|
SIGNIFICANCE OF STANDARDIZED SYSTEMS:
Public health in general tends to be victimized by its own success. Unfortunately, the recurrence of unexpected outbreaks of normally
controllable diseases are often required to remind the body politic that a constant unrestrained vigilance is required in disease monitoring and prevention. There are several recent public health events which bear this out.
The outbreak of measles in 1988-91 reported in Los Angeles Public Health Letter (1990) resulted in 39 deaths out of more than 5700
cases, about one third which required hospitalization. Resources are still being marshaled against the more recent appearance of multidrug resistant Mycobacterium tuberculosis (MDR-TB). The problem
is still unfolding.
For the lack of surveillance for vaccine failures in measles, we suffered an unexpected morbidity and mortality in that disease.
Failure to monitor tuberculosis patients led us into MDR-TB. Both of these diseases are classically monitored with the expertise of the public health laboratory.
According to the Institute of Medicine Report 1992) on Emerging Infections. Microbial Threats to Health in the United States (1992),
the important activities of public health, not listed in order of importance, are assessment, surveillance, intervention, control, prevention, treatment, and detection. It is worth noting that the public health laboratory is
essential to each of these activities. Public health is a fundamental part of government in the 20th century and must continue so in the 21st. This is based on the notion that the State's cultural, economic and social progress
all depend on the health and well being of its citizens. It is easy to miss the relationship of adverse health events. To some, the illness of another is of no consequence to themselves, especially when the ill person lives in
another community near or far. Rapid transportation has reduced the farthest place on the globe to a day's journey away. Air and water can spread pollutants from one place to another with an ease that is all too efficient.
There is a passel of effective vaccines and therapeutic agents to prevent or control many communicable diseases. Yet, inspite of the introduction and development of molecular biology and genetic engineering in the past 40
years, public health must contend with old and new readily communicable diseases. It is essential therefore that "a well developed and coordinated diseases surveillance system" be maintained and supported. The
Institute of Medicine's recent report on "Emerging Infectious: Microbial Threats to Health in the United States" (1992) speaks of unbalanced but well intended health organization when referring to the public health
system. The report also speaks of turmoil among new agencies, it may have spoken of turmoil within health organizations, for all these contribute to the decreased preparation and vigilance for emerging microbial threats.
Local public health laboratories do not operate in a vacuum. They provide standardized test results. Results which when assembled
statewide or nationwide
|
