO CLINICS (1:5) 25

HOSPITALIZATIONS (1:65) 2

DEATHS IN CHILDREN <5 YEARS (1:293) ~0.5


MODES & MEANS OF PATHOGEN SPREAD IN NATUREMODES & MEANS OF PATHOGEN SPREAD IN NATURE

Infected host Susceptible hostH O R I Z O N T A L

Susceptible host

VERTICAL

HORIZONTAL SPREAD

Infected host Susceptible hostDirect (person-to-person)

Infected host Susceptible hostIndirec

tIndirect spread is through vehicles such as

water, food, air, fomites, insects, animals, soil, hands, environmental surfaces, medical devices & transplanted blood & tissues


ENVIRONMENTAL SPREAD OF INFECTIOUS AGENTSENVIRONMENTAL SPREAD OF INFECTIOUS AGENTS

HUMANHOST

HUMANHOST

MEDICAL DEVICES(HEPATITIS B VIRUS)

WATER(CRYPTOSPORIDIUM)

FOOD(CAMPYLOBACTER)

AIR(INFLUENZAVIRUS)

WASTES(ESCHERICHIA COLI O157:H7)

SOIL(CLOSTRIDIUM TETANI)

ENVIRON. SURFACES(HEPATITIS A VIRUS)

ANIMALS(HANTAVIRUS)

INSECTS(WEST NILE VIRUS)

SECONDARY HOSTS (TOXOPLASMA GONDII)

HANDS (ROTAVIRUS)


SPREAD OF INFECTIONS IN NATURESPREAD OF INFECTIONS IN NATURE

PATHOGEN SOURCE

HANDS

ENVIRON. SURFACES

SUSCEPTIBLE HOST

INSECTS

FOOD WATER

AIR

ANIMALS


BACTERIA, PARASITES & VIRUSES IN FOODBORNE DISEASE IN THE U.S. (FROM MEAD ET AL., 1999)

BACTERIA, PARASITES & VIRUSES IN FOODBORNE DISEASE IN THE U.S. (FROM MEAD ET AL., 1999)

30.2

2.6

67.2

59.9

5.3

34.8

71.7

21.2

7.1

0

10

20

30

40

50

60

70

80

Bacterial Parasitic Viral

% F

oodb

orne

Dis

ease

Illnesses

Hospitalizations

Deaths


FELINE CALICIVIRUS SURVIVAL ON FOODS AT 4°CFELINE CALICIVIRUS SURVIVAL ON FOODS AT 4°C

BIDAWID ET AL. UNPUBLISHED DATA


FELINE CALICIVIRUS SURVIVAL ON METAL DISKS AT 4°CFELINE CALICIVIRUS SURVIVAL ON METAL DISKS AT 4°C

BIDAWID ET AL. UNPUBLISHED DATA


NEARLY 45% OF FCV REMAINS DETECTABLE ON THE HANDS OF ADULTS AFTER 20 MINUTES OF DRYING

SURVIVAL OF SELECTED ORGANISMS ON HANDS OF ADULTS AFTER ONE HOURSURVIVAL OF SELECTED ORGANISMS ON HANDS OF ADULTS AFTER ONE HOUR


GENERAL MEANS TO INTERRUPT SPREAD OF PATHOGENS

GENERAL MEANS TO INTERRUPT SPREAD OF PATHOGENS

VACCINATION (POLIO)

PASSIVE IMMUNIZATION (HEP. A)

CHEMOTHERAPY (ANTIBIOTICS)

VACCINATION OF ANIMALS (RABIES)

DISEASE SURVEILLANCE (TB)

QUARANTINE (RABIES)

BARRIER PROTECTION (AIDS)

SCREENING OF BLOOD & TISSUES (HEP. B)

QUALITY CONTROL ON IMPORTS (CYCLOSPORA)

EDUCATION (TOXOPLASMOSIS)

VACCINATION (POLIO)

PASSIVE IMMUNIZATION (HEP. A)

CHEMOTHERAPY (ANTIBIOTICS)

VACCINATION OF ANIMALS (RABIES)

DISEASE SURVEILLANCE (TB)

QUARANTINE (RABIES)

BARRIER PROTECTION (AIDS)

SCREENING OF BLOOD & TISSUES (HEP. B)

QUALITY CONTROL ON IMPORTS (CYCLOSPORA)

EDUCATION (TOXOPLASMOSIS)


ENVIRONMENTAL CONTROL MEASURESENVIRONMENTAL CONTROL MEASURES

WATER TREATMENT & DISTRIBUTION

FOOD TREATMENT & PRESERVATION

AIR FILTRATION & DISINFECTION

LIQUID & SOLID WASTE COLLECTION,

TREATMENT & DISPOSAL

CONTROL OF ANIMALS & INSECTS

CONTROL OF SECONDARY HOSTS

STERILIZATION

HANDWASHING CLEANING/DISINFECTION

WATER TREATMENT & DISTRIBUTION

FOOD TREATMENT & PRESERVATION

AIR FILTRATION & DISINFECTION

LIQUID & SOLID WASTE COLLECTION,

TREATMENT & DISPOSAL

CONTROL OF ANIMALS & INSECTS

CONTROL OF SECONDARY HOSTS

STERILIZATION

HANDWASHING CLEANING/DISINFECTION


ALCOHOL-BASED HAND RUBS AND FELINE CALICIVIRUS (SATTAR ET AL., UNPUBLISHED DATA)

ALCOHOL-BASED HAND RUBS AND FELINE CALICIVIRUS (SATTAR ET AL., UNPUBLISHED DATA)

TREATMENTMEAN VIRUS

TITER% REDUCTION

BASELINE 1.6 x 105 -

60% ETHANOL 1.0 x 104 94.0

70% ETHANOL 5.2 x 103 96.8

80% ETHANOL 6.2 x 103 96.2

THE FINGERPAD METHOD (ASTM 1838) WAS USED. TEN µL OF VIRUS IN SOIL LOAD WAS PLACED ON EACH FINGERPAD & DRIED. THE DRIED INOCULUM WAS EXPOSED TO CONTROL OR TEST

SOLUTION FOR 30 SECONDS. THE FINGERPADS WERE ELUTED & ELUATES PLAQUE ASSAYED.


AN ALCOHOL-BASED GEL AND CORONAVIRUS 229E(SATTAR ET AL., UNPUBLISHED DATA)

AN ALCOHOL-BASED GEL AND CORONAVIRUS 229E(SATTAR ET AL., UNPUBLISHED DATA)

TREATMENT MEAN SD % REDUCTION

BASELINE 1.32 X 104 0.4 -

HARD WATER (200 PPM CaCO3)

3.02 X 103 2.0 77.0

75% (V/V) ETHANOL 0 >99.99

ALCOHOL (60%) GEL 0 >99.99

THE FINGERPAD METHOD (ASTM 1838) WAS USED. TEN µL OF VIRUS IN SOIL LOAD WAS PLACED ON EACH FINGERPAD & DRIED. THE DRIED INOCULUM WAS EXPOSED TO CONTROL OR TEST

SOLUTION FOR 30 SECONDS. THE FINGERPADS WERE ELUTED & ELUATES PLAQUE ASSAYED.


CHEMICAL DISINFECTION TO INTERRUPT

ROTAVIRUS SPREAD*

CHEMICAL DISINFECTION TO INTERRUPT

ROTAVIRUS SPREAD*

TREATMENT NO. INFECTED %

OF VIRUS NO. TESTED INFECTED

NONE 13/14 93

LYSOL DISINFECTANT

SPRAY 0/14 0

Virus in fecal suspension was dried on plastic plates and volunteers asked to lick the surface with and without disinfection.

Virus in fecal suspension was dried on plastic plates and volunteers asked to lick the surface with and without disinfection.

Ward et al., J. Clin. Microbiol. 29: 1991-1996, 1991.Ward et al., J. Clin. Microbiol. 29: 1991-1996, 1991.


EMERGING ISSUESEMERGING ISSUES

INCREASED SCRUTINY OF MICROBICIDES WITH MICROBICIDAL

ACTIVITY AS ONLY ONE COMPONENT IN ACCEPTANCE & USE

FLAWED TEST METHODOLOGY

PROSPECTS FOR REGIONAL/GLOBAL HARMONIZATION

IMPROVED AWARENESS IN END-USERS

TREATED ARTICLES

MICROBICIDES & ANTIBIOTIC RESISTANCE (?)

MICROBICIDE RESIDUES & ENHANCED BACTERIAL

SPORULATION (WILCOX & FAWLEY. LANCET 2000; 356; 1324.)

INCREASED SCRUTINY OF MICROBICIDES WITH MICROBICIDAL

ACTIVITY AS ONLY ONE COMPONENT IN ACCEPTANCE & USE

FLAWED TEST METHODOLOGY

PROSPECTS FOR REGIONAL/GLOBAL HARMONIZATION

IMPROVED AWARENESS IN END-USERS

TREATED ARTICLES

MICROBICIDES & ANTIBIOTIC RESISTANCE (?)

MICROBICIDE RESIDUES & ENHANCED BACTERIAL

SPORULATION (WILCOX & FAWLEY. LANCET 2000; 356; 1324.)


HAZARDS IN MICROBICIDE USEHAZARDS IN MICROBICIDE USE

SOME 300 CHEMICALS USED AS MICROBICIDES;

MANY ARE NOW UNDER SCRUTINY MICROBICIDES ARE A DOUBLE-EDGED SWORD

NO CHEMICAL THAT CAN KILL PATHOGENS CAN BE TOTALLY SAFE

FOR OTHER LIFE FORMS

DAMAGE TO THE ENVIRONMENT VOLATILE ORGANICS & AIR QUALITY DISRUPTION OF HORMONE FUNCTIONS CHANGES IN BIOFILM COMPOSITION COMBINED IMPACT OF CHEMICALS & PATHOGENS

SOME 300 CHEMICALS USED AS MICROBICIDES;

MANY ARE NOW UNDER SCRUTINY MICROBICIDES ARE A DOUBLE-EDGED SWORD

NO CHEMICAL THAT CAN KILL PATHOGENS CAN BE TOTALLY SAFE

FOR OTHER LIFE FORMS

DAMAGE TO THE ENVIRONMENT VOLATILE ORGANICS & AIR QUALITY DISRUPTION OF HORMONE FUNCTIONS CHANGES IN BIOFILM COMPOSITION COMBINED IMPACT OF CHEMICALS & PATHOGENS


HOUSEHOLD MICROBICIDES & CHILDREN(M. SPANN ET AL., AM. J. PUB. HLTH. 2000;90:971-973)

HOUSEHOLD MICROBICIDES & CHILDREN(M. SPANN ET AL., AM. J. PUB. HLTH. 2000;90:971-973)

ANNUALLY ABOUT 800,000 CHILDREN (<6 YEARS IN AGE) IN THE U.S.

INGEST HOUSEHOLD PESTICIDES MEDICAL ATTENTION NEEDED IN 10% OF THE CASES MICROBICIDES INVOLVED IN >90% OF SEVERE CASES

ANNUALLY ABOUT 800,000 CHILDREN (<6 YEARS IN AGE) IN THE U.S.

INGEST HOUSEHOLD PESTICIDES MEDICAL ATTENTION NEEDED IN 10% OF THE CASES MICROBICIDES INVOLVED IN >90% OF SEVERE CASES

WORKING YOUTH & DISINFECTANTS(BREVARD ET AL., ENVIRON HLTH PERSPECT. 2003;111:1654-1659)

WORKING YOUTH & DISINFECTANTS(BREVARD ET AL., ENVIRON HLTH PERSPECT. 2003;111:1654-1659)

ACUTE OCCUPATIONAL EXPOSURE TO DISINFECTANTS IN WORKING YOUTH (15-17 YEARS OF AGE) IN THE U.S.

ANALYSIS OF 300 CASES IN A 5-YEAR PERIOD (1993-1998) THE RATE OF EXPOSURES 4-FOLD HIGHER IN THE YOUTH AS

COMPARED TO THAT IN 24-44 YEAR OLDS. 45% OF CASES OF ILLNESS INVOLVED SOD. HYPOCHLORITE

ACUTE OCCUPATIONAL EXPOSURE TO DISINFECTANTS IN WORKING YOUTH (15-17 YEARS OF AGE) IN THE U.S.

ANALYSIS OF 300 CASES IN A 5-YEAR PERIOD (1993-1998) THE RATE OF EXPOSURES 4-FOLD HIGHER IN THE YOUTH AS

COMPARED TO THAT IN 24-44 YEAR OLDS. 45% OF CASES OF ILLNESS INVOLVED SOD. HYPOCHLORITE

NEED BETTER EDUCATION OF PARENTSNEED BETTER EDUCATION OF PARENTS


REASONS FOR DESPAIRREASONS FOR DESPAIR

UNABATED POPULATION INCREASE

LEVELS OF POVERTY RISING

AIR & WATER POLLUTION STILL TOO HIGH

CLIMATE CHANGE WILL IMPACT DISEASE SPREAD

INCREASING ANTIBIOTIC RESISTANCE

AIDS CONTINUES ITS ONSLAUGHT

VACCINATION RATES IN CHILDREN DROPPING RECENT (OCT. 2005) CASES OF POLIO IN THE U.S.

REDUCED EMPHASIS ON PREVENTIVE STRATEGIES

UNABATED POPULATION INCREASE

LEVELS OF POVERTY RISING

AIR & WATER POLLUTION STILL TOO HIGH

CLIMATE CHANGE WILL IMPACT DISEASE SPREAD

INCREASING ANTIBIOTIC RESISTANCE

AIDS CONTINUES ITS ONSLAUGHT

VACCINATION RATES IN CHILDREN DROPPING RECENT (OCT. 2005) CASES OF POLIO IN THE U.S.

REDUCED EMPHASIS ON PREVENTIVE STRATEGIES


REASONS FOR HOPEREASONS FOR HOPE

RENEWED EMPHASIS ON BETTER NUTRITION

ELIMINATION/ERADICATION OF MANY CHILDHOOD DISEASES OVER 90% OF CHILDREN IN CANADA AND THE U.S. IMMUNIZED

AGAINST COMMON CHILDHOOD DISEASES

UN TREATY ON RIGHTS OF CHILDREN AN INTERNATIONAL TREATY THAT RECOGNIZES THE HUMAN RIGHTS

OF CHILDREN

AS OF NOV. 2003, TREATY RATIFIED BY 192 COUNTRIES, MORE THAN

ANY HUMAN RIGHTS TREATY IN HISTORY

SOMALIA UNABLE TO RATIFY AS IT HAS NO RECOGNIZED

GOVERNMENT

IN THE U.S., THE REVIEW TO RATIFY MAY TAKE SEVERAL YEARS


CONCLUDING REMARKSCONCLUDING REMARKS

PROTECTION OF CHILDREN FROM INFECTIONS IN

GENERAL REQUIRES SPECIAL CONSIDERATION

EVEN IN DEVELOPED COUNTRIES WIDE VARIATIONS & GAPS IN STANDARDS OF HYGIENE

EDUCATION & PARENTAL AWARENESS SAFE & EFFECTIVE ENVIRONMENTAL CONTROL

MEASURES LACKING USE OF MICROBICIDES IN HAND ANTISEPSIS &

DISINFECTION OF ENVIRONMENTAL SURFACES

REQUIRES REVIEW. REVIVAL OF EMPHASIS ON PREVENTION NEEDED

PROTECTION OF CHILDREN FROM INFECTIONS IN

GENERAL REQUIRES SPECIAL CONSIDERATION

EVEN IN DEVELOPED COUNTRIES WIDE VARIATIONS & GAPS IN STANDARDS OF HYGIENE

EDUCATION & PARENTAL AWARENESS SAFE & EFFECTIVE ENVIRONMENTAL CONTROL

MEASURES LACKING USE OF MICROBICIDES IN HAND ANTISEPSIS &

DISINFECTION OF ENVIRONMENTAL SURFACES

REQUIRES REVIEW. REVIVAL OF EMPHASIS ON PREVENTION NEEDED


ACKNOWLEDGMENTSACKNOWLEDGMENTS

DR. LIZ SCOTT & OTHERS AT THE

CENTER FOR HYGIENE & HEALTH IN

HOME & COMMUNITY, SIMMONS

COLLEGE

DR. LIZ SCOTT & OTHERS AT THE

CENTER FOR HYGIENE & HEALTH IN

HOME & COMMUNITY, SIMMONS

COLLEGE

SYED A. SATTAR, Ph.D. DIRECTOR, CENTRE FOR RESEARCH ON ENVIRONMENTAL MICROBIOLOGY (CREM) UNIVERSITY...

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Transcript of SYED A. SATTAR, Ph.D. DIRECTOR, CENTRE FOR RESEARCH ON ENVIRONMENTAL MICROBIOLOGY (CREM) UNIVERSITY...