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The Global Threat of Infectious Diseases

The Global Threat of Infectious Diseases. Background 20 th Century Re-Emergence of Infectious Diseases - Newly recognized diseases - Known diseases - Geographic spread - Increased epidemic activity 26% of Global Mortality – 2003. H5N1 AI. Dengue. Dengue. H5N1AI. Dengue. Chikungunya.

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The Global Threat of Infectious Diseases

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  1. The Global Threat of Infectious Diseases Background • 20th Century Re-Emergence of Infectious Diseases - Newly recognized diseases - Known diseases - Geographic spread - Increased epidemic activity • 26% of Global Mortality – 2003

  2. H5N1 AI Dengue Dengue H5N1AI Dengue Chikungunya Fauci, NIAID/NIH 2005

  3. The Global Threat of Infectious DiseasesGlobal Public Health Emergencies, 1994-2005 • Plague, India/Global, 1994 • Influenza, Hong Kong, 1997 • Nipah Encephalitis, Malaysia/Regional, 1999 • SARS, China/Hong Kong/Global, 2003 • Avian Influenza, Southeast Asia/Global, 2004/2006

  4. AISA-PACIFIC INSTITUTE OF TROPICAL MEDICINE AND INFECTIOUS DISEASES Rationale • Global Public Health Emergencies • Hawaii in Ideal Position to Develop a Center of Excellence • Geography • Cultural & Economic Ties • Training • East-West Center • Other partners

  5. Asia-Pacific Institute of Tropical Medicine and Infectious Diseases Organizational Structure Dean John A. Burns School of Medicine Asia-Pacific Institute of Tropical Medicine and Infectious Diseases Basic Science Departments Clinical Departments Asia-Pacific Center for Biosecurity and Conflict Research Asia-Pacific Center for Infectious Disease Ecology Research Asia-Pacific Center for Translational Research Pacific Center for AIDS Research Pacific Center for Emerging Infectious Diseases Research Asia-Pacific Center for Public Health and Population Research

  6. Asia-Pacific Institute of Tropical Medicine and Infectious Diseases Mission To develop a global center of excellence in Hawaii for emerging and re-emerging infectious diseases Emphasis will be placed on infectious diseases of the Asia-Pacific Region, and on developing trans-disciplinary research and development programs that will result in new diagnostics, drugs, vaccines and other treatment and prevention modalities.

  7. ASIA-PACIFIC INSTITUTE OF TROPICAL MEDICINE AND INFECTIOUS DISEASES Goals • Develop a balanced trans-disciplinary research and training program that focuses on basic, field and translational research. • Develop a laboratory reference and research center • Develop local and international partnerships. • To build laboratory and epidemiologic capacity, and research collaborations in selected countries of Asia where diseases with epidemic potential commonly occur. • Develop a graduate program that will attract highly motivated, research-oriented doctoral candidates.

  8. ASIA-PACIFIC INSTITUTE OF TROPICAL MEDICINE AND INFECTIOUS DISEASES Disease Priorities Zoonotic viruses Influenza Dengue/dengue hemorrhagic fever West Nile fever HIV/AIDS Malaria Leptospirosis

  9. Asia-Pacific Institute of Tropical Medicine and Infectious Diseases Scientific Capability • Laboratory Capacity • Biocontainment (BSL-2, BSL-3 , ABSL-3) • Basic research • Diagnostics • Pathogenesis • Epidemiology • Bioinformatics • Pathogens • Emerging infectious diseases • Viruses, parasites, bacteria, zoonoses

  10. Asia-Pacific Institute of Tropical Medicine and Infectious Diseases Progress Partnerships/Collaboration

  11. Hawaii’s PRETREAT AlliancePreventing, Responding, and Treating Emerging Asia-Pacific Disease Threats Hawaii’s Global Solution for Emerging Infectious Disease Threats

  12. PRETREAT Participants and Their Capabilities • UH/JABSOM/ • APITMID • Center of excellence • Basic & applied research • Pathogen discovery • Surveillance • Epidemiology • Asian field sites • Training • Hawaii Biotech • Vaccines and drugs • Product • Development • FDA approvals • DOD • Surveillance • Emergency response • Clinical Research • Clinical trials • MHPCC • East West • Center • Demography • Geography • Climate Change • Hawaii Pacific Health • Queen’s Hospital • Clinical Research • Clinical trials • Treatment • Hawaii DOH • Surveillance • Emergency response • NIH • PacRBL • PSWRCE • COBRE • RCMI? • CDC? • International • surveillance • response

  13. PRETREAT Components • Prevention and treatment • Early warning surveillance • Diagnostics • Drug and vaccine research • Preclinical development, GLP animal testing • GMP manufacturing • Clinical research • FDA approved products

  14. Asia-Pacific Institute of Tropical Medicine and Infectious Diseases PRETREAT Components • Asian field sites • Research, clinical & vaccine trials • Pathogen discovery • Surveillance, field epidemiology, “pathogens of tomorrow” • Biocontainment laboratories • Fixed, mobile • Basic research • Training

  15. International Partnerships WHO Viet Nam Thailand Singapore Indonesia Others

  16. Asia-Pacific Institute of Tropical Medicine and Infectious Diseases Progress - Funding State of Hawaii University of Hawaii NIH DOD

  17. Microbial Threats to Health Case in Point: SARS

  18. Global SARS Cases (Probable)WHO 26 September 2003

  19. Social Impact Dengue Hemorrhagic Fever

  20. Global Distribution of Dengue Virus Serotypes, 1970 DEN-1 DEN-2

  21. DEN-1 DEN-1 DEN-1 DEN-1 DEN-1 DEN-1 DEN-1 DEN-1 DEN-1 DEN-1 DEN-1 DEN-2 DEN-2 DEN-2 DEN-2 DEN-2 DEN-2 DEN-2 DEN-2 DEN-2 DEN-2 DEN-2 DEN-3 DEN-3 DEN-3 DEN-3 DEN-3 DEN-3 DEN-3 DEN-3 DEN-3 DEN-3 DEN-4 DEN-4 DEN-4 DEN-4 DEN-4 DEN-4 DEN-4 DEN-4 DEN-4 DEN-4 Global Distribution of Dengue Virus Serotypes, 2006 DEN-1 DEN-2 DEN-3 DEN-4

  22. Dengue/dengue hemorrhagic fever, average annual number of cases reported to WHO, 1955-2005 Number of Cases

  23. Wave III: Dec 04 - Present Humans & Birds Humans Birds Source: WHO

  24. Wave III: Dec 04 - Present ? Humans & Birds Humans Birds Source: WHO

  25. New York City

  26. Aedes aegypti

  27. 1930's 2006 1970 Aedes aegypti Distribution in the Americas

  28. POTENTIAL GLOBAL SPREAD OF URBAN YELLOW FEVER

  29. West Nile Virus in the Western Hemisphere

  30. Epidemic West Nile Virus in the United States, 1999-2005 * Reported as of 1/13/2006

  31. Epidemic/Epizootic West Nile Virus 1937 1950-75 1994 - 2005

  32. Factors Responsible for Increased Epidemic Infectious Diseases • Complacency, Lack of Political Will • Policy Changes • Changes in Public Health • Demographic Changes - Population growth - Urbanization - Agricultural/Land Use Practices - Animal Husbandry • Modern Transportation - Increased Movement of People, Animals, Commodities • Changing Life Styles/Behavior • Microbial Adaptation • Technology • Intent to Harm • Climate Change?

  33. Zoonotic Diseases: Hitching a Ride? Modern Transportation

  34. Asia-Pacific Institute of Tropical Medicine and Infectious Diseases Hawaii and the US mainland are highly vulnerable to the importation of exotic pathogens, and at high risk for epidemic disease. Demographic and cultural factors, along with economic growth and globalization will insure that the Asian region will be important in producing future epidemic disease. A center of excellence for research on emerging infectious diseases of Asia and the Pacific in Hawaii will be highly beneficial to the global efforts to detect, respond and control epidemic disease.

  35. Pacific Regional Biosafety Laboratory at Kaka’ako

  36. Pacific Regional Biosafety Laboratory at Kaka’ako

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