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Since the Age of Enlightenment, efforts to prevent disease in Europe have traditionally upheld an acceptably good standard. An implicit factor was the charitable attitude of many physicians and health workers as well as the drive to create the organizational and educational background necessary for the principles of primary prevention to be introduced into actual practice. The Institute of Hygiene of the Czech Faculty of Medicine, now known as the Institute of Hygiene and Epidemiology, 1st Faculty of Medicine at Charles University in Prague, was founded in 1 897. An analogical institute at the German Faculty of Medicine in Prague was founded at an earlier date, in 1 884.An important milestone in the development of regional efforts in the field of public health was the establishment of the National Institute of Public Health in 1925. The prominent figures in this process had largely acquired their expertise in the USA; hence a modern school of epidemiology was formed, among its leading lights the eminent Karel Raska, who became the Director of the Division of Communicable Diseases at the WHO Headquarters in Geneva and was one of the authors and managers of the smallpox eradication programme. During the post-war period, leading specialists from Czechoslovakia were trained in epidemiology at the London School of Hygiene and Tropical Medicine, a contact that has remained to this day.Anetwork of regional public health stations, based on the Soviet model, was set up in 1953. This was followed by the founding of Prague's 3rd Faculty of Medicine at Charles University in 1953.These days, what we miss most is an expert critical analysis of the successes, failures or potential errors of the public health service over the past six decades, and to even the score are some examples of the various practical applications of our preventive medicine, specifically in the field of epidemiology.The post-war period involved a campaign against venereal diseases, and decrease in incidence of tuberculosis and, with the much underestimated and close cooperation of the veterinary service, brucellosis.The former Czechoslovakia was the first country worldwide to start mass anti-polio vaccinations in the early 1960's, thus becoming a precedent for other states, and Czechoslovak doctors participated in the first ever eradication of smallpox; neither of these facts were ever fully appreciated both on the national and international level, although the eradication of smallpox as such was a global event that deserved the Nobel Prize Award.In the field of non-infectious diseases, there was an extensive epidemiological study of endemic goitre in the late 1 940's and early 1950's, performed by our clinical endocrinologists. The standards presented therein continue to mirror the relatively strict qualitative criteria of current epidemiological studies and have led to the systematic iodination of salt; likewise, this country was among the first to introduce fluoridation of drinking water to prevent caries, again on the basis of a thorough epidemiological study.Unfortunately, the frequent socio-political changes in this country throughout the last century undeniably disrupted the ongoing system of prevention. Accordingly, the present primary prevention system must adapt to existing social and economic change; much has been achieved, but a backup to the complex structure of existing primary prevention is urgently required.Czech public health is rooted in the German school founded by Max von Pettenkofer and Robert Koch. The Czech school enriched its predecessor with experimental aspects by providing safe drinking water via Kabrhel's Index and, later, through recognition of the pathophysiological factors expounded in the works of Teissinger, who by the mid-1 930's had laid the foundations of present-day biological exposure tests or biomarkers of exposure to environmental toxicants. Several years after the last London smog episode, when the best available health indicator was recorded mortality, Kapalin and Symon were demonstrating adverse environmental effects on growth changes and haematological parameters in exposed children; in this they contributed to the application of more sensitive and sophisticated indicators of health status. …

The Public Health Service in the Czech and Slovak Republics Celebrates its 60th Anniversary