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Why Have we Seen Such a Dramatic Increase in Epidemic Infectious Diseases?. Complacency, Lack of Political Will Policy Changes Changes in Public Health Changing Life Styles/Behavior Microbial Adaptation Technology Intent to Harm Climate Change?.

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why have we seen such a dramatic increase in epidemic infectious diseases
Why Have we Seen Such a Dramatic Increase in Epidemic Infectious Diseases?
  • Complacency, Lack of Political Will
  • Policy Changes
  • Changes in Public Health
  • Changing Life Styles/Behavior
  • Microbial Adaptation
  • Technology
  • Intent to Harm
  • Climate Change?
slide2

As Earth Warms Up, Tropical Virus Moves to Italy“ nytimes.com/2007/12/23

Dengue fever warning for Thailand

Deadly by the Dozen: 12 Diseases Climate Change May Worsen

Dengue fever outbreak kills dozens in Brazil

Climate change to hit coastal pregnancies

Dengue fears

Warming Increases Malaria,

Dengue Fever Threat,

Paraguay: Dengue and yellow fever outbreak DREF Operation No. MDRPY003 Update No.1

An exotic blendDengue Fever is ready to spread across the country

SOUTH AMERICA: Climate Change

Fuels Spread of Dengue Fever

Climate change will fuel dengue - WHO exec

Health alert - Dengue fever risk

Climate change, globalization, and other

drivers have made Europe a “hot spot” for

emerging infectious diseases, which calls

for changes in monitoring systems

27 APRIL 2012 VOL 336 SCIENCE.

Asian mosquito 'could bring tropical diseases to Britain‘, The Independent, 2013

Another death in Tonga from dengue fever

Chikungunya disease in NYC? Warming could make it happen

Virus causes severe joint pain, is spread by two mosquito species; NBC News

slide3

“Fueled by climate change, dengue fever is on the rise again throughout the developing world, particularly in Latin America”.

Reference: Dengue fever: a deadly scourge.

The Economist, April 19, 2007.

dengue dengue hemorrhagic fever average annual number of cases reported to who 1955 2003
Dengue/Dengue Hemorrhagic Fever, Average Annual Number of Cases Reported to WHO, 1955-2003

Number of Cases

slide5

There is no solid scientific evidence to date that global warming has been a major driving force of the 20th century re-emergence of vector-borne infectious diseases!

why have we seen such a dramatic increase in epidemic infectious diseases1
Why Have we Seen Such a Dramatic Increase in Epidemic Infectious Diseases?

Major Drivers

  • Demographic Changes (Pop Growth)
    • Environmental Change
      • Uncontrolled Urbanization
      • Agricultural/Land Use Practices
      • Deforestation
      • Climate change
    • Animal Husbandry
  • Modern Transportation (Globalization)
    • Increased Movement of People, Animals, Commodities
  • Lack of Public Health Infrastructure
slide7

Global population- 1950-2050

Population (Millions)

Evaluation of urban and rural population between 1950 and 2050

urban growth in asian 1 and american 2 cities 1950 2010
Urban Growth in Asian(1) and American(2) Cities, 1950-2010
  • Mean population of Dhaka, Bangkok, Jakarta, Manila and Saigon.
  • Mean population of Rio de Janeiro, Sao Paulo, San Juan, Caracas and Guayaquil.
average annual number of global airline passengers by decade 1950 2010
Average annual number of global airline passengers by decade, 1950-2010

Million of Passenger (Mil)

IATA 2010

Decade

exotic infectious diseases that have recently been introduced to the us
West Nile Fever

Dengue Fever

Yellow Fever

Mayaro Fever

Chikungunya

Epidemic Polyarthritis

SARS

Influenza

Lassa Fever

Monkeypox

CJD/BSE

HIV/AIDS

Cholera

E. coli O157

Malaria

Leishmaniasis

Chagas Disease

Cyclospora

Exotic Infectious Diseases That HaveRecently Been Introduced to the US
live animal importation into the usa 2002
Live Animal Importation into the USA - 2002
  • 47,000 mammals
    • 28 species of rodents
  • 379,000 birds
  • 2 million reptiles

& Poisonous snakes

  • 49 million amphibians
  • 223 million fish

Data from U.S. Fish & Wildlife Service

exotic mosquito species recently introduced and established in the us
Exotic Mosquito Species Recently Introduced and Established in the US
  • Aedes (Stegomyia) albopictus
  • Ochlerotatus (Aedes Finlaya) togoi
  • Ochlerotatus (Aedes Finlaya) japonicus
  • Aedesbahamensis
  • Culex biscayensis
slide18

Demographic Changes

Technology/Globalization

Socio-cultural organization

Global climate change

Agricultural, land use and animal husbandry changes/practices

Habitat alteration

Urbanization

NATURAL

ECOSYSTEM

HUMAN

ECOSYSTEM

REGIONAL ENVIRONMENTAL CHANGE

Species’ Ecological-evolutionary Dynamics

Opportunistic habitat expansion/ecological release

Vector (domestication) Domestic vector/reservoir species

Wildlife/reservoir transport/encroachment Human encroachment

Host-Pathogen Dynamics

Emergence Processes of ‘Host-Parasite Biology’

Host switching (host novelty) • Breaching of pathogen persistence thresholds

Transmission amplification and genetic change (pathogen novelty)

Disease Emergence

ecosystem continuum

global threat of epidemic infectious diseases
Global Threat of Epidemic Infectious Diseases
  • Disease and Trade-interwoven History
    • 14th century, Europe discovers exotic goods from Asia
  • Global Trade Flourishes
    • 18th, 19, 20th centuries
  • New Millennium
    • Integrated global economic system with a transnational flow of knowledge, capital, products, people, animals, and pathogens
    • Rapid spread of epidemic infectious disease from point of origin
global threat of epidemic infectious diseases1
Global Threat of Epidemic Infectious Diseases

Lessons Learned

  • Dawn of 21st century, we have come full circle
  • Expect the unexpected
  • New diseases will emerge
  • Old diseases will re-emerge
  • Modern transportation and globalization will disseminate
  • Unlikely that a zoonotic disease can be eradicated
global threat of epidemic infectious diseases lessons learned
Global Threat of Epidemic Infectious DiseasesLessons Learned
  • Disease detection and identification systems must be improved and maintained
  • International communication and cooperation are critical
  • Rapid response plans must be developed and implemented appropriately
  • More emphasis must be placed on prevention as opposed to emergency response
  • Outbreaks should be contained as local public health events if possible
  • Public and Press need reliable information to prevent panic and overreaction
slide26

The Global Threat of Infectious Diseases

  • Global Trends, 2012-20025
    • Most of global economic growth in Asian countries
      • Increased trade
      • Increased movement of people, animals and commodities from Asia to rest of world
    • Most of global population growth in cities of Asia
      • Rural to urban circular migration
    • Globalization
    • Increased movement of pathogens
global threat of epidemic infectious diseases challenge to reverse the trend
Global Threat of Epidemic Infectious DiseasesChallenge to Reverse the Trend
  • Movement of Pathogens and Vectors via Modern Transportation
  • International cooperation and data sharing
  • Lack of Effective Laboratory-based Surveillance
  • Lack of Public Health Infrastructure to Prevent & control Vector-borne and Zoonotic Diseases
    • Trained personnel
    • Laboratory capacity
    • Tools (vaccines, drugs, insecticides, vector control tools)
    • Understanding disease ecology
  • Political Will
    • Economic support
    • Regional prevention and control programs