Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall...y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati...ons.
These Guidelines, specifically tailored to small water supplies, build on over 60 years of guidance by the World Health Organization (WHO) on drinking-water quality and safety. They focus on establishing drinking-water quality regulations and standards that are health based and context appropriate; on proactively managing risks through water safety planning and sanitary inspections; and on carrying out independent surveillance. The guidance is intended primarily for decision-makers at national and subnational levels with responsibility for developing regulatory frameworks and support programmes related to these activities. Other stakeholders involved in water service provision will also benefit from the guidance in this document.
Designed to be practical and accessible, these Guidelines offer clear guidance that is rooted in the principle of progressive improvement. State-of-the-art recommendations and implementation guidance are provided, drawn from a comprehensive evidence review and established good practices. Additionally, case examples are provided from countries and areas around the world to demonstrate how the guidance in this publication has been implemented in practice in a wide variety of contexts.
Together with WHO’s 2024 Sanitary inspection packages – a supporting tool for the Guidelines for drinking-water quality: small water supplies, these Guidelines update and supersede WHO’s 1997 Guidelines for drinking-water quality. Volume 3: surveillance and control of community supplies. Key changes to this updated publication include a greater focus on preventive risk management and a broader range of small water supplies covered, including those managed by households, communities and professional entities.
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The Guidelines for drinking-water quality: small water supplies have been developed to address the needs and opportunities associated with small supplies to facilitate progressive improvement towards safe and sustainable drinking-water services for all. These Guidelines are based on the principal re...commendation in the World Health Organization’s Guidelines for drinking-water quality, and they provide guidance on applying that recommendation to small water supplies in particular. These Guidelines aim to help governments and practitioners improve the safety of drinking-water delivered through small supplies.
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The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases..., injuries and risk factors in more than 200 countries and territories and at the subnational level in more than 20 countries. The GBD is now produced by an active collaboration of over 8,000 scientists and analysts from more than 150 countries. With each GBD iteration, the data, data processing and methods used for data synthesis have evolved, with the goal of enhancing transparency and comparability of measurements and communicating various sources of uncertainty. The GBD has many limitations, but it remains a dynamic, iterative and rigorous attempt to provide meaningful health measurement to a wide range of stakeholders.
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt...ing a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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Approximately 80% of the 463 million adults worldwide with diabetes live in low-income and middle-income countries (LMICs). A major obstacle to designing evidence-based policies to improve diabetes outcomes in LMICs is the scarce availability of nationally representative data on the current patterns... of treatment coverage. The objectives of this study were to estimate the proportion of adults with diabetes in LMICs who receive coverage of recommended pharmacological and non-pharmacological diabetes treatment; and to describe country-level and individual-level characteristics that are associated with treatment.
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The purpose of this workbook is to assist ministries of health, health managers and practitioners in engaging with the private sector on delivery of quality maternal, newborn and child health (MNCH) services in lower- and middle-income countries. Private health care is one of the fastest growing seg...ments of the health-care system in lower- and middle-income countries, and private providers are an important source of health care. To accelerate progress to reach the Sustainable Development Goals for ending preventable maternal, newborn and child deaths, it is critical that whole health system organizations invest not only in increasing coverage of interventions, but also in quality. The audience for the workbook is those who are involved with organizing and implementing processes for engaging the private sector in delivery of quality MNCH services.
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Through technical consultations with countries and partners, WHO has led the development of Preparedness and Resilience for Emerging Threats Module 1: Planning for respiratory pathogen pandemics. Version 1.0. The Module, currently available as an advanced draft, builds on previous pandemic lessons a...nd guidance, and has the following new elements:
It presents an integrated and efficient respiratory pathogen pandemic planning approach covering both novel pathogens and those known to have pandemic potential;
It enables coherence in addressing pathogen-agnostic and pathogen-specific elements for better preparedness;
It gives an organizing framework including operational stages and triggers for escalation and de-escalation between pandemic preparedness and response periods;
It contextualizes 12 IHR (2005) core capacities within the five components of health emergency preparedness, response and resilience (HEPR), from the respiratory threats perspective; and
It describes the critical sectors for respiratory pathogen pandemic preparedness to trigger multisectoral collaboration.
WHO will finalize and publish this Module after a global technical meeting that will be held on 24-26 April 2023.
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The World Food Programme (WFP) has taken important steps to progress disability inclusion across its programming and operations. In late 2022, WFP commissioned the Nossal Institute, University of Melbourne in partnership with the Faculty of Psychology, Universitas Gadjah Mada, Indonesia to identify ...pathways for increasing disability inclusion in WFP’s emergency preparedness and response (EPR) programming.
The study explored WFP’s programming in Indonesia and the Philippines, including WFP’s advisory, technical assistance and service provision roles to government and partners and informed the development of this guide (see appendix 2). As general guidance on disability inclusion is increasingly available, the purpose of this guide is to contextualize disability inclusion in WFP’s emergency preparedness and response programming. The guide builds on core reference materials, such as the Inter-Agency Standing Committee (IASC) Guidelines on Inclusion of Persons with Disabilities in Humanitarian Action, 2019. While of wider relevance, this guide is directed at WFP’s EPR programming in Asia and the Pacific.
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To survive and thrive, children and adolescents need good health, adequate nutrition, security, safety and a supportive clean environment, opportunities for early learning and education, responsive relationships and connectedness, and opportunities for personal autonomy and self-realization. To prom...ote their health and wellbeing, children and adolescents need support from parents, families, communities, surrounding institutions, and an enabling environment. Scheduled well care visits provide a critical opportunity for support of individual children, adolescents, parents, caregivers and families promote health and wellbeing. This guidance on scheduled child and adolescent well-care visits is the first in a series of publications to support the operationalization of the comprehensive agenda for child and adolescent health and wellbeing. It provides guidance on what is required to strengthen health systems and services to ensure healthy growth and development of all children and adolescents, and to support their parents and caregivers.
The guidance focuses on scheduled routine contacts with providers to support children and adolescents in their growth and developmental trajectory, as well as their primary caregivers and families. It outlines the rationale and objectives of well care visits and proposes a minimum 17 scheduled visits; describes the expected tasks during a contact; provides age-specific content to be address during each contact; and proposes actions to build on and maximize existing opportunities and resources.
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For the global community to be able to achieve ambitious targets relating to the prevention and treatment of HIV, viral hepatitis and sexually transmitted infections (STIs), multiple types of medicines must be widely accessible to all affected populations in all countries.
The purpose of this rep...ort is to provide forecasts of future demand for medicines used in the fields of HIV, viral hepatitis and STIs. This report jointly presents medicines forecasts across three disease areas in recognition of the benefits of addressing HIV, viral hepatitis and STIs in a coordinated manner.
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This briefing note summarizes work undertaken by UN Women and WHO to inform the development of a module on violence against women 60 years and older that can be included in dedicated surveys on violence against women. It provides an overview of the challenges in the availability, measurement, and co...llection of data on violence against older women. It also makes recommendations to address some of the issues identified, with the aim of strengthening ongoing and future data collection efforts on violence against older women and increasing its availability.
Developed as part of the UN Women–WHO Global Joint Programme on Violence Against Women Data, this methodological briefing note is one in a series that aims to strengthen the measurement and data collection of violence against particular groups of women or specific aspects of violence against women. These briefing notes are meant for researchers, national statistics offices, and others involved in data collection on violence against women. They seek to contribute to strengthening the quality and availability of data on violence against women and enhance global, regional, and national level monitoring of progress towards its elimination.
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In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South
American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention
and rehabilitation (CVDPR). In the context of the imple...mentation of a regional and national health policy in Latin American
countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on
Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation
of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline
and adapt it to the national reality.
The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine
clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World
Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025.
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Unmet mental health needs in the Region of the Americas are a leading source of morbidity and mortality, which result in tremendous health, social, and economic consequences. The COVID-19 pandemic has exacerbated the mental health crisis in the Region, necessitating urgent action at the highest leve...ls of government and across sectors to build back better mental health now and for the future. This landmark report is the result of the PAHO High-Level Commission on Mental Health and COVID-19. It provides an analysis of the mental health situation in the Region, followed by a series of recommendations and corresponding actions to support countries in the Americas to prioritize and advance mental health using human rights- and equity-based approaches.
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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cance...r and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven ...percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%)
according to recent estimates.
Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers.
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This Guidance was developed in response to the increase in HIV-related human rights crises and the shrinking civic space for rights-related responses to HIV in recent years across the world. This document builds upon existing guidance documents, offering updated guidance for country-based United Nat...ions staff (United Nations Country Teams) and partners to use their respective mandates to coordinate effective responses to human rights-related crises within the framework of the Resident Coordinator system, the 2030 Agenda for Sustainable Development, global HIV and human rights strategies and frameworks.
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Global Development: Where Are We Now?
Today, we are facing a vital opportunity to change the profile of cardiovascular disease around the world.
The Millennium Development Goals (MDGs) are due to expire at the end of 2015, placing the cardiovascular health community in a unique position to shape t...he priorities for the next development agenda, and save millions of lives.
Despite its devastating impact on people of all ages, genders and ethnicities, cardiovascular disease was excluded from the Millennium Development Goals (MDGs), which were announced by the United Nations in 2000. That oversight was far-reaching;
for well over a decade, non-communicable diseases were omitted from the global funding agenda and deprioritized by other mechanisms. During that period of muted government action, the prevalence and burden of non-communicable diseases increased in every region of the world.
Fifteen years later, as the successors to the MDGs are being negotiated, we are in a position to call for the prioritization of cardiovascular disease on the forthcoming global development agenda. Once we have ensured that CVD is recognised at the global policy level, our efforts will turn to encouraging governments to honour their commitments on
the prevention and control of CVD.
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Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of children under 5 years old and
one-fi fth of adolescents are obese, while rates of overweight and obe...sity among adults approach 60%. Obesity is the major modifi able risk factor for diabetes.
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The document provides the NICE Quality Standard for managing Type 2 diabetes in adults (QS209). It outlines evidence-based recommendations for preventing Type 2 diabetes, structured education, continuous glucose monitoring (CGM), medication such as SGLT2 inhibitors, and regular care processes to mon...itor complications. The guidelines emphasize individualized care, addressing health inequalities, and improving patient outcomes. They are intended to support healthcare professionals and services in delivering high-quality, equitable diabetes care.
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