Emerging Infectious Diseases
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Emerging Infectious Diseases. Dorothy Cumbey, Ph.D., RN Director of Quality Management Health Services Jerry Dell Gimarc, MA Senior Planner South Carolina Department of Health and Environmental Control.

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Emerging Infectious Diseases

Dorothy Cumbey, Ph.D., RN

Director of Quality Management

Health Services

Jerry Dell Gimarc, MA

Senior Planner

South Carolina Department of Health and Environmental Control

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Developed as part of an Enhanced AHEC CommunityPartnership for Health Professions Workforce and Educational Reform project funded by the Health Resource and Service Administration (HRSA)

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At the completion of this module you will be able to

  • describe how the public health system can be mobilized to address emerging issues or threats to the public’s health

  • identify roles and responsibilities of different components of the public health system in confronting health challenges

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Objectives, Continued

  • describe the linkages needed within the public health system to effectively address these challenges

  • discuss health care needs of individuals and communities in the future

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  • Describe the public health approach to emerging issues.

  • Identify roles and responsibilities of public health system components.

  • Describe linkages needed to address challenges.

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What Are EmergingInfectious Diseases?

These are human illnesses caused by microorganisms or their poisonous byproducts and having the potential for occurring in epidemic numbers.

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Why are we concerned about Emerging Infectious Diseases?

  • These diseases:

    • Pose a threat to all persons regardless of age, sex, lifestyle, ethnic background, or socioeconomic status

    • Cause suffering and death

    • Impose a financial burden on society

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Trends in Death Caused by Infectious Diseases in the United States, 1900-94

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Economic and Societal Impact of States, 1900-94

Some Infectious Diseases

Economic and Social Impact of Some Infectious Diseases

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Emerging Infectious Diseases include conditions that States, 1900-94

  • emerge as a new infectious process

  • re-emerge as drug resistant forms

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Microbial Adaptation States, 1900-94

  • Mechanisms of genetic diversity

  • Respond to changes in physical and social environment.

  • Epidemiologic triangle

    • Host

    • Environment

    • Agent

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New Emerging States, 1900-94Infectious Diseases

  • Human Immunodeficiency Virus (AIDS)

  • Lyme disease

  • Ebola fever

  • Hantavirus Pulmonary Syndrome

  • West Nile encephalitis

  • Legionnaire’s disease

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Drug Resistant Diseases States, 1900-94

  • Malaria

  • Multiple drug resistant tuberculosis

  • Bacterial pneumonias

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How Are Infectious States, 1900-94Diseases Acquired?

  • Inhalation

  • Ingestion

    • Food, water, soil

  • Percutaneous inoculation

  • Mucous membranes

  • Blood and body fluids

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Origin of Emerging States, 1900-94Infectious Diseases

  • Changes in environment (technology and industry)

  • Economic development

  • Population growth or migration

  • Human behavior

  • International travel and commerce

  • Microbial adaptation

  • Breakdown in public health measures

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Discussion Time States, 1900-94

  • Identify some changes that may contribute to the rise of infectious diseases.

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Target Areas for Preventing Emerging Infectious Diseases States, 1900-94

  • Drug resistance

  • Food borne and water borne diseases

  • Vectorborne and zoonotic diseases

  • Diseases transmitted through exposure to blood and body fluids

  • Chronic diseases caused by infectious agents

  • Vaccine development and use

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Drug Resistance States, 1900-94

The emergence of drug resistance in bacteria, parasites, viruses, and fungi is reversing medical advances of the previous 50 years.

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Drug Resistant Diseases States, 1900-94More Examples

  • S. aureus in Japan and UK, 1997

  • HIV endemic in NY

  • Problems in South Carolina

    • Streptococccus pneumoniae

    • Vancomycin resistant Enterrococcus

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Influenza 1994-1997

Creutzfeldt-Jakob Disease

“Mad Cow Disease”

Lyme Disease


Vectorborne and Zoonotic Diseases

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West Nile Viral Encephalitis 1994-1997


Ebola fever

Hantavirus pulmonary syndrome

Vectorborne and Zoonotic Diseases

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Diseases Transmitted Through Exposure to Blood and Body Fluids

  • Human Immunodeficiency Virus

  • Hepatitis

    • A, B, C, D, E

    • NANE

    • SEN-V

  • Bacterial pathogens

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Other Target Areas Fluidsfor Prevention

  • Chronic Diseases Caused by Infectious Agents

  • Vaccine Development and Use

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Populations Particularly Fluidsat Risk

  • People with impaired host defenses

  • Pregnant women and newborns

  • Travelers, immigrants, refugees

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Bioterrorism as an Emerging Infectious Disease Threat Fluids

  • Intentional dissemination of disease

  • Infectious and toxic agents

    • viruses, bacteria, toxins, fungi

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Public Health Approach to Emerging Infectious Diseases Fluids

  • Surveillance

  • Epidemiology for early diagnosis

  • Early response to outbreaks and changing disease patterns

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Public Health Approach continued Fluids

  • PublicHealth Laboratory support for rapid and accurate diagnosis

  • Rapid Communication links to private providers and hospitals

  • Communication to public

  • Education about prevention and/or early detection

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CASE STUDY FluidsFoodborne Illness

  • Health care provider report

  • Epidemiologic investigation: Epi Team

  • Early Response: Consultation

  • Laboratory support for diagnosis

  • Rapid communication to health care provider/hospital

  • Communication to public

  • Education

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  • What is your role in addressing emerging infectious diseases?

    • Prevention

    • Education

    • Detection

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Your role in the Fluidsprevention of emerging infectious diseases

  • Best practices

  • Antibiotic use

  • Food preparation

  • Control exposure

  • Awareness of risk

  • Behavior change

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Your role in Fluidseducation about emerging infectious diseases

  • Stay informed

    • CDC Web Pages

    • MMWR on Web

    • EID Journal

  • Educate patients/family/friends

  • Know resources - who to call

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Your role in Fluidsdetection of emerging infectious diseases

  • Participate in surveillance activitieswithin yourclinical setting

  • Be alert for “clues”; assess risk

  • Know your resources - who to call for consultation

  • Report to local health department

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Summary Fluids

  • Shifts in the environment, human behavior and microorganisms can cause new diseases to emerge

  • We share responsibility to identify, minimize or avoid these situations