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mmmmm. Infectious Diseases. mmmmm. CHP400 COMMUNITY HEALTH PROGRAM-II. Emerging and Re-emerging Infectious Diseases. mmmmm. Mohamed M. B. Alnoor. mmmmm. Emerging and Re-emerging. mmmmm. Infectious Diseases. mmmmm. Contents. mmmmm. Definitions. Emerging Infections since 1973. mmmmm.

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  1. mmmmm Infectious Diseases mmmmm CHP400 COMMUNITY HEALTH PROGRAM-II Emerging and Re-emergingInfectious Diseases mmmmm Mohamed M. B. Alnoor mmmmm

  2. Emerging and Re-emerging mmmmm Infectious Diseases mmmmm Contents mmmmm • Definitions • Emerging Infections since 1973 mmmmm mmmmm • Major factors contributing to the • emergence of infectious diseases

  3. Emerging and Re-emerging mmmmm Infectious Diseases mmmmm Definitions mmmmm • Emerging Infectious Diseases “New, reemerging or drug-resistant infections whose incidence in humans has increased in the past two decades or threatens to increase in the near future.” mmmmm mmmmm

  4. Emerging and Re-emerging mmmmm Infectious Diseases mmmmm Definitions mmmmm • Emerging Infectious Diseases • Emerging/New Newly appeared in a population. • Re-emerging/Resurging mmmmm mmmmm Incidence increased over20 years or threatens to increase soon. • Deliberately emerging: • Developed for nefarious use

  5. Emerging and Re-emerging mmmmm Infectious Diseases mmmmm W H Y ????? mmmmm After great advances in medical research, antimicrobial drug discovery, technology development, improvement in sanitation.. WHY are microbes still posing such a problem!!?? mmmmm mmmmm

  6. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm قال رسول الله صلى الله عليه وسلم: «لم تظهر الفاحشة في قوم قط حتى يعلنوا بها إلا فشا فيهم الطاعون والأوجاع التي لم تكن مضت في أسلافهم الذين مضوا .» رواه ابن ماجه والحاكم mmmmm mmmmm

  7. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 1. Ecological changes & agricultural development 2. Human demographics and behavior 3. Technology and industry 4. Economic development and land use 5. International travel and commerce 6. Microbial adaptation and change 7.Breakdown of public health measures mmmmm mmmmm

  8. Emerging and Re-emerging mmmmm Infectious Diseases More Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 8. Human vulnerability 9. Climate and weather 10. Poverty and social inequality 11. War and famine 12. Lack of political will 13. Intent to harm mmmmm mmmmm

  9. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 1. Ecology & agriculture Placing people in contact with a reservoir of an infection (zoonotic or arthropod-borne) either by: mmmmm mmmmm • Increasing proximity • Changing conditions microbe natural host

  10. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 1. Ecology & agriculture Reforestation in USA Increased the number of deer & deer ticks mmmmm mmmmm Increased Human contact with deers Deer tick Human affection by Lyme disease

  11. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 1. Ecology & agriculture Conversion of grassland to maise cultivation mmmmm mmmmm Rodent Rodents & people come together Argentine Haemorrhagic fever in humans

  12. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 1. Ecology & agriculture C h i n a PigFarm Duck farm mmmmm mmmmm Mixing vessels Influenza Influenza Influenza

  13. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 1. Ecology & agriculture Increased Rice cultivation in South East Asia. Field mouse mmmmm mmmmm Increased human contact with Field mouse Introduction of Korean haemorrhagic fever in Humans

  14. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 2. Human demographics and behavior Inflation of population size Insufficient infrastructures mmmmm mmmmm Use open containers for water Breading mosquitos Dengue fever in Asia

  15. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 2. Human demographics and behavior • Urbanization • More people concentrated in cities-often without adequate infrastructure • Increases in the elderly populations mmmmm mmmmm

  16. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 2. Human demographics and behavior Urbanization • Urbanization • Increases in children in daycare: working woman with kids • under 5 was 30% in 1970, • became 75% in 2000. mmmmm mmmmm • Fast paced Lifestyles- increase in convenience items and more stress. • High-risk behavior- Drug use and unprotected sex

  17. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 3. Technology and industry • Modern mass production increases the chance of accidental contamination and amplifies the effect of such contamination. -Contamination of hamburger meat by E.coli strains causing haemolyticuraemic syndrome. -Feeding cattle by byproducts of sheep causing bovine spongiform encephalitis. mmmmm mmmmm

  18. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 3. Technology and industry • New diagnostics lead to identification of previously unknown microbes for known diseases e.g. Helicobacter pylori and • peptic ulcer. • Medical technology • - People living longer, but have weaker • immune systems. • - Blood & organ transplantation transmit infections. mmmmm mmmmm

  19. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 4. Economic development and land use • Changing ecology influencing waterborne, vectorborne disease transmission (e.g. dams, deforestation) • More exposure to wild animals and vectors (Lyme disease, ehrlichiosis, babesiosis, HPS,…) mmmmm mmmmm

  20. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 5. International travel and commerce • Circumnavigation: 365 days, now 36 hours • International travelers: 400 millions • Increased incidence of both Tuberculosis and Influenza transmission on long flights mmmmm mmmmm • Transportation of products • - Rapid transport of disease harboring fresh products. • - Transport of livestock facilitates transport of viruses and arthropods (esp. ticks)

  21. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 5. International travel and commerce • Travel and HIV/AIDS. • Cholera and Hajj. • Historically: mmmmm mmmmm - Silk route and plague. - Slaves trade and yellow fever. - Migration to new world and smallpox.

  22. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 6. Microbial adaptation and change • Lateral transfer is common: shown by genome sequencing. • Rapid adaptation: due to high mutation rates in RNA viruses. • Rapid build up of rare mutations: because of quick reproduction mmmmm mmmmm • Resistance: Antimicrobials used in livestock growth enhancement and over-prescription of antimicrobials by doctors.

  23. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 7. Breakdown of public health measures • Decrease in chlorine in water supplies lead to rapid spread of cholera in South America. mmmmm mmmmm • Non functioning water plant in Wisconsin, USA lead to outbreak of waterborne cryptosporidium

  24. Emerging and Re-emerging mmmmm Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases mmmmm mmmmm 7. Breakdown of public health measures • Inadequate vaccinations and Diphtheria in former USSR independent countries. • Discontinued mosquito control efforts and dengue and re-emergence of malaria. mmmmm mmmmm

  25. Emerging and Re-emerging mmmmm Infectious Diseases mmmmm Summary mmmmm • Infectious diseases will always be • there • New infectious diseases will always occur mmmmm mmmmm • Man and his behavior are the main • reasons

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