Michael H Merson
Michael Howard Merson
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Interim Chair of the Department of Social and Behavioral Sciences
Clinical Professor of Global and Environmental Health
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Professional overview
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Michael Merson is Interim Chair of the Department of Social and Behavioral Sciences and a Clinical Professor of Global and Environmental Health at NYU. He also the William Joklik Emeritus Professor of Medicine and Global Health at Duke University, where he served as the founding director of the Duke Global Health Institute and as Vice President and Vice Provost for Global Affairs. His current research is focused on policy issues related to the response to pandemics, evaluating the rollout of Paxlovid in low-income countries and on ways to regain trust in public health.
Prior to NYU, he joined the faculty at Yale University as its first Dean of Public Health. Before entering academia, between 1980 and 1995, Dr. Merson served as director of the World Health Organization (WHO) programs on Diarrheal Diseases and Acute Respiratory Infections, and subsequently the WHO Global Program on AIDS. He has authored over 150 articles, is the senior editor of a leading global health textbook “Global Health: Disease, Programs, Systems, and Policies” and lead author of The AIDS Pandemic: Searching for a Global Response on the history of the global response to AIDS. He has served in advisory capacities for UNAIDS, WHO, the Global Fund to Fight AIDS, TB and Malaria, World Bank, World Economic Forum, Bill & Melinda Gates Foundation, and was an advisor to various private sector entities on the COVID-19 pandemic. He has two honorary degrees and is a member of the National Academy of Medicine.
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Education
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B.A., 1966, cum laude, Amherst College, Amherst, MassachusettsM.D., 1970, summa cum laude, SUNY, Health Sciences Center at Brooklyn, New York
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Honors and awards
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Consortium of Universities for Global Health (CUGH) Distinguished Leadership Award (2018)Duke Medical Alumni Association Distinguished Faculty Award (2017)Master Teacher Award in Preventive Medicine, Downstate Medical Center (2010)Outstanding Contribution to the Campaign Against HIV/AIDS, Russian Association Against AIDS (2000)Connecticut Health Commissioner’s AIDS Leadership Award (1998)Connecticut Health Commissioner’s AIDS Leadership Award (1997)Frank Babbott Alumni Award (1995)Surgeon General's Exemplary Service Medal (1993)Commendation Medal, US Public Health Service; (1986)Arthur S. Flemming Award for Outstanding Federal Service (1983)Commendation Medal, US Public Health Service (1975)
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Publications
Publications
A CONTINUING COMMON-SOURCE OUTBREAK OF BOTULISM IN A FAMILY
AbstractHorwitz, M. A., Marr, J. S., Merson, M. H., Dowell, V. R., & Ellis, J. M. (n.d.).Publication year
1975Journal title
The LancetVolume
306Issue
7940Page(s)
861-863AbstractIn December, 1974, three cases of botulism occurred in a family; two were fatal. The first patient died after a 10-day illness without botulism being suspected. 4 days later, after a 2-day illness, the second patient was diagnosed as having botulism after a cardiorespiratory arrest; she died 3 days later. In the third patient, the only symptom was dysphagia. Clostridium botulinum type B was found in stool specimens from all three patients. Home-canned (bottled) mushrooms, which were found to contain C. botulinumtype B and its toxin, were believed to be responsible for the outbreak; mushrooms were found at necropsy in the gastrointestinal tracts of both patients who died. Heat treatment of the mushrooms during canning had been inadequate.A global partnership in medical education between Duke University and the National University of Singapore
AbstractWilliams, R. S., Casey, P. J., Kamei, R. K., Buckley, E. G., Soo, K. C., Merson, M. H., Krishnan, R. K., & Dzau, V. J. (n.d.).Publication year
2008Journal title
Academic MedicineVolume
83Issue
2Page(s)
122-127AbstractDuke University and the National University of Singapore (NUS) have partnered to launch a new medical school that brings the American style of postbaccalaureate medical education to Asia. The new institution, called the Duke-NUS Graduate Medical School (GMS) and located in Singapore adjacent to the Singapore General Hospital, admitted its inaugural class of students representing citizens of seven nations in August 2007. The project represents an investment of more than $350 million from three ministries of the Singapore government, and a commitment on Duke's part to provide senior leadership and recruit faculty from Duke, from other international locales, and from within Singapore itself. Graduating students who complete the four-year Duke curriculum will receive an MD degree awarded jointly by Duke and NUS, thereby distinguishing this school from medical education in most Asian institutions that award an MBBS degree after a five-year period of study that follows directly from secondary school. The emphasis of the Duke-NUS GMS is to prepare physician-scientists for academic careers, with plans for 20% of each class to complete a combined MD/PhD degree. This article describes events leading up to this partnership and details of the relationship, including curriculum, organizational structure, milestones, and goals.A Lancet Commission to address the global burden of hearing loss
AbstractWilson, B. S., Tucci, D. L., O'Donoghue, G. M., Merson, M. H., & Frankish, H. (n.d.).Publication year
2019Journal title
The LancetVolume
393Issue
10186Page(s)
2106-2108Abstract~A large outbreak of foodborne salmonellosis on the Navajo Nation Indian Reservation, epidemiology and secondary transmission
AbstractMerson, M. H., Horwitz, M. A., Pollard, R. A., Merson, M. H., & Martin, S. M. (n.d.).Publication year
1977Journal title
American journal of public healthVolume
67Issue
11Page(s)
1071-1076AbstractIn September 1974, the largest outbreak of foodborne salmonellosis ever reported to the Center for Disease Control - affecting an estimated 3,400 persons - occurred on the Navajo Nation Indian Reservation. The responsible agent was Salmonella newport and the vehicle of transmission was potato salad served to an estimated 11,000 persons at a free barbecue. The cooked ingredients of the potato salad had been stored for up to 16 hours at improper holding temperatures. The magnitude of the outbreak allowed the authors to study secondary transmission by calculating the rates of diarrheal illness during the 2 weeks following the outbreak in persons who did not attend the barbecue and by examining the results of stool cultures obtained after the outbreak. They found no secondary transmission. The authors conclude that a health official should monitor food preparation and service at large social gatherings and that person-to-person transmission of salmonellosis probably does not normally occur even in settings considered highly conductive to cross-infection.A new criterion for implicating Clostridium perfringens as the cause of food poisoning
AbstractMerson, M. H., Dowell, V. R., Torres-Anjel, M. J., Riemann, H. P., Merson, M., Whaley, D., & Darland, G. (n.d.).Publication year
1975Journal title
Revista Latinoamericana de MicrobiologiaVolume
17Issue
3Page(s)
137-142AbstractFor the first time the enterotoxin of Clostridium perfringens type A (CPE) was demonstrated in stools from patients suffering from the specific type of 'food poisoning'. Sensitivity was 100% and specificity 94% vs. diarrhea reporting. The only person in which the CPE was demonstrated without his reporting diarrhea, had consumed implicated food; and the suspect strain, Hobb's type 1, was isolated from him. The samples were studied in a 'blind' fashion, during an outbreak epidemiologically and bacteriologically assigned to C. perfringens. The methodology was based on reversed, passive, hemagglutination. Glutaraldehyde was both the fixative as well as Y globulin sensitizer (from anti CPE rabbit serum), upon sheep red blood cells. The simplicity of the test will allow for detection of CPE in stools from patients at local public health laboratories of any capacity. Protocols to be followed in further outbreaks are recommendedA social cognitive model of health for HIV-positive adults receiving care in India
AbstractTarakeshwar, N., Srikrishnan, A. K., Johnson, S., Vasu, C., Solomon, S., Merson, M. H., & Sikkema, K. (n.d.).Publication year
2007Journal title
AIDS and BehaviorVolume
11Issue
3Page(s)
491-504AbstractIn-depth interviews were conducted with 50 HIV-positive adults (23 women, 27 men) with access to care at a non-governmental organization in Chennai, India to gain a broad understanding of how they managed their HIV infection. Using a Social Cognitive Model of Health, we identified factors within the model's three domains-Personal, Environmental, and Behavioral-that are applicable to this socio-cultural context. The Personal domain's factors were a positive self-concept, family-focused goals, and treatment optimism; the Environmental domain comprised family-based support, treatment availability, access and quality, and HIV stigma and discrimination; and the Behavior domain's factors were medication adherence and health habits, sexual behavior, and social relationships and emotional well-being. Significant differences for many of the factors within the three domains were observed across married men and women, widowed women, unmarried men, and female sex workers. Implications for an enhanced intervention for HIV-infected individuals in similar treatment settings are discussed.A summary of the literature on global hearing impairment : Current status and priorities for action
AbstractTucci, D. L., Merson, M. H., & Wilson, B. S. (n.d.).Publication year
2010Journal title
Otology and NeurotologyVolume
31Issue
1Page(s)
31-41AbstractBackground: Hearing loss (HL) and deafness are global issues that affect at least 278 million people worldwide. Two thirds of the people who have HL worldwide live in developing countries. Importantly, it is estimated that 50% of this HL can be prevented. In developing countries, funding for prevention, early detection, and rehabilitative programs is severely limited, and therefore, agencies must compete against priorities to treat life-threatening, pandemic diseases such as human immunodeficiency virus, malaria, and tuberculosis. Delays in diagnosis are common, and social attitudes, local customs, and cultural bias are contributing factors. Objective: The purpose of this review is to gain an understanding of the prevalence of HL in the developing world and to focus attention on the growing need for both prevention and effective treatment programs. A second goal is to use this information to suggest priorities and approaches to address these problems worldwide. Data Sources: The data were compiled from a review of the literature on the global impacts of hearing impairment and recently published reports on the prevalence and cause of hearing impairment in developing nations. Conclusion:: The high prevalence of HL in the developing world is due to a variety of factors, including lack of widespread comprehensive immunization programs and other medical care, and inadequate funds for intervention once HL is identified. International organizations, governments, and nongovernment organizations have many opportunities to prevent and treat HL through cost-effective means.A two-year study of bacterial, viral, and parasitic agents associated with diarrhea in rural Bangladesh
AbstractMerson, M. H., Black, R. E., Merson, M. H., Rahman, A. S., Yunus, M., Alim, A. R., Huq, I., Yolken, R. H., & Curlin, G. T. (n.d.).Publication year
1980Journal title
Unknown JournalVolume
142Issue
5Page(s)
660-664AbstractEnteric pathogens associated with diarrhea were studied for two years at a diarrhea treatment center in rural Bangladesh. Enterotoxigenic Escherichia coli (ETEC) was the most frequently identified pathogen for patients of all ages. Rotavirus and ETEC were isolated from ~50% and ~25%, respectively, of patients less than two years of age. A bacterial or viral pathogen was identified for 70% of these young children and for 56% of all patients with diarrhea. Most ETEC isolates were obtained in the hot dry months of March and April and the hot wet months of August and September. Rotavirus identification peaked in the cool dry months of December and January, but infected patients were found year-round. The low case-fatality rates for patients with watery diarrhea and substantial dehydration further document the usefulness of treating patients with diarrhea with either a glucose- or sucrose-base electrolyte solution such as those used in this treatment center.AIDS : a special threat to women
AbstractMerson, M. H., Petros-Barvazian, A., & Merson, M. (n.d.).Publication year
1990Journal title
World HealthIssue
Nov-DecAbstractDeals with aspects of AIDS worldwide, with special reference to women: the challenge of the nineties; AIDS and haemophiliacs; mother and child; the Paris Declaration; psychological and social consequences; a Uganda casebook; a caring society; the research agenda for the 1990s; and World Aids Day 1990. -D.J.DavisAIDS : NEW DISEASES AND MORBIDITY PATTERNS
AbstractMerson, M. H., & MERSON, M. H. (n.d.).Publication year
1994Journal title
Medical educationVolume
28Page(s)
61-62Abstract~Aids : The world situation
AbstractMerson, M. H. (n.d.).Publication year
1992Journal title
Journal of Public Health PolicyVolume
13Issue
1Page(s)
8-26AbstractTHIS article appeared in WHO Features, No. 163, November 1991, in the form of an interview with Dr. Merson in connection with World AIDS Day, December 1, 1991. We are publishing it as a special article in order to bring to our readers this authoritative summary of the current situation, to emphasize the overwhelming significance of the AIDS pandemic, and to demonstrate the urgent need to fully mobilize world resources in order to combat and conquer this terrible threat to humanity. Dr. Merson, it’s ten years since AIDS was first recognized. What do you see as the most important achievements and the failures in the fight against it? One of the most important achievements is to have learned as much as we have about AIDS. The disease was first recognized in homosexual men in the United States of America in 1981; by 1983 the human immunodeficiency virus, or HIV, had been isolated; in 1985 an antibody test was available. Since then we have learned that HIV is spread mainly through sexual intercourse; like some other sexually transmitted infections, it can also be transmitted through blood and from an infected woman to her unborn or newborn baby. This knowledge showed us that transmission could be interrupted. We have also learned much about how the virus infects cells and how the body mounts an immune response to this infection, and this has led to the development of over 150 experi-mental drugs and vaccines. That is enormous progress in only ten years.Allocating HIV-prevention resources : Balancing efficiency and equity
AbstractKaplan, E. H., & Merson, M. H. (n.d.).Publication year
2002Journal title
American journal of public healthVolume
92Issue
12Page(s)
1905-1907AbstractThe primary goal of HIV prevention is to prevent as many infections as possible. This requires allocating HIV-prevention resources according to cost-effectiveness principles: those activities that prevent more infections per dollar are favored over those that prevent fewer. This is not current practice in the United States, where prevention resources from the federal government to the states flow in proportion to reported AIDS cases. Although such allocations might be considered equitable, more infections could be prevented for the same expenditures were cost-effectiveness principles invoked. The downside of pure cost-effective allocations is that they violate common norms of equity. In this article, we argue for a middle ground that promotes both equity and efficiency in allocating federal HIV-prevention resources.An evaluation of penicillin prophylaxis during an outbreak of foodborne streptococcal pharyngitis
AbstractRyder, R. W., Lawrence, D. N., Nitzkin, J. L., Feeley, J. C., & Merson, M. H. (n.d.).Publication year
1977Journal title
American Journal of EpidemiologyVolume
106Issue
2Page(s)
139-144AbstractRyder, R. W. (CDC, Atlanta, GA 30333), D. N. Lawrence, J. L. Nitzkin, J. C. Feeley and M. H. Merson. An evaluation of penicillin prophylaxis during an outbreak of foodborne ttreptococcal pharyngitis. Am J Epidemiol 106:139-144, 1977.Between August 16 and 21, 1974, an outbreak of β-hemolytic group A M-9 T-9 streptococcal pharyngitis affected 49% of a randomly selected group of inmates at a jail in southern Florida. Food-specific attack rates incriminated improperly stored egg salad served at lunch on August 16 as the vehicle of transmission. By August 20, 290 symptomatic inmates had been placed on penicillin or erythromycin; on that day fewer than 5% of throat cultures from 400 allegedly non-penicillin-allergic largely asymptomatic inmates, cultured just before penicillin prophylaxis, were positive for the epidemic strain. At the time prophylaxis was given, secondary transmission had accounted for only 3% of cases. No non-suppurative sequelae were observed but 5% of inmates who received penicillin prophylaxis experienced an adverse reaction to the drug. Although widespread penicillin prophylaxis during outbreaks of group A β-hemolytic streptococcal pharyngitis will likely prevent transmission of these organisms, prompt treatment of all symptomatic cases may be equally as effective in controlling adult institutional foodborne outbreaks of streptococcal pharyngitis and will likely minimize the number of adverse reactions to penicillin which may be seen.An Infected Wound as a Cause of Botulism in a 12-Year-Old Boy : Debridement, Medical Management, and Intensive Respiratory Support Resulted in Complete Recovery
AbstractKennedy, T. L., & Merson, M. H. (n.d.).Publication year
1977Journal title
Clinical PediatricsVolume
16Issue
2Page(s)
151-153Abstract~An outbreak of Shigella sonnei gastroenteritis on colorado river raft trips
AbstractMerson, M. H., Goldmann, D. A., Boyer, K. M., Peterson, N. J., Patton, C., Everett, L. G., Downs, H., Steckler, A., & Barker, W. H. (n.d.).Publication year
1974Journal title
American Journal of EpidemiologyVolume
100Issue
3Page(s)
186-196AbstractMerson, M. H. (Enteric Disease Section, Bacterial Disease Branch, Center for Disease Control, Atlanta, Ga. 30333), D. A. Goldmann, K. M. Boyer, N. J. Peterson, C. Patton, L. G. Everett, H. Downs, A. Steckler and W. H. Barker, Jr. An outbreak of Shigella sonnei gastroenteritis on Colorado River raft trips. Am J Epidemiol 100:186-196, 1974.-In the summer of 1972 an extensive outbreak of acute gastroenteritis occurred among passengers and boatmen on Colorado River raft trips. The illness was characterized by diarrhea, abdominal cramps, and fever, and laboratory results indicated that the outbreak was caused by Shigella sonnei. Epidemiologic evidence suggested that illness originated among boatmen and spread to passengers primarily by person-to-person transmission. No common food or water vehicle could be identified as the source of the outbreak. A bacteriologic and chemical analysis of water from the Colorado River and some of its tributaries demonstrated that this water is unsuitable for drinking unless purified. As a result of the outbreak, the Colorado River Health Committee was created to establish guidelines for food and water handling and sewage disposal aboard the rafts and to initiate a health training course for boatmen.Childhood Immunizations
AbstractKim-Farley, R. J., Merson, M. H., Tulloch, J. L., Deisenhammer, F., Pohl, P., Grubwieser, G., Sepkowitz, S., & Peter, G. (n.d.).Publication year
1993Journal title
New England Journal of MedicineVolume
328Issue
19Page(s)
1420-1422AbstractTo the Editor: Dr. Peter's review of childhood immunizations in the United States (Dec. 17 issue)1 mentions policies that differ from those of the World Health Organization (WHO), especially with respect to immunization against cholera and poliomyelitis. We wish to clarify these differences. The WHO does not recommend cholera vaccine for travelers, and no country requires it for entry2. The only available cholera vaccine is of low efficacy and provides at best only short-term immunity. Immunization against cholera may impart a false sense of security, making travelers less likely to use more effective protective measures3. The safety of…Chinese medical teams in Africa : A flagship program facing formidable challenges
AbstractChen, S., Pender, M., Jin, N., Merson, M. H., Tang, S., & Gloyd, S. (n.d.).Publication year
2019Journal title
Journal of Global HealthVolume
9Issue
1Abstract~Cholera on Guam, 1974 : Epidemiologic findings and isolation of non-toxinogenic strains
AbstractMerson, M. H., Martin, W. T., Craig, J. P., Morris, G. K., Blake, P. A., Craun, G. F., Feeley, J. C., Camacho, J. C., & Gangarosa, E. J. (n.d.).Publication year
1977Journal title
American Journal of EpidemiologyVolume
105Issue
4Page(s)
349-361AbstractIn August 1974, six cases of cholera occurred on Guam. The index case had severe diarrhea and metabolic acidosis and died from pneumonia on the ninth day of illness; the other five cases had only mild to moderate diarrhea. Fish caught in Agana Bay and home-preserved was found to be the vehicle most likely responsible for the cases. Vibrio cholerae, El Tor Ogawa, was isolated from two patients, the Guam sewerage system, and a river emptying into Agana Bay. V. cholerae, El Tor Inaba, was isolated from the sewerage system, three storm drains emptying into Agana Bay, and Agana Bay. The Ogawa and Inaba isolates differed in their sucrose fermentation and hemolysis reactions, phage type and ability to produce toxin. Although this was the first reported cholera outbreak on Guam, the isolation of different V. cholerae strains suggested that multiple introductions of V. cholerae had occurred on the island.Ciguatera in Puerto Rico and the Virgin Islands
AbstractPayne, C. A., Payne, S. N., Hughes, J. M., & Merson, M. H. (n.d.).Publication year
1977Journal title
New England Journal of MedicineVolume
296Issue
16Page(s)
949-950AbstractTo the Editor: The report of Hughes and Merson1 presented a concise résumé of the general problem of ciguatera (fish poisoning) and once again brought the topic to the clinical literature, where it is seldom seen. The major neurology and gastroenterology textbooks contain no reference to this entity, which was apparently known to the ancient Egyptians. The authors state, “Ninety per cent of outbreaks reported to the Center for Disease Control occurred in Hawaii and Florida.” This figure apparently represents deficiency in case reporting rather than the actual incidence of the problem. We became interested in ciguatera in mid-1975.Clinical features of types A and B food-borne botulism
AbstractMerson, M. H., Hughes, J. M., Blumenthal, J. R., Merson, M. H., Lombard, G. L., Dowell, V. R., & Gangarosa, E. J. (n.d.).Publication year
1981Journal title
Unknown JournalVolume
95Issue
4Page(s)
442-445AbstractMedical records of 55 patients with type A and type B food-borne botulism reported to the Centers for Disease Control during 2 years were reviewed to assess the clinical features and severity of illness, diagnostic test results, nature of complications, and causes of death. Some patients had features not usually associated with botulism including paresthesia (14%), asymmetric extremity weakness (17%), asymmetric ptosis (8%), slightly elevated cerebrospinal fluid protein values (14%), and positive responses to edrophonium chloride (26%). Several observations suggest that type A was more severe than type B disease. Although the case-fatality ratio was not significantly greater, patients with type A disease saw a physician earlier in the course of illness, were more likely to need ventilatory support, and were hospitalized longer. Patients who died were older than those who survived. Deaths within the first 2 weeks resulted from failure to recognize the severity of the disease or from pulmonary or systemic infection whereas the three late deaths were related to respirator malfunction.Combination HIV prevention
AbstractMerson, M. H., Padian, N., Coates, T. J., Gupta, G. R., Bertozzi, S. M., Piot, P., Mane, P., Bartos, M., & for the Lancet HIV Prevention Series authors, the L. (n.d.).Publication year
2008Journal title
The LancetVolume
372Issue
9652Page(s)
1805-1806Abstract~Comparison of four plating media for isolating Vibrio cholerae
AbstractMerson, M. H., Morris, G. K., Merson, M. H., Huq, I., Kibrya, A. K., & Black, R. (n.d.).Publication year
1979Journal title
Journal of Clinical MicrobiologyVolume
9Issue
1Page(s)
79-83AbstractTwo brands of thiosulfate citrate bile salts sucrose agar and Monsur taurocholate tellurite gelatin (TTG) agar were compared with two newly developed media, sucrose tellurite teepol agar and Vibrio parahaemolyticus agar for isolation and identification of Vibrio cholerae. The thiosulfate citrate bile salts sucrose and TTG agars were the best selective media, whereas sucrose tellurite teepol agar was the poorest. Both TTG and sucrose tellurite teepol agars were good for use in follow-up serological tests, whereas only TTG agar could be used for follow-up oxidase tests. In our opinion, TTG agar has more advantages for cholera research laboratories routinely culturing large numbers of patients for cholera on a daily basis and where media needs can be accurately predicted. In contrast, in smaller clinical laboratories or in laboratories investigating epidemics, thiosulfate citrate bile salts sucrose agar is best because it is commercially available and easy to prepare and can be used to distinguish colonies of suspect V. cholerae from V. parahaemolyticus.Contamination of weaning foods and transmission of enterotoxigenic Escherichia coli diarrhoea in children in rural Bangladesh
AbstractBlack, R. E., Black, R. E., Brown, K. H., Becker, S., Alim, A. R., Merson, M. H., Black, R. E., Brown, K. H., Brown, K. H., & Brown, K. H. (n.d.).Publication year
1982Journal title
Transactions of the Royal Society of Tropical Medicine and HygieneVolume
76Issue
2Page(s)
259-264AbstractIn longitudinal studies of infectious diseases and nutrition in Bangladesh, we determined the degree of bacterial contamination of traditional weaning foods and evaluated the role of these foods in the transmission of diarrhoeal diseases. 41% of samples of food items fed to weaning aged children contained Escherichia coli; these organisms were used as indicators of faecal contamination. Milk and foods prepared particularly for infants were more frequently and heavily contaminated with E. coli than was boiled rice, and E. coli levels were found to be related to the storage of cooked foods at high environmental temperatures. 50% of drinking water specimens also contained E. coli, but colony counts were approximately 10-fold lower than in food specimens. The proportion of a child’s food samples that contained E. coli was significantly related to the child’s annual incidence of diarrhoea associated with enterotoxigenic E. coli. This observation underscores the importance of seeking locally available foods that are hygienic as well as nutritious to supplement the diets of breastfeeding children in developing countries.Control of diarrhoeal diseases
AbstractMerson, M. H., Martinez, C. A., Barua, D., & Merson, M. H. (n.d.).Publication year
1988Journal title
World Health Statistics QuarterlyVolume
41Issue
2Page(s)
74-81AbstractThis article traces the history of the worldwide struggle to control diarrheal diseases. When the 7th pandemic of cholera began in 1961, WHO responded with a greatly expanded program of activities which included cooperation with countries in training and control efforts, and research on treatment and prevention. In 1970, when the cholera pandemic spread to Africa, the emergency assistance program was reactivated, with increasing attention to the provision of appropriate treatment, especially oral rehydration therapy. Another public health problem of importance during the 1970s was the increase in antibiotic resistance of enteric bacteria. The demonstration of the effectiveness of a single formulation of oral rehydration salts (ORS) in the treatment of all diarrheas was instrumental in convincing public health administrators that diarrheal diseases control should become an essential component of primary health care and led to the creation of a global Diarrheal Diseases Control program. The Program, which has the objective of reducing childhood mortality and morbidity due to diarrheal diseases and their associated ill effects, especially malnutrition, consists of 2 main components: a health services and control component and research component. If the targets set by the Program for 1989 can be attained, it is expected that by then at least 1.5 million childhood deaths due to diarrhea will be prevented annually.Coproexamination for Botulinal Toxin and Clostridium botulinum : A New Procedure for Laboratory Diagnosis of Botulism
AbstractDowell, V. R., Hatheway, C. L., Lombard, G. L., McCroskey, L. M., Hughes, J. M., & Merson, M. H. (n.d.).Publication year
1977Journal title
JAMA: The Journal of the American Medical AssociationVolume
238Issue
17Page(s)
1829-1832AbstractStool or serum specimens or both from 318 persons pertaining to 165 botulism investigations over a three-year period were examined. Botulinal toxin was detected in stools of 19 of 56 patients and in sera of 20 of 60 patients with clinical botulism; it was not detected in specimens from 246 persons with an illness other than botulism or well contacts of patients. Clostridium botulinum was identified in stools of 36 of 60 clinical botulism patients and in four of 27 asymptomatic contacts of patients with botulism victims, but not in stools of 65 persons not associated with confirmed botulism. When stool and serum samples were examined, confirmatory evidence was obtained for 72.9% of the botulism cases. Detection of botulinal toxin or C botulinum in the stool of a person should be considered evidence supporting the clinical diagnosis of botulism.