Emerging Infectious Diseases - EAGOSH › ... › diseases › ...diseases_may05.pdf · •...

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Emerging Infectious Diseases

Emerging Infectious Emerging Infectious DiseasesDiseases

RenRenéé GottschalkGottschalk

Competence Center Highly Infectious DiseasesCompetence Center Highly Infectious DiseasesState of State of HesseHesse

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Quelle: APQuelle: AP

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≈≈ 4.500 4.500 yearsyears

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Emerging Infectious DiseasesEmerging Infectious Diseases• Pathogens that had never before infected humans

Ebola-VirusHIVInfluenza A Virus SubtypesSARS-CoV

• Pathogens spreading into new geographical areasWest Nile-Virus

• Newly discovered pathogens causing previously known diseases

Kaposi Sarcoma associated Herpes-Virus

• Pathogens with increasing significance due to increasing numbers of immunocompromised patients

Cytomegaly-Virus

• Pathogens causing increasing numbers of infectionsDengue-Virus

• Re-emerging pathogensYersinia pestis (Plague)Smallpox-Virus ???

• Pathogens that had never before infected humansEbola-VirusHIVInfluenza A Virus SubtypesSARS-CoV

• Pathogens spreading into new geographical areasWest Nile-Virus

• Newly discovered pathogens causing previously known diseases

Kaposi Sarcoma associated Herpes-Virus

• Pathogens with increasing significance due to increasing numbers of immunocompromised patients

Cytomegaly-Virus

• Pathogens causing increasing numbers of infectionsDengue-Virus

• Re-emerging pathogensYersinia pestis (Plague)Smallpox-Virus ???

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Emerging Infectious DiseasesEmerging Infectious Diseases

Quelle: The Journal of Clinical Investigation Volume 113 Number 6 March 2004 ��

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Worldwide Distribution ofViral-Hemorrhagic FeverWorldwide Distribution ofViral-Hemorrhagic Fever

Yellow-FeverJunin-FeverMachupo-FeverSabia-FeverHanta-FeverDengue-Fever

YellowYellow--FeverFeverJuninJunin--FeverFeverMachupoMachupo--FeverFeverSabiaSabia--FeverFeverHantaHanta--FeverFeverDengueDengue--FeverFever

Hanta-FeverHantaHanta--FeverFeverHanta-FeverCrimean-Congo-FeverHantaHanta--FeverFeverCrimeanCrimean--CongoCongo--FeverFever

Dengue-FeverHanta-FeverCrimean-Congo-Fever

DengueDengue--FeverFeverHantaHanta--FeverFeverCrimeanCrimean--CongoCongo--FeverFever

Rift Valley-FeverLassa-FeverEbola-FeverYellow-FeverCrimean-Congo-FeverDengue-Fever

RiftRift ValleyValley--FeverFeverLassaLassa--FeverFeverEbolaEbola--FeverFeverYellowYellow--FeverFeverCrimeanCrimean--CongoCongo--FeverFeverDengueDengue--FeverFever

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YearYear EmergingEmerging AgentAgent

2XXX2XXX

YearYear EmergingEmerging AgentAgent

19691969 LassaLassa--VirusVirus

CryptosporidiumCryptosporidium parvumparvum

LegionellaLegionella pneumoniapneumonia

EbolaEbola--VirusVirus

19771977 CampylobacterCampylobacter jejunijejuni

19801980 Human Human TT--LymphotropicLymphotropic--VirusVirus

EscherichiaEscherichia colicoli O157:H7O157:H7

BorreliaBorrelia burgdorferiburgdorferi

HTLV2HTLV2--VirusVirus

19831983 Human Human ImmundeficiencyImmundeficiency--VirusVirus

Hepatitis EHepatitis E--VirusVirus

Human HerpesHuman Herpes--Virus 6Virus 6

19891989 Hepatitis CHepatitis C--VirusVirus

19881988

19761976

19821982

19911991 GuanaritoGuanarito--VirusVirus

19921992 VibrioVibrio choleracholera O139O139

19931993 SinSin NombreNombre--VirusVirus

SabiaSabia--VirusVirus

HendraHendra--VirusVirus

19951995 Kaposi Kaposi SarcomaSarcoma Virus (HHV8)Virus (HHV8)

CreutzfeldCreutzfeld--JakobJakob--DiseaseDisease

Australien Bat Australien Bat LyssaLyssa--VirusVirus

19971997 AvianAvian FluFlu (H5N1)(H5N1)--VirusVirus

19991999 NipahNipah--VirusVirus

20022002 GarissaGarissa--VirusVirus

20032003 SARSSARS--CoVCoV

19941994

19961996

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• 09/94 CH Côte d'Ivoire Ebola (EBO-CI) f, 34• 04/96 CH Brazil Yellowfever m, 53 †• 09/97 D Ghana Lassafever m, 37 †• 12/97 GB Zimbabwe Crimean-Congo HF f, 78 †• 08/99 D Côte d'Ivoire Yellowfever m, 40 †• 01/00 D Ghana, Burkina Lassafever f, 23 †

Faso, Côte d'Ivoire• 03/00 GB Sierra Leone Lassafever m, 50 †• 03/00 D Nigeria Lassafever m, 57 †• 06/00 NL Sierra Leone Lassafever m, 48 †• 12/00 D Kenya HSV-1 m, 47 †• 07/01 - Kosovo Crimean-Congo HF 69, 6 †• 07/03 RUS Russia Crimean-Congo HF 14, 2 †• 04/05 I Angola Marburg Fever (susp.)

•• 09/9409/94 CHCH Côte Côte d'Ivoired'Ivoire Ebola (EBOEbola (EBO--CI) CI) f, 34f, 34•• 04/9604/96 CHCH BrazilBrazil YellowfeverYellowfever m, 53 m, 53 ††•• 09/9709/97 DD GhanaGhana LassafeverLassafever m, 37 m, 37 ††•• 12/9712/97 GBGB ZimbabweZimbabwe CrimeanCrimean--CongoCongo HF HF ff, 78 , 78 ††•• 08/9908/99 DD Côte Côte d'Ivoired'Ivoire YellowfeverYellowfever m, 40 m, 40 ††•• 01/0001/00 DD Ghana, BurkinaGhana, Burkina LassafeverLassafever f, 23 f, 23 ††

Faso, Côte Faso, Côte d'Ivoired'Ivoire•• 03/0003/00 GBGB Sierra LeoneSierra Leone LassafeverLassafever m, 50 m, 50 ††•• 03/0003/00 DD NigeriaNigeria LassafeverLassafever m, 57 m, 57 ††•• 06/0006/00 NLNL Sierra LeoneSierra Leone LassafeverLassafever m, 48 m, 48 ††•• 12/0012/00 DD KenyaKenya HSVHSV--1 1 m, 47 m, 47 ††•• 07/0107/01 -- KosovoKosovo CrimeanCrimean--CongoCongo HF HF 69, 6 69, 6 ††•• 07/0307/03 RUSRUS RussiaRussia CrimeanCrimean--CongoCongo HF HF 14, 2 14, 2 ††•• 04/0504/05 II AngolaAngola Marburg Marburg FeverFever (susp.)(susp.)

Imported Cases of VHF in EuropeImported Cases of VHF in Europe

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LassaLassa

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Marburg-/EbolavirusMarburg-/Ebolavirus

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Marburg-Virus 1967Marburg-Virus 1967

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EbolaEbola

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EbolaEbola

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Case Fatality RatesEbola-/Marburg-Epidemics

Case Fatality RatesEbola-/Marburg-Epidemics

0

10

20

30

40

50

60

70

80

90

100

5353

Sudan1976

8888

Zaire1976

6565

Sudan1979

9292

Zaire1995

7070

Gabun1996

CFR

(%)

SourceSource: WHO: WHO

5353

Uganda2001

8989

DRC2002

8383

DRC2003

9292

Angola2005

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West Nile Virus (WNV)West Nile Virus (WNV)

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West Nile Virus in the United States, 1999 - 2002

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West Nile Virus in the United States, 2002

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West Nile Virus in the United States, 2004

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Quelle: The Journal of Clinical Investigation Volume 113 Number 8 April 2004

WNV: TransmissionWNV: Transmission

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�� CulexCulex restuansrestuans

CulexCulex pipienspipiens

AedesAedes vexansvexans

19991999

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AedesAedes vexansvexansCulex Culex pipienspipiensCx Cx restuansrestuans

19991999

AeAe vexansvexansAnopheles Anopheles punctipennispunctipennis

CxCx pipienspipiensCulisetaCuliseta melanuramelanura

OchlerotatusOchlerotatus cantatorcantatorOcOc japonicusjaponicusOcOc triseriatustriseriatus

PsorophoraPsorophora feroxferox

20002000

AeAe albopictusalbopictusAeAe cinereuscinereusAeAe vexansvexans

An An punctipennispunctipennisAn An quadrimaculatusquadrimaculatus

CoquillettidiaCoquillettidia perturbansperturbansCxCx nigripalpusnigripalpus

CxCx pipienspipiensCxCx quinquefasciatusquinquefasciatus

CxCx restuansrestuansCxCx salinariussalinariusCs Cs melanuramelanura

OcOc canadensiscanadensisOcOc cantatorcantator

OcOc japonicusjaponicusOcOc sollicitanssollicitansOcOc trivattatustrivattatus

OrthopodomyiaOrthopodomyia signiferasigniferaPsPs columbiaecolumbiae

PsPs feroxferoxUranotaeniaUranotaenia sapphirinasapphirina

20012001

AeAe aegyptiaegyptiAeAe albopictusalbopictus

AeAe vexansvexansAn An atroposatroposAn An barberibarberi

An An crucianscrucians//bradleyibradleyiAn An punctipennispunctipennis

An An quadrimaculatusquadrimaculatusAn An walkeriwalkeri

CqCq perturbansperturbansCxCx erraticuserraticus

CxCx nigripalpusnigripalpusCxCx pipienspipiens

CxCx quinquefasciatusquinquefasciatusCxCx restuansrestuansCxCx salinariussalinariusCxCx tarsalistarsalisCxCx territansterritansCs Cs inornatainornata

Cs Cs melanuramelanuraDeinoceritesDeinocerites cancercancer

OcOc atropalpusatropalpusOcOc atlanticusatlanticus//tormentortormentor

OcOc canadensiscanadensisOcOc cantatorcantator

OcOc japonicusjaponicusOcOc sollicitanssollicitans

OcOc taeniorhynchustaeniorhynchusOcOc triseriatustriseriatusOcOc trivattatustrivattatusOrOr signiferasignifera

PsPs ciliataciliataPsPs columbiaecolumbiae

PsPs feroxferoxUr Ur sapphirinasapphirina

20022002

AeAe aegyptiaegyptiAeAe albopictusalbopictusAeAe cinereuscinereusAeAe vexansvexansAn An atroposatroposAn An barberibarberi

An An crucianscrucians//bradleyibradleyiAn An punctipennispunctipennis

An An quadrimaculatusquadrimaculatusAn An walkeriwalkeri

CqCq perturbansperturbansCxCx erraticuserraticus

CxCx nigripalpusnigripalpusCxCx pipienspipiens

CxCx quinquefasciatusquinquefasciatusCxCx restuansrestuansCxCx salinariussalinariusCxCx tarsalistarsalisCxCx territansterritansCs Cs inornatainornataCs Cs melanuramelanuraDe De cancercancer

OcOc atropalpusatropalpusOcOc atlanticusatlanticus//tormentortormentor

OcOc canadensiscanadensisOcOc cantatorcantatorOcOc dorsalisdorsalis

OcOc infirmatusinfirmatusOcOc fitchiifitchii

OcOc japonicusjaponicusOcOc provocansprovocansOcOc sollicitanssollicitansOcOc sticticussticticus

OcOc stimulansstimulansOcOc taeniorhynchustaeniorhynchus

OcOc triseriatustriseriatusOcOc trivattatustrivattatusOrOr signiferasignifera

PsPs ciliataciliataPsPs columbiaecolumbiae

PsPs feroxferoxPsPs howardiihowardii

Ur Ur sapphirinasapphirina

20032003

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MonkeypoxMonkeypox

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MonkeypoxMonkeypox

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Ultimately, whenever novel infectious agents Ultimately, whenever novel infectious agents appear suddenly, it is probably inevitable that appear suddenly, it is probably inevitable that

there will be speculations and rumors: that there will be speculations and rumors: that they were designed in they were designed in biowarfarebiowarfare laboratories laboratories

or emerged from biomedical research (as or emerged from biomedical research (as was argued for HIV), that they came from was argued for HIV), that they came from

space (as suggested for SARS), or that they space (as suggested for SARS), or that they represent a bioterrorist attack. However, represent a bioterrorist attack. However,

reality is more banal but nevertheless painful: reality is more banal but nevertheless painful: Nature itself is the best bioreactor for Nature itself is the best bioreactor for

apocalyptic biological agents and, through apocalyptic biological agents and, through evolution, has at the same time developed evolution, has at the same time developed the best defense strategies against themthe best defense strategies against them……

Gottschalk & Preiser 2005Gottschalk & Preiser 2005

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Contact:ContactContact::

[email protected]@stadt--frankfurt.defrankfurt.de

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