How do diseases spread in a population
Geographer, born 1983; research assistant at the Bernhard Nocht Institute for Tropical Medicine, Bernhard-Nocht-Straße 74, 20359 Hamburg. [email protected]
Prof. Dr. med., born 1965; Head of the "Infection Epidemiology" working group at the Bernhard Nocht Institute for Tropical Medicine. [email protected]
Infectious diseases are diseases that are triggered by infectious agents - usually bacteria, viruses or parasites - or their toxic products. They are differentiated from non-communicable, such as degenerative, hereditary or mental illnesses. Infections do not necessarily go hand in hand with an illness, so they are often not immediately recognizable. Highly contagious infectious diseases are also known as "epidemics".
Infectious diseases can be endemic, epidemic and pandemic. An endemic is the constant circulation of an infection or infectious disease in the population. For example, malaria is endemic in many African countries. A temporal and spatial accumulation of cases of illness is referred to as an epidemic. This also includes disease outbreaks that are normally endemic to the population. The recurring measles outbreaks in Germany fall into this category. If such an outbreak crosses national borders and spreads indefinitely, one speaks of a pandemic. The immune disease AIDS caused by the HI virus has been spreading pandemically since the late 1980s.
The mortality and morbidity caused by infectious diseases has been decreasing in industrialized countries since the 20th century due to improved hygiene and medical innovations - such as vaccinations and antibiotics. As a result, average life expectancy is increasing and noncommunicable diseases - such as cardiovascular disease, cancer, diabetes and chronic respiratory diseases - are replacing diarrhea, measles, smallpox and tuberculosis as the main causes of death. In Germany, 16.5 times more people die from the consequences of noncommunicable diseases than from infectious diseases.  This trend is also evident in other affluent regions of the world.
Infectious diseases are now a major problem in poorer countries. In many regions of Africa and Asia, poor hygienic conditions prevail, especially in rural areas. There is insufficient access to medical care, and health education is often not available at all. Such conditions provide ideal conditions for infectious diseases to spread. While diseases such as HIV / AIDS have all become rare in our latitudes thanks to extensive awareness-raising campaigns and access to condoms, tuberculosis thanks to good diagnosis and therapy options, diarrheal diseases thanks to improved hygiene and measles due to broad vaccination campaigns, these diseases belong to the poorest countries in the world the main causes of death.
History of the origins of epidemiologyHippocrates recognized a connection between the external environment and the occurrence of diseases as early as the 5th century BC. In his book "Lüfte, Gewässer, Orte". Among other things, he described the influence of weather, water quality and living conditions on physical and mental health. The basic idea of epidemiology is thus as old as medicine itself. However, at that time Hippocrates suspected miasms (poisonous fumes from the soil) as the cause of infectious diseases; a theory that was still widespread into the 19th century and - despite the wrong basic assumption - saved the lives of many people through isolation and hygiene measures.
During the following 2000 years the influence of the environment on the human organism was accepted, but scientific studies on the exact effects have not been recorded. In 1662 the British haberdashery seller John Graunt compiled detailed birth and death statistics for the first time and discovered characteristic distribution patterns, broken down by gender, age and season. In the middle of the 19th century, the physician William Farr established a routine recording of deaths, which made it possible to make statistical statements about the state of health of different population groups.
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