| Abstract |
Introduction: The 20th century is characterized as an era of major developments in the field of infectious diseases and hence in public health. The application of sanitary measures, the distribution of antimicrobials and the development and systematic use of vaccines have contributed to the dramatic reduction of morbidity and mortality from infections, resulting in the belief that humankind would be freed from communicable diseases. Although, the infections never disappeared. Newly emerging infectious diseases, as well as old ones, either persisting or re-emerging despite their previous limitation, are presenting world-wide, including our country, posing threats to public health. The primary objective of the present study is to highlight the long-term epidemiological trends of infectious diseases, for which recording and surveillance data in Greece are available. A secondary objective is to attempt to interpret these epidemiological trends and to identify possible factors that have defined the limitation, emergence or re-emergence of each disease separately, knowledge that can be used as an important tool for developing new policies and implementing alternative prevention strategies for infectious diseases, which are concerning us today.
Method: This is a review study of the Greek and English literature. Data from the Hellenic Statistical Authority on the reported cases of notifiable infectious diseases of the recent past are presented. The study period is defined as the last almost fifty years from 1970 until 2014. For the interpretation of the epidemiological trends of infectious diseases and their changes over time, published data from the Center for Disease Control and Prevention were studied and articles, related to the subject of the study, were searched from the “Pubmed” and “Iatrotek” databases. Results: During the study period, several infectious diseases, such as ankylostomiasis, Bornholm disease, sandfly fever, yellow fever, cholera, etc., are presented over time with minimal recorded cases, without causing any concerns to the public health authorities. Other communicable diseases such as diphtheria, rabies, poliomyelitis, meningitis, etc., which in the past were responsible for significant morbidity and mortality, have been significantly reduced, mainly following the systematic application of vaccinations. At the same time, however, infections either persisting or re-emerging despite their previous limitation are reported, due to failures of epidemiological surveillance and prevention programs, increased migratory flows from countries endemic for these infections, environmental changes, and resistance to the drugs which are being used. Typical examples are malaria, brucellosis, measles and tuberculosis. In addition to these infections, other emerging diseases in the country, such as West Nile Virus and legionellosis, are also a challenge to public health authorities.
Conclusion: As the list of infections of concern in our country is long, and as their epidemiology changes rapidly and poses public health risks, it is necessary to strengthen epidemiological surveillance by monitoring the trends in infectious diseases over time, timely detection of outbreaks and epidemics and evaluation of applied interventions and prevention measures. Finally, for the proper function of epidemiological surveillance in our country, it is important to increase the completeness of reporting of notifiable infectious diseases, that is reported via the Notifiable Infectious Disease Reporting System, which seems to malfunction.
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