title: New challenges in infectious diseases.
abstract: Predicting the behaviour of infectious disease is particularly difficult because it is inextricably linked with microbial mutation and the potentially rapid expression of that change. Nevertheless, the dominant issue in infectious disease in New Zealand into the 1990s, and perhaps in all medicine, is the impact of the spread of HIV infection. Many other new agents and new causes for old familiar syndromes have also been unearthed in recent years and will continue to be so. We need to continue to explore aetiology, mechanisms of prevention and treatment for both the old and the new infectious diseases. Optimal vaccine delivery to those who most need it is a continuing challenge. New vaccines coming will complicate this. In treatment there has been a refreshing shift from chemotherapy to alternative approaches, perhaps summarised as attempts to enhance host immunity. All these treatments will need to be evaluated, and potentially uncomfortable cost benefit decisions made about the relative needs of all these competing costs in our health service. There are enormous research implications in this for basic scientists, laboratory microbiologists, infectious disease physicians and those in community health.
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000453:epidemiology; D003154:Community Medicine / Q000639:trends; D005544:Forecasting; D006801:Humans; D017053:Infection Control; D007239:Infections / Q000209:etiology; D009520:New Zealand; D011634:Public Health / Q000639:trends*; D014611:Vaccination