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      Lung Infection—A Public Health Priority

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      PLoS Medicine
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          Abstract

          The pervasive burden of lung infections receives proportionately little attention from the biomedical and public health communities, argues Mizgerd.

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          Most cited references18

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          Evidence-based health policy--lessons from the Global Burden of Disease Study.

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            Trends in infectious disease mortality in the United States during the 20th century.

            Recent increases in infectious disease mortality and concern about emerging infections warrant an examination of longer-term trends. To describe trends in infectious disease mortality in the United States during the 20th century. Descriptive study of infectious disease mortality in the United States. Deaths due to infectious diseases from 1900 to 1996 were tallied by using mortality tables. Trends in age-specific infectious disease mortality were examined by using age-specific death rates for 9 common infectious causes of death. Persons who died in the United States between 1900 and 1996. Crude and age-adjusted mortality rates. Infectious disease mortality declined during the first 8 decades of the 20th century from 797 deaths per 100000 in 1900 to 36 deaths per 100000 in 1980. From 1981 to 1995, the mortality rate increased to a peak of 63 deaths per 100000 in 1995 and declined to 59 deaths per 100000 in 1996. The decline was interrupted by a sharp spike in mortality caused by the 1918 influenza epidemic. From 1938 to 1952, the decline was particularly rapid, with mortality decreasing 8.2% per year. Pneumonia and influenza were responsible for the largest number of infectious disease deaths throughout the century. Tuberculosis caused almost as many deaths as pneumonia and influenza early in the century, but tuberculosis mortality dropped off sharply after 1945. Infectious disease mortality increased in the 1980s and early 1990s in persons aged 25 years and older and was mainly due to the emergence of the acquired immunodeficiency syndrome (AIDS) in 25- to 64-year-olds and, to a lesser degree, to increases in pneumonia and influenza deaths among persons aged 65 years and older. There was considerable year-to-year variability in infectious disease mortality, especially for the youngest and oldest age groups. Although most of the 20th century has been marked by declining infectious disease mortality, substantial year-to-year variation as well as recent increases emphasize the dynamic nature of infectious diseases and the need for preparedness to address them.
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              Burden of disease--implications for future research.

              One overall challenge for public health and medicine in the future is to allocate available resources effectively to reduce major causes of disease burden globally and to decrease health disparities between poor and affluent populations. The major risk factors for death and disability worldwide are malnutrition; poor water supply, sanitation, and personal and domestic hygiene; unsafe sexual behavior; tobacco use; alcohol use; occupational hazards; hypertension; physical inactivity; illicit drugs; and air pollution. The challenge for research in the 21st century is to maintain and improve life expectancy and the quality of life that was achieved for most of the world's population during the 20th century.
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                Author and article information

                Journal
                PLoS Med
                pmed
                PLoS Medicine
                Public Library of Science (San Francisco, USA )
                1549-1277
                1549-1676
                February 2006
                17 January 2006
                : 3
                : 2
                : e76
                Author notes

                Joseph P. Mizgerd is at the Harvard School of Public Health, Boston, Massachusetts, United States of America. E-mail: jmizgerd@ 123456hsph.harvard.edu

                Competing interests: The author studies innate immunity and respiratory infections. It would be to the author's professional benefit if more resources were available for such research.

                Article
                10.1371/journal.pmed.0030076
                1326257
                16401173
                f13ddfb7-2df4-40ab-a68c-f1b5655a15db
                Copyright: © 2006 Joseph P. Mizgerd. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                Categories
                Essay
                Immunology
                Infectious Diseases
                Microbiology
                Physiology
                Science Policy
                Epidemiology/Public Health
                Respiratory Medicine
                Pneumonia
                Infectious Diseases
                Microbiology
                Medicine in Developing Countries
                Public Health

                Medicine
                Medicine

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