CLS 351 Lecture 12 Note_emerging

Emerging diseases
CLS 351
Outline
• Emerging and re-emerging disease.
• Factors contributing to the emergence of diseases.
• Antibiotic resistance.
• Bioterrorism.
• Managing emerging diseases.
Emerging disease
Emerging diseases are diseases that
(1) have not occurred in humans before (this type of emergence is
difficult to establish and is probably rare);
(2) have occurred previously but affected only small numbers of people
in isolated places (AIDS and Ebola hemorrhagic fever are examples);
or
(3) have occurred throughout human history but have only recently
been recognized as distinct diseases due to an infectious agent
(Lyme disease and gastric ulcers are examples).
Re-emerging disease
Re-emerging infectious diseases are 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 (malaria and tuberculosis are examples).
Many (60 to 80%) emerging infections are derived from an animal
source.
Infectious disease emergence can be viewed operationally as a two-

step process:
1. Introduction of the agent into a new host population, followed by
2. Establishment and further dissemination within the new host
population (adoption).
Infections have been emerging for thousands of years as humans have

had more and more interactions with animals and their environment.
Factors contributing to the emergence of
infectious diseases:
The reasons for disease emergence are complex and multi-factorial, but
essentially result from an interaction between the microorganism itself
and human activities.
These interactions can be complex and new infections often result from
several factors together or in sequence.
Microbial adaptation and change
• Microbes continually have to adapt to the environment in which they
live. The changes that result may allow them to evade the human
immune system, or provide them with a new ability to invade human
or animal cells.
• They can also develop resistance to drug treatments, such as
antibiotics, and some changes may make vaccines less effective.
Ecological changes
• Ecological changes, including those due to agricultural, are among the
most frequently identified factors in emergence.
• Climate change can have a direct impact on how diseases are spread;
through effects on microorganisms and vectors, that can carry and
transmit disease.
• Infectious diseases may also be affected by short-term weather
conditions (such as drought or flood) or appear at particular times of
the year (such as influenza in the winter).
Human demographics and behavior
• Activities, which range from sexual contact, drug use to outdoor
recreational activities can result in increased exposure to an infectious
agent. Infections can then rapidly spread, especially in more heavily
populated areas or where there are population movements.
• Other important factors include the ageing populations and the
increase in chronic diseases.
• ‘Bush-meat’ harvested from previously remote forested areas
remains a risk for animal-derived emerging infections.
Technology, industry and healthcare
• Some diseases emerge as a direct consequence of technological
change. New medical treatments and procedures like blood
transfusion and organ transplantation, including the use of animal
tissues or organs in humans, have created new ways for micro-
organisms to spread and infect people.
• Changes in food processing and packaging, animal farming (including
the widespread use of antibiotics in farm animals) and the rapid
dissemination of food supplies from all over the world also provide
the potential for new diseases to emerge.
International travel and commerce
The speed and ease with which humans,

animals, food and other goods can be
transported around the world has made it
much easier to spread both infectious agents
and the vectors or vehicles that can transmit
them.
Breakdown in public health measures
Spread of existing infections and the emergence of new ones in many
areas of the world can be caused by insanitary conditions, poor
hygiene and a lack of drinkable water. Breakdown of public health
initiatives, such as spraying mosquitoes (vector control) or preventative
immunization programs can result in diseases that were previously
controlled re-emerging.
Antibiotic resistance
• Emerge in environment due to inappropriate use
of antibiotic
• Antibiotic resistance occurs when bacteria
change in response to the use of antibiotics.
• WHO estimates that 10 million people are dying
of infectious diseases related to antibiotic
resistance.
• Proper antibiotic guidelines needed to prevent
the drug resistance.
Bioterrorism
• Possible deliberate release of infectious agents by dissident
individuals or terrorist groups
• Biological agents are attractive instruments of terror- easy to
produce, mass casualties, difficult to detect, widespread panic &
civil disruption.
Example - Anthrax
• Anthrax is a human disease largely occurs through
contact with animal products, such as animal skins.
• In 2001, 22 cases of anthrax occurred in the United

States as an act of bioterrorism through the postal
system, placing anthrax on the forefront of
bioterrorism.
Key tasks in dealing with emerging diseases
• Surveillance at national, regional, global level.
• Investigation and early control measures.
• Implement prevention measures:
Behavioural, political, environmental
• Monitoring, evaluation.
Internet-based information technologies:

• Improve disease reporting
• Facilitate emergency communications &
• Dissemination of information
• Human Genome Project
Role of human genetics in disease susceptibility,
progression & host response.
• Microbial genetics
Methods for disease detection, control &
prevention.
• Improved diagnostic techniques & new vaccines
• Geographic Imaging Systems

Monitor environmental changes that influence disease emergence &
transmission.
Can we apply the same
concepts to chronic diseases?

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Emerging diseases

Infectious disease emergence can be viewed operationally as a two-

Infections have been emerging for thousands of years as humans have

The speed and ease with which humans,

• In 2001, 22 cases of anthrax occurred in the United

Internet-based information technologies:

• Geographic Imaging Systems

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