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By Peter Washer (auth.)

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By 1991, as TB had reached epidemic levels in NYC, the media also began to report that a drug-resistant strain of TB was causing deaths in New York’s prisons. By then, multi-drug-resistant tuberculosis (MDR-TB) was already present in 13 states of the USA and in NYC (Reichman & Tanne, 2002). The cost to NYC of dealing with MDR-TB ran into millions of dollars and MDR-TB served as a catalyst, forcing restructuring of the health bureaucracy and new funding to TB programmes. Yet even after an announcement in 1990 by the NYC authorities of a dramatic rise in TB incidence, the George Bush Snr.

The development of antimicrobial drugs and vaccinations that followed in the early twentieth century built on these foundations. One of the first benefits from the discoveries of bacteriology was their practical application by Joseph Lister, then a surgeon in Glasgow, who sought to apply Pasteur’s discoveries of germ theory to his own field. Through his experiments with carbolic acid solution swabbed on wounds, published in The Lancet in 1867, Lister found that he could markedly reduced the incidence of gangrene (Winslow, 1943).

In most people cryptosporidiosis causes self-limiting diarrhoea; however, the elderly, people with HIV and cancer, or those on immunosuppressive treatments, were more vulnerable, and they were more likely to have serious consequences when they contracted the infection (Hewitt & Schmid, 2002). Another newly identified food-borne pathogen was Cyclosporidium, which had first been described as causing severe diarrhoea in humans in 1979. Identification of cyclospora began to be made more often after acid-fast staining was modified in the mid-1980s, facilitating its detection.

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