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SYED A. SATTAR, Ph.D. DIRECTOR, CENTRE FOR RESEARCH ON ENVIRONMENTAL MICROBIOLOGY (CREM) UNIVERSITY OF OTTAWA, OTTAWA, ON, CANADA SYED A. SATTAR, Ph.D.

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Presentation on theme: "SYED A. SATTAR, Ph.D. DIRECTOR, CENTRE FOR RESEARCH ON ENVIRONMENTAL MICROBIOLOGY (CREM) UNIVERSITY OF OTTAWA, OTTAWA, ON, CANADA SYED A. SATTAR, Ph.D."— Presentation transcript:

1 SYED A. SATTAR, Ph.D. DIRECTOR, CENTRE FOR RESEARCH ON ENVIRONMENTAL MICROBIOLOGY (CREM) UNIVERSITY OF OTTAWA, OTTAWA, ON, CANADA SYED A. SATTAR, Ph.D. DIRECTOR, CENTRE FOR RESEARCH ON ENVIRONMENTAL MICROBIOLOGY (CREM) UNIVERSITY OF OTTAWA, OTTAWA, ON, CANADA THE ROLE OF THE ENVIRONMENT IN THE TRANSMISSION OF BACTERIA AND VIRUSES AMONGST CHILDREN DESIGNING A SAFER TOMORROW POUR UN FUTUR PLUS SAIN DESIGNING A SAFER TOMORROW POUR UN FUTUR PLUS SAIN

2 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., INTRODUCTION WHY THE EMPHASIS ON CHILDREN? WHY THE CONCERN WITH BACTERIAL & VIRAL INFECTIONS? NEWER PATHOGENS & NEWER ROLES FOR THEM? LONGER-TERM IMPACTS OF INFECTIONS? WHAT IS THE GLOBAL PICTURE? WHAT IS THE SITUATION IN CANADA & THE U.S.? HOW DO BACTERIA & VIRUSES SPREAD IN NATURE? WHAT ROLE DOES THE ENVIRONMENT PLAY? HOW CAN ENVIRONMENTAL SPREAD BE INTERRUPTED? WHAT DOES THE FUTURE HOLD? WHY THE EMPHASIS ON CHILDREN? WHY THE CONCERN WITH BACTERIAL & VIRAL INFECTIONS? NEWER PATHOGENS & NEWER ROLES FOR THEM? LONGER-TERM IMPACTS OF INFECTIONS? WHAT IS THE GLOBAL PICTURE? WHAT IS THE SITUATION IN CANADA & THE U.S.? HOW DO BACTERIA & VIRUSES SPREAD IN NATURE? WHAT ROLE DOES THE ENVIRONMENT PLAY? HOW CAN ENVIRONMENTAL SPREAD BE INTERRUPTED? WHAT DOES THE FUTURE HOLD?

3 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., TERMS OF REFERENCE A CHILD: ANY PERSON UNDER 18 YEARS OF AGE THE ENVIRONMENT: ANYTHING OUTSIDE THE BODY OF THE HUMAN HOST A CHILD: ANY PERSON UNDER 18 YEARS OF AGE THE ENVIRONMENT: ANYTHING OUTSIDE THE BODY OF THE HUMAN HOST

4 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., WHY THE EMPHASIS ON CHILDREN? MORE VULNERABLE TO INFECTION GREATER EXPOSURE TO MICROBES POTENTIAL FOR LONGER-TERM HEALTH IMPACT DEPENDENCE ON CARE-GIVERS LOWER LEVELS OF AWARENESS INCREASING GROUPING IN DAYCARE CENTERS POVERTY, MALNUTRITION & NEGLECT MORE VULNERABLE TO INFECTION GREATER EXPOSURE TO MICROBES POTENTIAL FOR LONGER-TERM HEALTH IMPACT DEPENDENCE ON CARE-GIVERS LOWER LEVELS OF AWARENESS INCREASING GROUPING IN DAYCARE CENTERS POVERTY, MALNUTRITION & NEGLECT SIMPLY PUT, A HEALTHY CHILD IS MORE LIKELY TO BE A HEALTHY ADULT

5 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., WHY WORRY ABOUT THE GLOBAL PICTURE? INFECTIONS CONTINUE TO BE A MAJOR KILLER OF CHILDREN WORLDWIDE (GRAPHS) INCREASING LEVELS OF POLLUTION POVERTY MALNUTRITION IMPACT OF NATURAL DISASTERS IMPACT OF DISEASES SUCH AS AIDS OVC’S (ORPHANS & VULNERABLE CHILDREN) INFECTIONS CONTINUE TO BE A MAJOR KILLER OF CHILDREN WORLDWIDE (GRAPHS) INCREASING LEVELS OF POLLUTION POVERTY MALNUTRITION IMPACT OF NATURAL DISASTERS IMPACT OF DISEASES SUCH AS AIDS OVC’S (ORPHANS & VULNERABLE CHILDREN) “NO ONE IS SAFE UNTIL EVERYONE IS SAFE”

6 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., CHILDREN AND BASIC DEPRIVATION FACTORS (UNICEF, STATE OF THE WORLD CHILDREN, 2005) FACTORMILLIONS NO ADEQUATE SHELTER640 NO ACCESS TO SANITATION500 NO ACCESS TO SAFE WATER400 NO ACCESS TO INFORMATION300 NO ACCESS TO HEALTH CARE SERVICES270 HAVE NEVER BEEN TO SCHOOL140 ARE SEVERELY FOOD-DEPRIVED90 AIDS HAS CREATED 15 MILLION OVC’S

7 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., DEMOGRAPHICS IN CANADA AND THE U.S. – 2003* ( *BASED ON UNICEF REPORT THE STATE OF WORLD’S CHILDREN, 2005 CANADAU.S. TOTAL POPULATION31,510,000294,043,000 POPULATION UNDER AGE 186,942,00075,893,000 POPULATION UNDER AGE 51,663,00020,794,000 % OF CHILDREN LIVING IN POVERTY

8 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., MAIN CAUSES OF DEATH AMONG CHILDREN 0-4 YEARS (WORLD HEALTH ORGANIZATION, 1999)

9 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., CAUSES OF PREMATURE DEATH AMONGST 0-44 YEAR OLDS (WORLD HEALTH ORGANIZATION, 1999) CAUSES OF PREMATURE DEATH AMONGST 0-44 YEAR OLDS (WORLD HEALTH ORGANIZATION, 1999)

10 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., BREAKDOWN OF KNOWN HUMAN PATHOGENS (TAYLOR ET AL. PHIL. TRANS. R. SOC. LOND. B. 2001; 356: ) OF THESE 1415 PATHOGENS, THE MEANS OF SPREAD OF >200 ARE NOT KNOWN!! 287 HELMINTHS (20%) 66 PROTOZOA (5%) 307 FUNGI (22%) 217 VIRUSES & PRIONS (15%) 538 BACTERIA (38%) BACTERIA & VIRUSES TOGETHER CONSTITUTE >50% OF KNOWN HUMAN PATHOGENS

11 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., HUMAN HEALTH IMPACT OF INFECTIOUS AGENTS GLOBALLY, INFECTIONS DIRECT CAUSE OF >32% (18/56 MILLION) OF ALL DEATHS/YEAR; >45% IN DEVELOPING COUNTRIES (WHO 2001)  40 NEW PATHOGENS FOUND IN PAST 30 YEARS ALONE (DESSELBERGER, J. INFECT. 2000; 40:3-15) INFECTIONS & DELAYED OUTCOMES, E.G., POST-POLIO & GUILLAIN-BARRÉ SYNDROMES (WHO 2003) VIRUSES (HBV, HCV, HPV) & BACTERIA (H. PYLORI) CAUSING CANCERS (WHO 2003) GLOBALLY, INFECTIONS DIRECT CAUSE OF >32% (18/56 MILLION) OF ALL DEATHS/YEAR; >45% IN DEVELOPING COUNTRIES (WHO 2001)  40 NEW PATHOGENS FOUND IN PAST 30 YEARS ALONE (DESSELBERGER, J. INFECT. 2000; 40:3-15) INFECTIONS & DELAYED OUTCOMES, E.G., POST-POLIO & GUILLAIN-BARRÉ SYNDROMES (WHO 2003) VIRUSES (HBV, HCV, HPV) & BACTERIA (H. PYLORI) CAUSING CANCERS (WHO 2003)

12 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., HEALTH IMPACT (CONT’D.) CHRONIC CONDITIONS (ARTERIOSCLEROSIS, ARTHRITIS) EXACERBATION OF ASTHMA POLYMICROBIC DISEASES E.G., ~15% OF CASES OF ACUTE OTITIS MEDIA DUE TO A MIXTURE OF VIRUSES & BACTERIA (HEIKKINEN & CHONMAITREE. CLIN. MICROBIOL. REV. 2003; 16: ) VIRUSES & OBESITY – INFECTOBESITY (DHURANDHAR, J. NUTR. 2001; 131:2794S-2797S) INFECTIONS & BEHAVIORAL CHANGES, E.G., TOXOPLASMA GONDII (BERDOY ET AL. PROC R SOC LOND. B BIOL. SCI. 2000; 267: ) LACK OF NEW VACCINES & DRUGS DECREASING RATES OF CHILDHOOD VACCINATIONS CHRONIC CONDITIONS (ARTERIOSCLEROSIS, ARTHRITIS) EXACERBATION OF ASTHMA POLYMICROBIC DISEASES E.G., ~15% OF CASES OF ACUTE OTITIS MEDIA DUE TO A MIXTURE OF VIRUSES & BACTERIA (HEIKKINEN & CHONMAITREE. CLIN. MICROBIOL. REV. 2003; 16: ) VIRUSES & OBESITY – INFECTOBESITY (DHURANDHAR, J. NUTR. 2001; 131:2794S-2797S) INFECTIONS & BEHAVIORAL CHANGES, E.G., TOXOPLASMA GONDII (BERDOY ET AL. PROC R SOC LOND. B BIOL. SCI. 2000; 267: ) LACK OF NEW VACCINES & DRUGS DECREASING RATES OF CHILDHOOD VACCINATIONS

13 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., GLOBAL HEALTH IMPACT OF ROTAVIRAL INFECTIONS (PARASHAR ET AL. EMERG. INFECT. DIS. 2003; 9: ) SAFE & EFFECTIVE VACCINE STILL UNAVAILABLE PERSONAL & ENVIRONMENTAL HYGIENE EFFECTIVE IN PREVENTING SPREAD OF ROTAVIRAL INFECTIONS RELATIVE IMPORTANCE OF VARIOUS VEHICLES REMAINS UNCLEAR SAFE & EFFECTIVE VACCINE STILL UNAVAILABLE PERSONAL & ENVIRONMENTAL HYGIENE EFFECTIVE IN PREVENTING SPREAD OF ROTAVIRAL INFECTIONS RELATIVE IMPORTANCE OF VARIOUS VEHICLES REMAINS UNCLEAR EVENT (RISK) NUMBER/YEAR IN MILLIONS EPISODES OF DIARRHEA REQUIRING HOME CARE (1:1)111 VISITS TO CLINICS (1:5)25 HOSPITALIZATIONS (1:65)2 DEATHS IN CHILDREN <5 YEARS (1:293)~0.5

14 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., MODES & MEANS OF PATHOGEN SPREAD IN NATURE Infected host Susceptible host H O R I Z O N T A L Susceptible host VERTICALVERTICAL HORIZONTAL SPREAD Infected hostSusceptible host Direct (person-to-person) Infected host Susceptible host Indirect Indirect spread is through vehicles such as water, food, air, fomites, insects, animals, soil, hands, environmental surfaces, medical devices & transplanted blood & tissues

15 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., ENVIRONMENTAL SPREAD OF INFECTIOUS AGENTS HUMAN HOST HUMAN HOST MEDICAL DEVICES (HEPATITIS B VIRUS) WATER (CRYPTOSPORIDIUM) FOOD (CAMPYLOBACTER) AIR (INFLUENZAVIRUS) WASTES (ESCHERICHIA COLI O157:H7) SOIL (CLOSTRIDIUM TETANI) ENVIRON. SURFACES (HEPATITIS A VIRUS) ANIMALS (HANTAVIRUS) INSECTS (WEST NILE VIRUS) SECONDARY HOSTS (TOXOPLASMA GONDII) HANDS (ROTAVIRUS)

16 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., SPREAD OF INFECTIONS IN NATURE PATHOGEN SOURCE HANDS ENVIRON. SURFACES SUSCEPTIBLE HOST INSECTS FOOD WATER AIR ANIMALS

17 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., BACTERIA, PARASITES & VIRUSES IN FOODBORNE DISEASE IN THE U.S. (FROM MEAD ET AL., 1999)

18 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., FELINE CALICIVIRUS SURVIVAL ON FOODS AT 4°C BIDAWID ET AL. UNPUBLISHED DATA

19 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., FELINE CALICIVIRUS SURVIVAL ON METAL DISKS AT 4°C BIDAWID ET AL. UNPUBLISHED DATA

20 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., NEARLY 45% OF FCV REMAINS DETECTABLE ON THE HANDS OF ADULTS AFTER 20 MINUTES OF DRYING SURVIVAL OF SELECTED ORGANISMS ON HANDS OF ADULTS AFTER ONE HOUR

21 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., GENERAL MEANS TO INTERRUPT SPREAD OF PATHOGENS n VACCINATION (POLIO) n PASSIVE IMMUNIZATION (HEP. A) n CHEMOTHERAPY (ANTIBIOTICS) n VACCINATION OF ANIMALS (RABIES) n DISEASE SURVEILLANCE (TB) n QUARANTINE (RABIES) n BARRIER PROTECTION (AIDS) n SCREENING OF BLOOD & TISSUES (HEP. B) n QUALITY CONTROL ON IMPORTS (CYCLOSPORA) n EDUCATION (TOXOPLASMOSIS) n VACCINATION (POLIO) n PASSIVE IMMUNIZATION (HEP. A) n CHEMOTHERAPY (ANTIBIOTICS) n VACCINATION OF ANIMALS (RABIES) n DISEASE SURVEILLANCE (TB) n QUARANTINE (RABIES) n BARRIER PROTECTION (AIDS) n SCREENING OF BLOOD & TISSUES (HEP. B) n QUALITY CONTROL ON IMPORTS (CYCLOSPORA) n EDUCATION (TOXOPLASMOSIS)

22 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., ENVIRONMENTAL CONTROL MEASURES n WATER TREATMENT & DISTRIBUTION n FOOD TREATMENT & PRESERVATION n AIR FILTRATION & DISINFECTION n LIQUID & SOLID WASTE COLLECTION, TREATMENT & DISPOSAL n CONTROL OF ANIMALS & INSECTS n CONTROL OF SECONDARY HOSTS n STERILIZATION n HANDWASHING n CLEANING/DISINFECTION n WATER TREATMENT & DISTRIBUTION n FOOD TREATMENT & PRESERVATION n AIR FILTRATION & DISINFECTION n LIQUID & SOLID WASTE COLLECTION, TREATMENT & DISPOSAL n CONTROL OF ANIMALS & INSECTS n CONTROL OF SECONDARY HOSTS n STERILIZATION n HANDWASHING n CLEANING/DISINFECTION

23 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., ALCOHOL-BASED HAND RUBS AND FELINE CALICIVIRUS (SATTAR ET AL., UNPUBLISHED DATA) TREATMENT MEAN VIRUS TITER % REDUCTION BASELINE1.6 x % ETHANOL1.0 x % ETHANOL5.2 x % ETHANOL6.2 x THE FINGERPAD METHOD (ASTM 1838) WAS USED. TEN µL OF VIRUS IN SOIL LOAD WAS PLACED ON EACH FINGERPAD & DRIED. THE DRIED INOCULUM WAS EXPOSED TO CONTROL OR TEST SOLUTION FOR 30 SECONDS. THE FINGERPADS WERE ELUTED & ELUATES PLAQUE ASSAYED.

24 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., AN ALCOHOL-BASED GEL AND CORONAVIRUS 229E (SATTAR ET AL., UNPUBLISHED DATA) TREATMENT MEAN  SD % REDUCTION BASELINE 1.32 X 10 4  HARD WATER (200 PPM CaCO 3 ) 3.02 X 10 3  % (V/V) ETHANOL0>99.99 ALCOHOL (60%) GEL0>99.99 THE FINGERPAD METHOD (ASTM 1838) WAS USED. TEN µL OF VIRUS IN SOIL LOAD WAS PLACED ON EACH FINGERPAD & DRIED. THE DRIED INOCULUM WAS EXPOSED TO CONTROL OR TEST SOLUTION FOR 30 SECONDS. THE FINGERPADS WERE ELUTED & ELUATES PLAQUE ASSAYED.

25 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., CHEMICAL DISINFECTION TO INTERRUPT ROTAVIRUS SPREAD* TREATMENT NO. INFECTED % OF VIRUS NO. TESTED INFECTED NONE 13/14 93 LYSOL DISINFECTANT SPRAY 0/14 0 TREATMENT NO. INFECTED % OF VIRUS NO. TESTED INFECTED NONE 13/14 93 LYSOL DISINFECTANT SPRAY 0/14 0 Virus in fecal suspension was dried on plastic plates and volunteers asked to lick the surface with and without disinfection. Ward et al., J. Clin. Microbiol. 29: , 1991.

26 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., EMERGING ISSUES INCREASED SCRUTINY OF MICROBICIDES WITH MICROBICIDAL ACTIVITY AS ONLY ONE COMPONENT IN ACCEPTANCE & USE FLAWED TEST METHODOLOGY PROSPECTS FOR REGIONAL/GLOBAL HARMONIZATION IMPROVED AWARENESS IN END-USERS TREATED ARTICLES MICROBICIDES & ANTIBIOTIC RESISTANCE (?) MICROBICIDE RESIDUES & ENHANCED BACTERIAL SPORULATION (WILCOX & FAWLEY. LANCET 2000; 356; 1324.) INCREASED SCRUTINY OF MICROBICIDES WITH MICROBICIDAL ACTIVITY AS ONLY ONE COMPONENT IN ACCEPTANCE & USE FLAWED TEST METHODOLOGY PROSPECTS FOR REGIONAL/GLOBAL HARMONIZATION IMPROVED AWARENESS IN END-USERS TREATED ARTICLES MICROBICIDES & ANTIBIOTIC RESISTANCE (?) MICROBICIDE RESIDUES & ENHANCED BACTERIAL SPORULATION (WILCOX & FAWLEY. LANCET 2000; 356; 1324.)

27 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., HAZARDS IN MICROBICIDE USE SOME 300 CHEMICALS USED AS MICROBICIDES; MANY ARE NOW UNDER SCRUTINY MICROBICIDES ARE A DOUBLE-EDGED SWORD NO CHEMICAL THAT CAN KILL PATHOGENS CAN BE TOTALLY SAFE FOR OTHER LIFE FORMS DAMAGE TO THE ENVIRONMENT VOLATILE ORGANICS & AIR QUALITY DISRUPTION OF HORMONE FUNCTIONS CHANGES IN BIOFILM COMPOSITION COMBINED IMPACT OF CHEMICALS & PATHOGENS SOME 300 CHEMICALS USED AS MICROBICIDES; MANY ARE NOW UNDER SCRUTINY MICROBICIDES ARE A DOUBLE-EDGED SWORD NO CHEMICAL THAT CAN KILL PATHOGENS CAN BE TOTALLY SAFE FOR OTHER LIFE FORMS DAMAGE TO THE ENVIRONMENT VOLATILE ORGANICS & AIR QUALITY DISRUPTION OF HORMONE FUNCTIONS CHANGES IN BIOFILM COMPOSITION COMBINED IMPACT OF CHEMICALS & PATHOGENS

28 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., HOUSEHOLD MICROBICIDES & CHILDREN (M. SPANN ET AL., AM. J. PUB. HLTH. 2000;90: ) ANNUALLY ABOUT 800,000 CHILDREN (<6 YEARS IN AGE) IN THE U.S. INGEST HOUSEHOLD PESTICIDES MEDICAL ATTENTION NEEDED IN 10% OF THE CASES MICROBICIDES INVOLVED IN >90% OF SEVERE CASES ANNUALLY ABOUT 800,000 CHILDREN (<6 YEARS IN AGE) IN THE U.S. INGEST HOUSEHOLD PESTICIDES MEDICAL ATTENTION NEEDED IN 10% OF THE CASES MICROBICIDES INVOLVED IN >90% OF SEVERE CASES WORKING YOUTH & DISINFECTANTS (BREVARD ET AL., ENVIRON HLTH PERSPECT. 2003;111: ) ACUTE OCCUPATIONAL EXPOSURE TO DISINFECTANTS IN WORKING YOUTH (15-17 YEARS OF AGE) IN THE U.S. ANALYSIS OF 300 CASES IN A 5-YEAR PERIOD ( ) THE RATE OF EXPOSURES 4-FOLD HIGHER IN THE YOUTH AS COMPARED TO THAT IN YEAR OLDS. 45% OF CASES OF ILLNESS INVOLVED SOD. HYPOCHLORITE ACUTE OCCUPATIONAL EXPOSURE TO DISINFECTANTS IN WORKING YOUTH (15-17 YEARS OF AGE) IN THE U.S. ANALYSIS OF 300 CASES IN A 5-YEAR PERIOD ( ) THE RATE OF EXPOSURES 4-FOLD HIGHER IN THE YOUTH AS COMPARED TO THAT IN YEAR OLDS. 45% OF CASES OF ILLNESS INVOLVED SOD. HYPOCHLORITE NEED BETTER EDUCATION OF PARENTS

29 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., REASONS FOR DESPAIR UNABATED POPULATION INCREASE LEVELS OF POVERTY RISING AIR & WATER POLLUTION STILL TOO HIGH CLIMATE CHANGE WILL IMPACT DISEASE SPREAD INCREASING ANTIBIOTIC RESISTANCE AIDS CONTINUES ITS ONSLAUGHT VACCINATION RATES IN CHILDREN DROPPING RECENT (OCT. 2005) CASES OF POLIO IN THE U.S. REDUCED EMPHASIS ON PREVENTIVE STRATEGIES UNABATED POPULATION INCREASE LEVELS OF POVERTY RISING AIR & WATER POLLUTION STILL TOO HIGH CLIMATE CHANGE WILL IMPACT DISEASE SPREAD INCREASING ANTIBIOTIC RESISTANCE AIDS CONTINUES ITS ONSLAUGHT VACCINATION RATES IN CHILDREN DROPPING RECENT (OCT. 2005) CASES OF POLIO IN THE U.S. REDUCED EMPHASIS ON PREVENTIVE STRATEGIES

30 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., REASONS FOR HOPE RENEWED EMPHASIS ON BETTER NUTRITION ELIMINATION/ERADICATION OF MANY CHILDHOOD DISEASES OVER 90% OF CHILDREN IN CANADA AND THE U.S. IMMUNIZED AGAINST COMMON CHILDHOOD DISEASES UN TREATY ON RIGHTS OF CHILDREN AN INTERNATIONAL TREATY THAT RECOGNIZES THE HUMAN RIGHTS OF CHILDREN AS OF NOV. 2003, TREATY RATIFIED BY 192 COUNTRIES, MORE THAN ANY HUMAN RIGHTS TREATY IN HISTORY SOMALIA UNABLE TO RATIFY AS IT HAS NO RECOGNIZED GOVERNMENT IN THE U.S., THE REVIEW TO RATIFY MAY TAKE SEVERAL YEARS RENEWED EMPHASIS ON BETTER NUTRITION ELIMINATION/ERADICATION OF MANY CHILDHOOD DISEASES OVER 90% OF CHILDREN IN CANADA AND THE U.S. IMMUNIZED AGAINST COMMON CHILDHOOD DISEASES UN TREATY ON RIGHTS OF CHILDREN AN INTERNATIONAL TREATY THAT RECOGNIZES THE HUMAN RIGHTS OF CHILDREN AS OF NOV. 2003, TREATY RATIFIED BY 192 COUNTRIES, MORE THAN ANY HUMAN RIGHTS TREATY IN HISTORY SOMALIA UNABLE TO RATIFY AS IT HAS NO RECOGNIZED GOVERNMENT IN THE U.S., THE REVIEW TO RATIFY MAY TAKE SEVERAL YEARS

31 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., CONCLUDING REMARKS PROTECTION OF CHILDREN FROM INFECTIONS IN GENERAL REQUIRES SPECIAL CONSIDERATION EVEN IN DEVELOPED COUNTRIES WIDE VARIATIONS & GAPS IN STANDARDS OF HYGIENE EDUCATION & PARENTAL AWARENESS SAFE & EFFECTIVE ENVIRONMENTAL CONTROL MEASURES LACKING USE OF MICROBICIDES IN HAND ANTISEPSIS & DISINFECTION OF ENVIRONMENTAL SURFACES REQUIRES REVIEW. REVIVAL OF EMPHASIS ON PREVENTION NEEDED PROTECTION OF CHILDREN FROM INFECTIONS IN GENERAL REQUIRES SPECIAL CONSIDERATION EVEN IN DEVELOPED COUNTRIES WIDE VARIATIONS & GAPS IN STANDARDS OF HYGIENE EDUCATION & PARENTAL AWARENESS SAFE & EFFECTIVE ENVIRONMENTAL CONTROL MEASURES LACKING USE OF MICROBICIDES IN HAND ANTISEPSIS & DISINFECTION OF ENVIRONMENTAL SURFACES REQUIRES REVIEW. REVIVAL OF EMPHASIS ON PREVENTION NEEDED

32 SYED A. SATTAR, SIMMONS COLLEGE SYMPOSIUM, OCT., ACKNOWLEDGMENTS DR. LIZ SCOTT & OTHERS AT THE CENTER FOR HYGIENE & HEALTH IN HOME & COMMUNITY, SIMMONS COLLEGE


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