One in five people in the United States had a sexually transmitted infection (STI) on any given day in 2018, totaling nearly 68 million estimated infections. STIs are often asymptomatic (especially in women) and are therefore often undiagnosed and unreported. Untreated STIs can have severe health consequences, including chronic pelvic pain, infertility, miscarriage or newborn death, and increased risk of HIV infection, genital and oral cancers, neurological and rheumatological effects. In light of this, the Centers for Disease Control and Prevention, through the National Association of County and City Health Officials, commissioned the National Academies of Sciences, Engineering, and Medicine to convene a committee to examine the prevention and control of sexually transmitted infections in the United States and provide recommendations for action. In 1997, the Institute of Medicine released a report, The Hidden Epidemic: Confronting Sexually Transmitted Diseases. Although significant scientific advances have been made since that time, many of the problems and barriers described in that report persist today; STIs remain an underfunded and comparatively neglected field of public health practice and research. The committee reviewed the current state of STIs in the United States, and the resulting report, Sexually Transmitted Infections: Advancing a Sexual Health Paradigm, provides advice on future public health programs, policy, and research.

The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexualityâ€"the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs.

This fully updated edition of Infectious Disease Surveillance is for frontline public health practitioners, epidemiologists, and clinical microbiologists who are engaged in communicable disease control. It is also a foundational text for trainees in public health, applied epidemiology, postgraduate medicine and nursing programs. The second edition portrays both the conceptual framework and practical aspects of infectious disease surveillance. It is a comprehensive resource designed to improve the tracking of infectious diseases and to serve as a starting point in the development of new surveillance systems. Infectious Disease Surveillance includes over 45 chapters from over 100 contributors, and topics organized into six sections based on major themes. Section One highlights the critical role surveillance plays in public health and it provides an overview of the current International Health Regulations (2005) in addition to successes and challenges in infectious disease eradication. Section Two describes surveillance systems based on logical program areas such as foodborne illnesses, vector-borne diseases, sexually transmitted diseases, viral hepatitis healthcare and transplantation associated infections. Attention is devoted to programs for monitoring unexplained deaths, agents of bioterrorism, mass gatherings, and disease associated with international travel. Sections Three and Four explore the uses of the Internet and wireless technologies to advance infectious disease surveillance in various settings with emphasis on best practices based on deployed systems. They also address molecular laboratory methods, and statistical and geospatial analysis, and evaluation of systems for early epidemic detection. Sections Five and Six discuss legal and ethical considerations, communication strategies and applied epidemiology-training programs. The rest of the chapters offer public-private partnerships, as well lessons from the 2009-2010 H1N1 influenza pandemic and future directions for infectious disease surveillance.

From Victorian anxieties about syphilis to the current hysteria over herpes and AIDS, the history of venereal disease in America forces us to examine social attitudes as well as purely medical concerns. In No Magic Bullet, Allan M. Brandt recounts the various medical, military, and public health responses that have arisen over the years--a broad spectrum that ranges from the incarceration of prostitutes during World War I to the establishment of required premarital blood tests. Brandt demonstrates that Americans' concerns about venereal disease have centered around a set of social and cultural values related to sexuality, gender, ethnicity, and class. At the heart of our efforts to combat these infections, he argues, has been the tendency to view venereal disease as both a punishment for sexual misconduct and an index of social decay. This tension between medical and moral approaches has significantly impeded efforts to develop "magic bullets"--drugs that would rid us of the disease--as well as effective policies for controlling the infections' spread. In this 35th anniversary edition of No Magic Bullet, Brandt reflects on recent scholarship, the persistence of sexually transmitted diseases, and the trajectory of the HIV epidemic, as they have informed contemporary conceptions of biomedicine and global health.

Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective packages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.