Selected topics related to occupational exposures - Part II. Occupational infectious diseases

The spectrum of occupational infectious disease is staggering. Occupational infectious disease continues to pose a significant public health challenge in many parts of the world. In other areas, most of these diseases have be en virtually eliminated or are well under control. A potential consequence of control is that, as the burden of suffering caused by many occupationall y acquired diseases decreases, the likelihood of accurately diagnosing occu pationally acquired disease when it does occur also decreases. Although man y of these diseases are uncommon enough that a health care provider may nev er see a particular infection, the potential for morbidity and death associ ated with some diseases requires an awareness of possible work-related infe ctions. For the purposes of this chapter, an occupational infectious disease is def ined as any infectious disease or illness for which occupation places a wor ker at increased risk of infection. The diseases have been broadly categori zed: diseases that affect those who work with people, diseases that affect those who work with animals, diseases that affect those who work outdoors, diseases that affect those who work in or around water, diseases that affec t those who work indoors, and diseases that affect travelers. Detailed info rmation regarding diagnosis and treatment has purposely been omitted. The r eader is urged to use current and reliable references and obtain appropriat e consultation when confronted with these diseases. Accurate diagnosis requires a thorough occupational history. A detailed des cription of the patient's workplace and occupational activities is essentia l. Other more specific questions such as contact with or exposure to potent ially infectious animal tissue or secretions, recent travel, outdoor activi ty, and insect bites may be helpful in some instances. In addition to the s tandard occupational history, it is crucial to develop a clear picture of t he development and time course of symptoms. The presence or absence of feve r (especially periodic fever), skin symptoms such as a rash or petechiae, a nd other symptoms peculiar to a specific disease may be extremely helpful i n establishing a diagnosis. As the world becomes smaller, the possibility of dealing with diseases with which we are unfamiliar increases. Many of the diseases discussed here are not considered classic occupational infectious diseases, but as workers tr avel further from home and new workers come from other parts of the world, the possibility of seeing these diseases increases considerably.