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Emerging and Re-emerging Infectious Diseases

Emerging and Re-emerging Infectious Diseases. Samantha Rosenthal, MPH, PhD Candidate. WNV. Monkeypox from Prairie Dogs. Are infectious diseases emerging more than before?. Institute of Medicine 1992 Report on Emerging Infections.

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Emerging and Re-emerging Infectious Diseases

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  1. Emerging and Re-emerging Infectious Diseases Samantha Rosenthal, MPH, PhD Candidate

  2. WNV

  3. Monkeypox from Prairie Dogs

  4. Are infectious diseases emerging more than before?

  5. Institute of Medicine 1992 Report on Emerging Infections Defined emerging infections as: “New, reemerging or drug-resistant infections whose incidence in humans has increased within the past two decades or whose incidence threatens to increase in the near future.”

  6. Major Factors Contributing to Emerging Infections: 1992 1. Human demographics and behavior 2. Technology and Industry • Economic development and land use 4. International travel and commerce 5. Microbial adaptation and change 6. Breakdown of public health measures Institute of Medicine Report, 1992

  7. More Factors Contributing to Emerging Infections: 2003 7. Human vulnerability • Climate and weather • Changing ecosystems • Poverty and social inequality • War and famine • Lack of political will • Intent to harm Institute of Medicine Report, 2003

  8. Emerging Infections:Human Demographics, Behavior, Vulnerability • More people, more crowding • Changing sexual mores (HIV, STDs) • Injection drug use (HIV, Hepatitis C) • Changing eating habits (foodborne infections) • More populations with weakened immune system: elderly, HIV/AIDS, cancer patients and survivors, persons taking antibiotics and other drugs

  9. Emerging Infections:Technology and Industry • Mass food production (Campylobacter, E.coli O157:H7, etc…) • Use of antibiotics in food animals (antibiotic-resistant bacteria) • New drugs for humans (prolonging vulnerability)

  10. Emerging Infections:Economic Development, Land Use, Changing Ecosystems • Changing ecology influencing waterborne, vectorborne transmission (e.g. dams, deforestation) • Contamination of watershed areas by cattle (Cryptosporidium) • More exposure to wild animals and vectors (Lyme disease)

  11. Emerging Infections:International Travel and Commerce • Persons infected with an exotic disease anywhere in the world can be into major US city within hours (SARS, VHF,…) • Foods from other countries imported routinely into US (Cyclospora,….) • Vectors hitchhiking on imported products (Asian tiger mosquitoes on lucky bamboos,….)

  12. Speed of Global Travel in Relation to World Population Growth From: Murphy and Nathanson. Semin. Virol. 5, 87, 1994 CDC

  13. Emerging Infections:Microbial Adaptation and Change • Increased antibiotic resistance with increased use of antibiotics in humans and food animals (VRE, VRSA, penicillin- and macrolide-resistant Strep pneumonia, multidrug-resistant Salmonella, TB,….) • Jumping species from animals to humans (avian influenza, HIV, SARS?)

  14. Emerging Infections:Poverty, Social Inequality, Breakdown of Public Health Measures • Lack of basic hygienic infrastructure (safe water, foods) • Inadequate vaccinations (measles, diphtheria) • Discontinued mosquito control efforts (dengue, malaria) • Lack of monitoring and reporting (SARS

  15. Emerging Infections:Intent to Harm • Bioterrorism: Anthrax in US 2001 • Bio-Crimes: Salmonella in OR, Shigella in TX. • Potential agents: Smallpox, Botulism toxin, Plague, Tularemia, ….

  16. CDC

  17. Prevention of Emerging Infectious Diseases Will Require Action in Each of These Areas Surveillance and Response Applied Research Infrastructure and Training Prevention and Control CDC

  18. Preventing EmergingInfectious Diseases: More to Do Enhance communication: locally, regionally, nationally, globally Increase global collaboration Share technical expertise and resources Provide training and infrastructure support globally Ensure political support Ensure judicious use of antibiotics Vaccines for all

  19. Rosenthal SR, Ostfeld RS, McGarvey ST, Lurie MN, and Smith KF. The Overlooked Pathways to Infectious Disease Emergence. Emerging Infectious Diseases; under review.

  20. Rosenthal SR, Ostfeld RS, McGarvey ST, Lurie MN, and Smith KF. The Overlooked Pathways to Infectious Disease Emergence. Emerging Infectious Diseases; under review.

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  22. Questions?

  23. Preventing EmergingInfectious Diseases Surveillance and Response Detect, investigate, and monitor emerging pathogens, the diseases they cause, and the factors influencing their emergence, and respond to problems as they are identified. CDC

  24. Preventing EmergingInfectious Diseases Applied Research Integrate laboratory science and epidemiology to increase the effectiveness of public health practice. CDC

  25. Preventing EmergingInfectious Diseases Infrastructure and Training Strengthen public health infrastructures to support surveillance, response, and research and to implement prevention and control programs. Provide the public health work force with the knowledge and tools it needs. CDC

  26. Preventing EmergingInfectious Diseases Prevention and Control Ensure prompt implementation of prevention strategies and enhance communication of public health information about emerging diseases. CDC

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