Hospitals

On this page you can find a lot of new things about the hospitals where you can find asistance for tropical diseases and where you can research in this domain.You will find general things about the hospitals and then the link to the page of the hospital.

I.
The Hospital for Tropical Diseases in London is part of the University College Hospitals London (UCLH) NHS Trust, and associated with University College London. It is the only UK NHS hospital dedicated to the prevention, diagnosis and treatment of tropical diseases and travel-related infections.

It was founded on 8 March 1821 on board an ex-naval ship and moved onto dry land as the Dreadnought Seamen's Hospital in 1870 as part of the Royal Greenwich Hospital. The management of infectious disease moved in 1919 near to Euston Square, in central London, still under the Seamen's Hospital Society. The general in-patient wards at Greenwich continued until that hospital's closure in 1986 with special services for seamen and their families then provided by the 'Dreadnought Unit' at St Thomas's Hospital in Lambeth.

After several moves during the Second World War, The Hospital for Tropical Diseases was reestablished under the newly formed NHS in 1951 at the site of the St Pancras Hospital. Finally it moved in 1998 in to new purpose built premises within UCLH.

II.
In Romania, in Bucharest it exists a big hospital called "Spitalul Clinic"Dr. Victor Babeş" Boli infecţioase şi tropicale"(in english "Dr. Victor Babes Hospital of infectious and tropical diseases".

III.
Also in Bucharest, Romania it exists "Institutul de boli infecţioase"Dr. Matei Balş""(in english "Dr. Matei Bals Infectious diseases Institute".

IV.
CDC, ATLANTA, GEORGIA, USA

The Centers for Disease Control and Prevention (or CDC) is an agency of the United States Department of Health and Human Services based in unincorporated DeKalb County, Georgia adjacent to the campus of Emory University and east of the city of Atlanta. It works to protect public health and the safety of people, by providing information to enhance health decisions, and promotes health through partnerships with state health departments and other organizations. The CDC focuses national attention on developing and applying disease prevention and control (especially infectious diseases), environmental health, occupational safety and health, health promotion, prevention and education activities designed to improve the health of the people of the United States.

CDC Health Protection Goals
CDC is committed to achieving true improvements in people’s health. To do so, the agency is defining specific health impact goals to prioritize and focus its work and investments and measure progress.

Healthy People in Every Stage of Life
All people, and especially those at greater risk of health disparities, will achieve their optimal lifespan with the best possible quality of health in every stage of life.

Start Strong: Increase the number of infants and toddlers that have a strong start for healthy and safe lives. (Infants and Toddlers, ages 0-3 years). Grow Safe and Strong: Increase the number of children who grow up healthy, safe, and ready to learn. (Children, ages 4-11 years). Achieve Healthy Independence: Increase the number of adolescents who are prepared to be healthy, safe, independent, and productive members of society. (Adolescents, ages 12-19 years). Live a Healthy, Productive, and Satisfying Life: Increase the number of adults who are healthy and able to participate fully in life activities and enter their later years with optimum health. (Adults, ages 20-49 years). Live Better, Longer: Increase the number of older adults who live longer, high-quality, productive, and independent lives. (Older Adults, ages 50 and over).

Healthy People in Healthy Places
The places where people live, work, learn, and play will protect and promote their health and safety, especially those at greater risk of health disparities.

Healthy Communities: Increase the number of communities that protect, and promote health and safety and prevent illness and injury in all their members. Healthy Homes: Protect and promote health through safe and healthy home environments. Healthy Schools: Increase the number of schools that protect and promote the health, safety and development of all students, and protect and promote the health and safety of all staff. (e.g. – healthy food vending, physical activity programs). Healthy Workplaces: Promote and protect the health and safety of people who work by preventing workplace-related fatalities, illnesses, injuries, and personal health risks. Healthy Healthcare Settings: Increase the number of healthcare settings that provide safe, effective, and satisfying patient care. Healthy Institutions: Increase the number of institutions that provide safe, healthy, and equitable environments for their residents, clients or inmates. Healthy Travel and Recreation: Ensure that environments enhance health and prevent illness and injury during travel and recreation.

People Prepared for Emerging Health Threats
People in all communities will be protected from infectious, occupational, environmental, and terrorist threats. Preparedness goals will address scenarios that include natural and intentional threats. The first round of these scenarios will encompass influenza, anthrax, plague, emerging infections, toxic chemical exposure, and radiation exposure.

Pre-Event

Increase the use and development of interventions known to prevent human illness from chemical, biological, radiological agents, and naturally occurring health threats.

Decrease the time needed to classify health events as terrorism or naturally occurring in partnership with other agencies.

Decrease the time needed to detect and report chemical, biological, radiological agents in tissue, food or environmental samples that cause threats to the public’s health.

Improve the timeliness and accuracy of communications regarding threats to the public’s health.

Event

Decrease the time to identify causes, risk factors, and appropriate interventions for those affected by threats to the public’s health.

Decrease the time needed to provide countermeasures and health guidance to those affected by threats to the public’s health.

Post-Event

Decrease the time needed to restore health services and environmental safety to pre-event levels.

Improve the long-term follow-up provided to those affected by threats to the public’s health.

Decrease the time needed to implement recommendations from after-action reports following threats to the public’s health.

Healthy People in a Healthy World
People around the world will live safer, healthier and longer lives through health promotion, health protection, and health diplomacy.

Health Promotion: Global health will improve by sharing knowledge, tools and other resources with people and partners around the world. Health Protection: Americans at home and abroad will be protected from health threats through a transnational prevention, detection and response network. Health Diplomacy: CDC and the United States Government will be a trusted and effective resource for health development and health protection around the globe.

CDC Structure
CDC is one of the major operating components of the Department of Health and Human Services. CDC's major organizational components respond individually in their areas of expertise and pool their resources and expertise on cross-cutting issues and specific health threats. The agency comprises these major organizational components:

Office of the Director manages and directs the activities of the Centers for Disease Control and Prevention; provides overall direction to, and coordination of, the scientific/medical programs of CDC; and provides leadership, coordination, and assessment of administrative management activities.

The CDC is under the direction of Dr. Julie Louise Gerberding, M.D., M.P.H. Dr. Gerberding has been the director of the CDC since July 2002.

Coordinating Center for Environmental Health and Injury Prevention
National Center for Environmental Health/ Agency for Toxic Substances and Disease Registry (NCEH-ATSDR) provides national leadership in preventing and controlling disease and death resulting from the interactions between people and their environment.

National Center for Injury Prevention and Control (NCIPC) prevents death and disability from non occupational injuries, including those that are unintentional and those that result from violence.

Coordinating Center for Health Information and Services
National Center for Health Statistics (NCHS) provides statistical information that guides actions and policies to improve the health of the American people.

National Center for Public Health Informatics (NCPHI) provides national leadership in the application of information technology in the pursuit of public health.

National Center for Health Marketing (NCHM) provides national leadership in health marketing science and in its application to impact public health.

Coordinating Center for Health Promotion
National Center on Birth Defects and Developmental Disabilities (NCBDDD) provides national leadership for preventing birth defects and developmental disabilities and for improving the health and wellness of people with disabilities.

National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) prevents premature death and disability from chronic diseases and promotes healthy personal behaviors.

National Office of Public Health Genomics provides national leadership in fostering understanding of human genomic discoveries and how they can be used to improve health and prevent disease.

Coordinating Center for Infectious Diseases
National Center for Infectious Diseases (NCID) prevents illness, disability, and death caused by infectious diseases in the United States and around the world.

National Immunization Program (NIP) prevents disease, disability, and death from vaccine-preventable diseases in children and adults.

National Center for HIV, STD, and TB Prevention (NCHSTP) provides national leadership in preventing and controlling human immunodeficiency virus infection, sexually transmitted diseases, and tuberculosis.

Coordinating Office for Global Health provides national leadership, coordination, and support for CDC’s global health activities in collaboration with CDC’s global health partners.

Coordinating Office for Terrorism Preparedness & Emergency Response provides strategic direction for the Agency to support terrorism preparedness and emergency response efforts.

National Institute for Occupational Safety and Health (NIOSH) ensures safety and health for all people in the workplace through research and prevention.


 * CDC performs many of the administrative functions for the Agency for Toxic Substances and Disease Registry (ATSDR), a sister agency of CDC, and one of eight federal public health agencies within the Department of Health and Human Services. The Director of CDC also serves as the Administrator of ATSDR.

CDC Workforce
CDC’s budget for 2006 is $8.5 billion. Today the staff numbers nearly 15,000 (including 6,000 contractors and 840 Commissioned Corps officers) in 170 occupations. Engineers, entomologists, epidemiologists, biologists, physicians, veterinarians, behaviorial scientists, nurses, laboratorians, economists, health communicators, toxicologists, chemists, computer scientists, and statisticians—to name only a few—each are dedicated to the pursuit of public health.

CDC is headquartered in DeKalb County, Georgia, but it has 10 other locations in the United States and Puerto Rico. Those locations include Anchorage, Alaska; Cincinnati, Ohio; Fort Collins, Colorado; Hyattsville, Maryland; Morgantown, West Virginia; Pittsburgh, Pennsylvania; Research Triangle Park, North Carolina; San Juan, Puerto Rico; Spokane, Washington; and Washington, D.C. In addition, CDC staff are located in state and local health agencies, quarantine/border health offices at ports of entry, and 45 countries around the world, from Angola to Zimbabwe.

The work force is diverse and well qualified. More than a third of CDC’s employees are members of a racial or ethnic minority group, and women account for nearly 60 percent of CDC’s workforce. Nearly 40 percent of employees have a master’s degree; 25 percent have a Ph.D.; and 10 percent have medical degrees. The average age of a CDC worker is 46.

The CDC campus in Atlanta houses facilities for the research of extremely dangerous biological agents. This setting was well represented in the Dustin Hoffman film Outbreak, although the location depicted in the film was supposed to be the United States Army Medical Research Institute of Infectious Diseases bio-research facility. The CDC labs also figure prominently in the book "The Demon in the Freezer" by Richard Preston and "Virus Hunter" by C.J. Peters, former head of the Special Pathogens Branch at the CDC.

The CDC also conducts the Behavioral Risk Factor Surveillance System,  the world’s largest, on-going telephone health survey system.

CDC Timeline
CDC Timeline

CDC: Then and Now
On July 1, 1946, the Communicable Disease Center was established. Its founder was a visionary leader in public health, Dr. Joseph Mountin. The new agency, which was established the year after World War II ended, descended from the wartime agency, Malaria Control in War Areas. Established as a small branch of the U.S. Public Health Service, the CDC was located on the sixth floor of the Volunteer Building on Peachtree Street in Atlanta, Georgia, hundreds of miles from Washington, D.C., and other federal agencies. The organization took root deep in the South, once the heart of the malaria zone.

CDC initially focused on fighting malaria by killing mosquitoes. In fact, malaria was by far CDC’s most absorbing interest; during the first year of operations, 59 percent of its personnel were engaged in this effort. Among its 369 employees, the key jobs at CDC were originally entomology and engineering. In 1946, there were only seven medical officers on duty.

Back then, CDC’s budget was about $1 million. The insecticide DDT, available since 1943, was the primary weapon in the malaria fight, and CDC’s early challenges included obtaining enough trucks, sprayers, and shovels to wage the war on mosquitoes. In CDC’s initial years, more than six and a half million homes were sprayed, and an early organization chart was even drawn—somewhat fancifully—in the shape of a mosquito.

But CDC was soon to spread its wings. CDC founder Dr. Joseph Mountin continued to advocate for public health issues and to push for CDC to extend its responsibilities to many other communicable diseases. In 1947, CDC made a token payment of $10 to Emory University for 15 acres of land on Clifton Road in Atlanta, the home of CDC headquarters today. CDC employees collected the money to make the purchase. The benefactor behind the “gift” was Robert Woodruff, Chairman of the Board of the Coca-Cola Company. Woodruff had a long-time interest in malaria control; it had been a problem in areas where he went hunting. As you can see, malaria was the catalyst for the agency’s creation. The scene was now set for CDC to expand its home, its mission, and its reach.

Today, CDC is the nation's premier health promotion, prevention, and preparedness agency and a global leader in public health. During the past 60 years, its name has changed to reflect its more complex mission. While it’s still known by the initials CDC, the agency’s name today is Centers for Disease Control and Prevention.

In the six decades since its founding, CDC has grown dramatically: in staff, budget and mission. The world authority on communicable disease, CDC has broadened its focus to include chronic diseases, disabilities, injury control, workplace hazards, environmental health threats, and terrorism preparedness. Whereas malaria was once considered a threat to the country’s security, new threats have now emerged. CDC tackles emerging diseases and other health risks, including birth defects, West Nile virus, obesity, avian and pandemic flu, E. coli, auto wrecks, and bioterrorism, to name a few.

CDC remains committed to its vision of healthy people in a healthy world. Part of the Department of Health and Human Services, CDC applies research and findings to improve people’s daily lives and responds to health emergencies, and in 60 years, CDC has grown in size and stature, scope and science, and reputation and reach. Memories have been built and milestones achieved. World-class scientists work in world-class facilities. But while much has changed since 1946, the heart of CDC is still its people—dedicated and diligent, persevering and professional, making a difference in lives around the world.

The CDC is one of the few Bio-Safety Level 4 laboratories in the country, as well as one of only two "official" repositories of smallpox in the world. The second smallpox stores reside at the State Research Center of Virology and Biotechnology VECTOR in the Russian Federation, though it is possible that other countries may have obtained samples during the collapse of the Soviet Union.

CDC Data and Survey Systems

 * CDC Scientifc Data, Surveillance, Health Statistics, and Laboratory Information.
 * Behavioral Risk Factor Surveillance System.
 * Mortality Medical Data System.

CDC Publications

 * Comprehensive list of publications and products


 * State of CDC report


 * CDC Programs in Brief


 * Morbidity and Mortality Weekly Report


 * Emerging Infectious Disease Journal

Nosocomial Infection
Nosocomial infections, also referred to as hospital-acquired infections of health care-associated infections – are defined as infections that are not present or incubating in a patient at the time of admission to a hospital or health care facility. These infections affect 2 million Americans every year, costing 100,000 lives and adding $30.5 billion to the nation’s healthcare tab. According to the CDC, 91% of these deaths are preventable.

The most important types of nosocomial infections include urinary tract infections, pneumonia, and diarrhea, infections following surgery or invasive medical procedures, and maternal and newborn infections. • Urinary tract infections, the most prevalent type of nosocomial infection, account for approximately 35% of all nosocomial infections. Studies have demonstrated that these infections occur after urinary catheterization. • Surgical-incision-site infections account for 20% of nosocomial infections. • Pneumonia (ventilator-associated) is a prevalent type of nosocomial infection. The most susceptible individuals are those with chronic obstructive pulmonary disease and those utilizing mechanical ventilation. Pneumonia accounts for 15% of nosocomial infections. • Bloodstream infections account for another 15% of nosocomial infections.

The organisms causing most nosocomial infections usually come from the patient’s own body, known as endogenous flora. They can also come from contact with hospital staff, which occurs via cross-contamination, contaminated instruments and needles, or the environment (exogenous flora). Since patients are highly mobile and hospital stays are becoming increasingly shorter, patients are often discharged before the infection becomes apparent. As a consequence, it is often difficult to determine whether the source of the organism causing the infection is endogenous or exogenous.

Studies show that approximately 70% of bacteria that cause nosocomial infections are resistant to at least one antibiotic commonly used to treat them. The increased incidence of resistance is a common concern in health care. According to the CDC’s National Nosocomial Infection Surveillance (NNIS) System, multidrug-resistant pathogens have become increasingly problematic in recent years, especially in the critical care setting.

A 1987 study by the World Health Organization (WHO) found that the highest prevalence of nosocomial infections occur in intensive care units and acute care surgical and orthopedic wards. Not surprisingly, infection rates are higher among patients increased susceptibility because of old age and the severity of the underlying disease. Nosocomial infections add to functional disability, emotional stress, and may even lead to disabling conditions that reduce the quality of life.

Nosocomial infections can affect the quality of patient care and increase health care treatment costs. Health care institutions can prevent or reduce the incidence of many nosocomial infections by effectively incorporating an infection control program and by following the recommendations of the CDC. In an effort to improve the quality of health care for patients, it is imperative for health care professionals to understand clearly how infections can be transmitted, to focus on means of implementing preventive measures, and potentially to reduce these types of infections.

References: Nibley, M. (2007). Hospital infection control saves lives, cuts costs. Medical News Today. Retrieved September 30, 2007, from [www.medicalnewstoday.com]. Preventing nosocomial infections. Infection Prevention Guidelines. Retrieved September 24, 2007, from [www.reproline.jhu.edu/English/4morerh/4ip/IP_manual/20_Nosocomial.pdf]. Terrie, Y. C. (2006). Nosocomial infections: Impact on patient care. Pharmacy Times. Retrieved September 30, 2007, from 

Infection Prevention in Hospitals
About 5 percent of hospital patients end up having a longer hospital stay because of nosocomial infections. According to the Centers for Disease Control and Prevention, each year about 2 million patients get at least one unwanted visitor -- an infection. What's more, each year nearly 90,000 people die from hospital-acquired infections.

In recent years, hospitals have worked hard to reduce these statistics, resulting in a 30 percent drop in the number of infections over the last decade. However, it still makes sense to do what you can to protect yourself. If you're worried about not feeling well enough to stay on top of things, ask a friend or relative to stay with you in the hospital and serve as your advocate. Paying attention to cleanliness and asking questions can help you have a shorter and healthier hospital stay. Here are some other tips: • Make sure doctors and nurses wash their hands before examining you. The CDC cites hand washing as the single most effective way to control the spread of disease. • Wash your own hands carefully after using the bathroom or handling soiled materials: Scrub for at least 15 seconds with warm, soapy water. • If you're receiving fluids through an intravenous catheter, let your nurse know if the dressing around it becomes wet or soiled. • Infections from urinary catheters are common, so these dressings should be clean and dry, and the catheter should not remain in longer than necessary. • Keep an eye on wound dressings and drainage tubes, and let your nurse know if they become loose or wet. • Ask friends and family not to visit if they're feeling ill.

• If you need surgery and are overweight, losing a few pounds before you go in the hospital can help reduce your risk of post-surgery infection. • Be extra vigilant if you have diabetes because high blood sugar increases your risk of infection. Work with your doctor to control your blood sugar before, during, and after your hospital stay. • Don't be afraid to ask questions! Understanding your treatment plan will make it easier for you to be involved in your own recovery.

Paying attention to cleanliness and asking questions can help you have a shorter and healthier hospital stay.

Hand hygiene Cleansing hands is the easiest way to reduce the risk of spreading germs that cause infections. •	Wash your hands after using the bathroom, blowing your nose, coughing, sneezing, and before eating. •	If you cannot get to a sink, please ask your health care provider for a waterless alcohol handrub. •	Please ask your health care team members if they have cleansed their hands. They remove germs from their hands with a waterless alcohol handrub or with soap and water to protect you.

How to wash your hands Use soap and warm, running water. 1.	Wet your hands. 2.	Put some soap on your hands. 3.	Rub your hands together for at least 15 to 20 seconds. Cover all surfaces, including between your fingers and under fingernails. 4.	Rinse with running water. 5.	Dry your hands with a paper towel. 6.	Use a paper towel to turn off the faucet.

Surgery site infections To help prevent infection at the site of your surgery, you may be given an antibiotic within 60 minutes before surgery which should be stopped within 24 hours after surgery (48 hours after heart surgery).

If you need hair removed from the surgery site, a member of the health care team should use clippers instead of a razor. This will help avoid cuts.

RERFERENCES: Montgomery, N. (2006). How to Prevent Hospital Infections. “A Healthy Me.” Retrieved October 1, 2007 from http://www.ahealthyme.com/topic/hospitalinfections. A Healthy Me. 2006.

How to Prevent Infections during Your Hospital Stay. (2007). Allina Health Systems Press. Retrieved October 1, 2007 from http://www.allinahealth.org/ac/transcript.nsf/alltopics/InfectionPreventionDuringHospitalStay

Further Information

 * CDC Emerging Infectious Diseases Laboratory -- Atlanta, Georgia