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Summary
objective domain 7: Protection against communicable
diseases
Knowledge base for the public health policy report 2010
this sub-report is one of several background reports to the Swedish Public Health
Policy Report 2010. Here, we provide a more detailed picture of developments in
objective domain 7: Protection against communicable diseases. The report highlights
the occurrence of antibiotic resistance, immunity and infectious agents, and
effect of these factors on our protection against communicable diseases and the
health of the population.
Antibiotic resistance, immunity and infectious agents are all factors that fundamentally
determine the health of the population and society’s protection against
communicable diseases. These factors were all selected in 2005 when working on
the Swedish Public Health Policy Report 2005. Indicators used for the follow-up
of these factors are the annual incidence of antibiotic resistance (methicillin-resistant
Staphylococcus aureus, MRSA), annual monitoring of the childhood vaccination
situation (vaccinations against measles, mumps and rubella), and annual
cases of continuously surveyed diseases through statutory notifications according
to the Communicable Diseases Act (chlamydia infection, HIV infection, hepatitis
B, and legionella). Antibiotic resistance complicates and prolongs treatment, and
causes increased mortality. Antibiotic resistance also causes increased medical costs.
Vaccination has proven to be one of the most effective medical interventions available,
and the vaccines included in the Swedish national vaccination programme, has
almost completely removed the morbidity and mortality caused by these diseases.
At the same time, outbreaks of measles in Europe show that vaccinations do not
reach all children. This also shows the importance of cooperation between countries
for adequate immunization coverage. Infectious diseases caused 26 per cent of total
mortality in the world in 2001.
Since the Public Health Policy Report 2005, antibiotic resistance has increased.
The number of reported cases of MRSA (as well as other resistance monitored pursuant
to the Communicable Diseases Act) has increased every year. An important
change is that the endemic cases of MRSA are now spreading primarily in the community,
affecting new groups such as children and young adults. In addition, several
new types of resistance have evolved and spread. Here, the intestinal bacteria with
carbapenem resistance and gram-negative intestinal bacteria that produce ESBL are
particularly important since some are completely resistant to existing antibiotics.
M å l o M r å d e 7 – S K Y d d M o T S M I T T S P r I d n I n G 9