WELCOME
EMERGING AND RE-EMERGING INFECTIOUS
DISEASES
CAPT SHAHARUL
INTRODUCTIONDespite remarkable advances in medical science and treatment during 20th century, infectious diseases remain the leading cause of death worldwide
Emergence of new infectious diseases, re-emergence of old infectious diseases and persistence of intractable infectious diseases.
During the last 20 years, at least 30 new diseases have emerged
These diseases are the leading cause of death worldwide, claiming at least 17 million lives every year. In the South-East Asia region, 7 million people die from diseases annually.
AIM
To introduce major concepts related to emerging and re-
emerging infectious diseases.
SCOPE
Emerging and Re-emerging infectious diseasesFactors contributing to emergeBasic concept of the infectious diseasesChallenges to prevent the emergenceRecommendation Conclusion
“Emerging” & “Re-Emerging”EmergingDiseases that have not occurred in humans before orthat occurred onlyin small numbersin isolated places.
Re-emerging Diseases that once were major health problems globally or in a particular country, and then declined dramatically, but are again becoming health problems for a significant proportion of the population.
Diseases thought to be adequately controlled making a “comeback” are “re-emerging”
CONT..
NEW DISEASE EMERGE&
OLD DISEASE RE-EMERGE
DRIVING FORCES TO ENERGE
Ecological disruption and human intrusion into new
ecological system increases the exposure of human to new
infectious agents.Usually tropical &
Developing countries are HOT SPOT of outbreak
of diseases
Climate change is another potential driver that shifts the
ecological niche or range of the diseases.
Long-term impact of global warming, some major climatic events caused disease outbreaks in the areas that have not experienced the disease
before.
Urbanization and Industrialization impact the
prevalence and scope of both infectious and chronic diseases.
High risked sexual practices, multiple sexual partners and use of substances directly transmit
the diseases
Overcrowding causes person to person rapid spreading of diseases.
Poor housing quality, poor sanitation and water supply infrastructure.
International trade of goods and services through international border facilitate the
spread of diseases by bringing pathogen to new geographical areas.
Travelers are exposed to variety of pathogen, many of them have never
encountered and no immunity to many diseases.
EVOLUTION OF THE INFECTIOUS AGENT
Mutations in bacterial genes that confer resistance to antibiotics – 20%Multidrug-resistant & extremely drug-resistant TB Multi drug resistant P.falciparum
REDUCED HUMAN IMMUNITY
Immunization failure (breakdowns in public health measures)
Increased number of
immunocompromised hosts.
War & Political conflict cuase
breakdown of public health
infrastructure has role in emergence
of diseases.
Poor primary health care services may not be equipped to
deal with some infectious outbreaks
Year recognized Disease Infectious agentNew viral strain
emerge periodicallyPandemic Influenza Influenza virus
1967 Murburg hemorrhagic fever
Marburg virus
Before 1976 Salmonellosis Salmonella entertidis1976 Ebola hemorrhagic
feverEbola virus
1983 AIDS Human Immuno-deficiency Virus
1983 Gastric ulcers Helicobacter pylori 1989 Hepatitis C Hepatitis C virus (HCV)1998 Nipah encephalitis Nipah encephalitis2002 VRSA infection Vancomycin resistant
S. aureus2003 SARS (severe acute
respiratory syndrome)
SARS-associated coronavirus
2015 Zika Zika virus
EMERGING DISEASES
RE-EMERGING DISEASESDISEASE AGENT
DENGUE FEVER Dengue virus
MALARIA Plasmodium species (protozoan)
MENINGITIS Group A Streptococcus (bacterium)
SCHISTOSOMIASIS Schistosoma species (helminth)
RABIES Rabies virus
CHOLERA Vibrio cholerae 0139 (bacterium)
POLIO Poliovirus
YELLOW FEVER Yellow fever virus
TUBERCULOSIS Mycobacterium tuberculosis (bacterium)
SARS: The First Emerging Infectious Disease Of The 21st
Century (China, 2003)
SARS(Severe Acute Respiratory Syndrome)
Total 8429 cases; 824 deaths30 countries in 7-8 months
in 2003
The 2014 Ebola outbreak is the largest in history.
Primarily affecting Guinea, Northern Liberia, and Sierra Leone.
Ebola virus disease (EVD), previous known as Ebola hemorrhagic fever
(Ebola HF)
Fatality rate of up to 90%
Transmitted by direct contact with the blood, body fluids and tissues of
infected animals or people
More than 11,000 deaths only in Africa
Tuberculosis or TB is an infectious bacterial disease caused by Mycobacterium tuberculosis, which most
commonly affects the lungs.
In the 18th and 19th centuries, a tuberculosis epidemic rampaged
throughout Europe and North America.
In 1993 the World Health Organization (WHO) declared that TB was a Global Emergency; the
first time that a disease had been labeled as such.
TUBERCULOSIS
Approximately 390 million people worldwide infected with the dengue virus each year.
Since December
2014, swine flu has
claimed the lives of over 1,300 people
in India, making it the
worst outbreak of the virus in the country since 2009
SWINE FLU (H1N1 Virus)
Highly Pathogenic Avian Influenza (H5N1)
Epidermodysplasia Verruciformis(Tree Man)
GENETICSThe cause of this condition is an inactivating PH mutation in the EVER1 or EVER2 genes which are located adjacent
to one another on Chromosome 17
MALARIA
Infectious agent is Plasmodium species
Malaria is transmitted among humans by female mosquitoes of the genus
Anopheles.
LEPTOSPIROSIS
CHOLERA
Causative agent is Vibrio cholera
Water borne disease
Varying pathogenicity (mortality ranging from 21-80%).
Responsible for 1967 outbreak in Europe.
Outbreaks in 2000 in Democratic Republic of the Congo and 2005 in
Angola.
Currently no vaccine or treatment.
MURBURG VIRUS(Murburg Hemorrhagic Fever)
PNEUMONIC PLAGUE SEPTICEMIC PLAGUE
BUBONIC PLAGUETlea (Ceratophyllus faciatus)
EID IN SEA REGIONEID – a leading cause of death globally17 m die annually from ID – SEA accounts for 41% or 7 m deathsEID cause suffering & impose financial burden on societyPlague outbreak in 1994 cost India over 1.5 B USD due to loss in trade, employment & tourismIn Thailand cost of one AIDS patient more than 5000 USDOverall costs for India on account of AIDS estimataed at 11 b USDIncreasing or persistent poverty & poor living conditions continue to expose millions of people to the hazards of infectious diseases.The low priority & support given to public health services is most important factor.
MANAGEMENT OF EIDA proactive and planned approach to ensure the appropriate prevention and control of the spread of disease. Strategic planning should include:
Phase I (non-alert) is a routine, preparatory state;
Phase II (alert) is the detection, confirmation and declaration of changes identified during non-alert conditions;
Phase III (response) includes the ongoing assessment of information and the planning and implementation of an appropriate response, which includes the coordination and mobilization of resources to support intervention activities
Phase IV (follow-up) activities include re-evaluation, restructuring, reporting and continuing education, and redefining strategic parameters.
RECOMMENDATIONStrengthening epidemiological surveillance & laboratory capabilities and services .Establishment of a rapid response team.Monitoring antimicrobial resistance.Establishment of international disease surveillance. networking and advocacy.Screening on International travels and trades.Networks of laboratories that link countries and regions need to be established.Strong national and regional public health systems.
CONCLUSION
Thank You!!!
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