Control of diarrhoeal diseases

Area of Science:

• Public Health
• Infectious Diseases
• Epidemiology

Background:

• Early World Health Organization (WHO) efforts focused on epidemic control and vaccine standardization.
• Cholera pandemics, particularly the seventh starting in 1961, demanded expanded WHO interventions.
• The 1970s saw rising antibiotic resistance in enteric bacteria, posing significant public health challenges.

Purpose of the Study:

• To document the World Health Organization's evolving strategies in combating acute enteric infections, especially cholera.
• To highlight the shift in treatment focus from vaccines to oral rehydration therapy.
• To underscore the growing concern and research into antibiotic resistance of enteric pathogens.

Main Methods:

• Review of WHO's historical programs and responses to cholera pandemics.
• Analysis of training courses and field trials for enteric infection vaccines.
• Monitoring of trends in antibiotic resistance and diarrheal disease research.

Main Results:

• WHO transitioned from emphasizing cholera vaccination to promoting oral rehydration therapy (ORT).
• Cholera vaccination requirements for international travel were abolished in 1973.
• Significant research advancements occurred in diarrheal disease, including new pathogen discoveries and the effectiveness of oral rehydration salts (ORS).
• Increased antibiotic resistance in Shigella dysenteriae 1 and Salmonella typhi was observed.

Conclusions:

• WHO's response to cholera evolved towards more effective treatments like ORT.
• Research into diarrheal diseases accelerated, leading to better understanding and treatment strategies.
• Antibiotic resistance emerged as a critical public health issue requiring ongoing attention.