A state of disease endemicity in which disease transmission has been stopped but the agent persists is -

Ans. is 'b' i.e., Elimination o State of disease endemicity in which disease transmission has been stopped (zero incidence) but agent persists is best defined by the term 'Elimination'. o I think following three closely related terms require specific mention here :? i) Disease control o In disease control, the disease "agent" is permitted to persist in the community at a level where it ceases to be a public health problem according to the tolerance of the local population. o A state of equilibrium becomes established between the disease agent, host and environment components of the disease process. ii) Disease elimination o Between disease control and eradication, an intermediate goal has been described, called "regional elimination". o The term elimination is used to describe complete interruption of transmission of disease in a defined geographical area. o Elimination is a "geographical term" --> can be used for a country or region. o Regional elimination is an impoant precursor of eradication. o Three diseases have been eliminated in India -4 Dracunculiasis, Leprosy, Yaws. o Next diseases likely to be eliminated from India --> Kala-azar (because of wonder drug for kala-azar, i.e. milte-fosine), neonatal tetanus, poliomyelitis, lymphatic .filariasis. iii)Disease eradication o Eradication implies termination of all transmission of infection by extermination of infectious agent. o It is an absolute process, i.e. all or none phenomenon. o It literally means "tearing out by roots". o Eradication is a "global term" -4 used only cessation of infection from the whole world. o Smallpox is the only disease that has been eradicated. o Other diseases which are candidates for global eradication ---> Polio, measles, dracunculiasis, diphtheria. Note -Though eradication is global term, sometimes it is used for a country also (where elimination should be used) -"Small pox and Guinea worm have been eradicated from India".