A poll conducted by the British Medical Journal (BMJ) has named sanitation as the most important medical milestone since the journal was first published in 1840. BMJ editors asked its readers to vote on the greatest medical breakthrough since the journal began 166 years ago as part of a celebration to mark the journal's redesign. The BMJ selected 15 medical advances and published articles arguing the merits of each one. With more than 11,000 votes from around the world, sanitation beat out other medical achievements such as antibiotics, the contraceptive pill, vaccines, anesthesia and the discovery of DNA.

The recent BMJ article on sanitation notes that new sewage disposal and water supply systems in the 1800s revolutionized public health in Europe. Edwin Chadwick published The Sanitary Conditions of the Labouring Population in 1842, arguing that there was a desperate need for public health reform. Chadwick's thesis is credited with originating the idea of sewage disposal and home sewage piping water. The importance of the home sanitation innovation was cemented in 1854 when Dr. John Snow discovered that cholera was a waterborne disease, not airborne as had previously believed.

Inadequate sanitation remains a major public health problem around the globe. Highly infectious, diarrheal diseases attributed to poor sanitation and unsafe water, such as cholera, continue to affect entire communities in developing countries. According to the World Health Organization (WHO), approximately 1.8 million people die every year from diarrheal diseases, with 90% of those affect being children under the age of five.

Please click on the following link to read the BJM sanitation article:
http://www.bmj.com/cgi/content/full/334/suppl_1/s17

The U.S. Environmental Protection Agency (EPA) announced it will begin a three year environmental study investigating on the condition of the nation's lakes, ponds and reservoirs. The "Survey of the Nation's Lakes" will study a combined total of 909 water sites as part of a larger effort by EPA, states and tribes to study the state of U.S. water sources, including coastal waters, streams, rivers, and wetlands. EPA will release the results of the study in 2009.

EPA researchers will examine water samples for turbidity, color, shoreline habitat conditions, and pathogen indicators with the officially stated goal of addressing two key questions:

1) What is the condition of U.S. lakes in terms of trophic state, ecological health, and recreation?

2) What is the relative importance of key stressors such as nutrients and pathogens in the water sources?

Trophic indicators defined by the study include dissolved oxygen profiles, water chemical quality, nutrient concentrations and the presence of chlorophyll a.

EPA last measured the status of lakes during a period from 1972-1976, when 815 lakes were evaluated nationwide. According to EPA, the new study will resample 113 lakes from the earlier survey for comparison.

More information about the Survey of the Nation's Lakes is available at:
http://www.epa.gov/owow/lakes/lakessurvey/

Fears of infectious disease outbreaks are increasing in Johor, Malaysia in the wake of heavy December flooding that killed 17 people and forced more than 100,000 people to evacuate their homes. With flood waters slow to recede, Malaysian health officials have urged an immediate clean-up of standing water to avoid outbreaks of illnesses including diarrheal disease, typhoid, and cholera.

As the displaced residents begin returning to their flood damaged homes, the Malaysian government has mobilized work crews to begin disinfection procedures and promote public education on the importance of personal hygiene as measures to prevent disease outbreak.

Currently, 375 relief centers operated by the Malaysian government are housing a total of 115,000 evacuees. The volunteer organization, Mercy Malaysia is conducting health assessments of evacuees and distributing hygiene packs throughout the affected region.

The Johor flooding is reportedly the worst in 100 years.

For information from the CDC on flood water clean-up, please go to:
http://www.bt.cdc.gov/disasters/floods/cleanupwater.asp

Researchers at Texas A&M Health Science Center Institute of Biosciences and Technology have discovered that a toxin present in a common staph infection germ also plays a role in an aggressive pneumonia that can be fatal within 72 hours. The study was reported in the January 19 issue of the American Association for the Advancement of Science's journal, Science.

Staphylococcus aureus bacteria (S. aureus) is the most common cause of hospital-acquired infections, potentially leading to inflammation of the heart, toxic-shock syndrome and meningitis. However, a new strain of S. aureus called CA-MRSA (community-associated methicillin-resistant Staphylococcus aureus) causes severe skin and tissue infections in healthy persons who have not been in the hospital or undergone invasive medical procedures. In addition to the antibiotic methicillin, the strain is also resistant to oxacillin, penicillin and amoxicillin.

In the study, researchers showed that CA-MRSA can cause pneumonia and may create the deteriorating conditions in which the acquired pneumonia can cause debilitating illness and possibly death.

According to the researchers, back-to-basics personal hygiene routines, including common hand-washing is the best line of defense against infection.

For more information about CA-MRSA, please go to:
http://www.cdc.gov/ncidod/dhqp/ar_mrsa_ca.html

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