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CHANGING PATTERN OF DISEASES
(EMERGING AND RE-EMERGING INFECTIONS)

                Presented by;
         Dr. Alteib Yousif Abdelgadir
     Student of Public and Tropical Health
         Master program - Patch 11
               September 2012
   Objectives
   Key terms
   Background
   Emerging and re emerging infections
   Potential contributing factors
   Control of infectious diseases
   Critical epistemology
   Emerging diseases and globalization
   Developing global response
By the end of this session, participants are
  expected to have some ideas about:
 Emerging diseases, key terms, history and
  potential contributing factors
 Control of infectious diseases
 Emerging diseases and globalization
 Developing global response
 Emerging infections: An infection that has
  newly appeared in a population or has previously
  existed but has rapidly increasing in incidence or
  geographic range
 Population at risk: A population subgroup that
  is more likely to be exposed or is more sensitive
  to the infection than the general population
 Quarantine: The practice of isolating an
  individual who has or is suspected of having a
  disease, in order to prevent spreading the
  disease to others.
 Infections remain a major global public health
  problem
 Humans originated in the tropical climate in
  Africa were affected by the same parasites as
  other primates in these areas.
 Humans as hunters moved to more temperate
  zones and the infectious agents they were
  exposed to changed due to new climate.
 In due time hunting gave way to agriculture and
  domestic animals living in close proximity to
  human...(opportunity for many zoonotic
  diseases) to spread to humans
   Increase population size and density provided
    ideal conditions for further spread of person
    to person spread of infections
   Humans, food and water became reservoirs
    for many of these infections
   Trade routes became established and
    movement of people and goods carried new
    pathogens to susceptible populations
 A climate of irrational fear has been a common
  feature of responses to infectious diseases for
  many centuries ( before and after the role of
  microorganism as a causative agents).
 Germ theory: Theory that all contagious
  diseases are cause by microorganism ( 1870)
 Control of infectious disease became through
  the work of Robert Koch and Louis Pasteur and
  the isolation and identification of the etiological
  agent
 Nature of infectious diseases changing not
  only in magnitude but also inability of science
  to provide all answers because of:
 New disease notably HIV/AID, SARS
 Ancient and re-emerging diseases such as
  tuberculosis, diptheria ( these had
  disappeared in some parts of the world)
 New agents are being implicated in the
  causation of a number of clinical syndromes;
 Parvovirus B19 (causes a childhood rash
  called fifth disease or erythema infectiosum
  which is commonly called slapped cheek
  syndrome)
 Herpes viruses; herpes type 1 (oral herpes)
  and herpes type 2 (genital herpes).
 HPV (warts, anal lesions, genital cancer, oro
  pharyngeal cancers, oral papillomas, etc
   Many new drug resistant organisms,
    unresponsive to anti microbial agents have
    emerged over the last 60 years
   Multidrug resistant organisms such as M.
    Tuberculosis, Staph. Aureus and Salmonella
    species
   Bovine spongiform encephalitis decimated
    the British beef industry and cost $40 billion.
   Population growth and Poverty: more than 2
    billion suffer from under nutrition or
    malnutrition.
   Population movement ( 150million, 2.5%,
    people live outside their country of
    birth),more migrants live in overcrowded
    conditions
   Human behavior: Changes including sexual
    behavior and IV drug use
   Non compliance by health care
    workers....drug resistance
   Technological development: Bovine
    Spongiform Encephalopathy (BSE; Mad
    Cow Disease) spread has been attributed to
    technological changes in animal and food
    chain dating back to the 1980s. BSE are
    transmissible
   Economic development and land use e.g
    malaria in newly agricultural area
   Microbial adaptation and change...Antigenic
    shifts and drifts. Major epidemic are caused
    by antigenic drifts
   Breakdown of public infrastructure and public
    policy due to war or political change.
   Climate change: Vectors will be able survive in
    areas where they had not.
   Warfare/ terrorism/conflict: British in 18th
    Century Distributed small pox infected
    blankets to North American Indians.
   Countries have sought to produce an Anthrax
    bomb and increasing concern about
    biological weapons
   Involves going beyond the focus on host and
    organism to socioeconomic, cultural, and
    political necessary
   Globalization has challenged infectious
    diseases in a way that has become starker.
   The role of the state has become more
    important
   Tension between the individual and the state:
    compulsory HIV test for employment and
    travel, compulsory immunization, Quarantine
    e.g H1NI.
   Many borders in African serve as semi-
    permeable membranes; open to disease and
    yet closed to cure.
   What qualifies as emerging infectious
    diseases?
   Why do some persons constitute ‘risk group’
    while others are ‘individuals’ at risk?
   Can standard epidemiology, (sometimes
    short on critical theory) help us to take hold
    of deep socio-economic issues relating to
    disease emergence?
 Modern epidemiology is oriented to
  explaining and quantifying the bobbing of
  corks on the surface waters, while largely
  disregarding the strong undercurrents that
  determine where, on the average, the cluster
  of corks end up along the shoreline of risk’
-McMichael 1995
   Ancient trade route and early globalization
   WHO in 1948 became responsible for
    International Health Regulation, binding
    member states regarding cholera, plague,
    yellow fever and smallpox. (IHR has now been
    revised enhancing timeliness and reporting)
   IHR does not provide legal framework for
    other diseases including threats of emerging
    diseases
   Enforcement of IHR depends on the
    cooperation of governments and there are no
    resources to ensure compliance such as
    punitive measures
   Good health is both essential and instrumental
    to achieving human security’ (illness and death
    are critical threat to human life)-The Commission
    on Human Security.
   Violence, infections and poverty are the three
    health challenges that critically impact human
    security
   Bioterrorism
   The potential to cause mass casualty
   HIV/AIDS risk to population, military and
    peacekeepers... Uganda soldiers in Somalia
 Development of global surveillance
  networks...surveillance remains fundamentally a
  local activity so collaboration is needed across
  borders
 International mechanism for control of
  infectious diseases depends heavily on
  government institutions
 While globalizations creates new risks it also
  offers new opportunities for enhancing
  communicable disease response e.g facilitating
  surveillance and reporting
THANK YOU

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Changing pattern of diseases

  • 1. CHANGING PATTERN OF DISEASES (EMERGING AND RE-EMERGING INFECTIONS) Presented by; Dr. Alteib Yousif Abdelgadir Student of Public and Tropical Health Master program - Patch 11 September 2012
  • 2. Objectives  Key terms  Background  Emerging and re emerging infections  Potential contributing factors  Control of infectious diseases  Critical epistemology  Emerging diseases and globalization  Developing global response
  • 3. By the end of this session, participants are expected to have some ideas about:  Emerging diseases, key terms, history and potential contributing factors  Control of infectious diseases  Emerging diseases and globalization  Developing global response
  • 4.  Emerging infections: An infection that has newly appeared in a population or has previously existed but has rapidly increasing in incidence or geographic range  Population at risk: A population subgroup that is more likely to be exposed or is more sensitive to the infection than the general population  Quarantine: The practice of isolating an individual who has or is suspected of having a disease, in order to prevent spreading the disease to others.
  • 5.  Infections remain a major global public health problem  Humans originated in the tropical climate in Africa were affected by the same parasites as other primates in these areas.  Humans as hunters moved to more temperate zones and the infectious agents they were exposed to changed due to new climate.  In due time hunting gave way to agriculture and domestic animals living in close proximity to human...(opportunity for many zoonotic diseases) to spread to humans
  • 6. Increase population size and density provided ideal conditions for further spread of person to person spread of infections  Humans, food and water became reservoirs for many of these infections  Trade routes became established and movement of people and goods carried new pathogens to susceptible populations
  • 7.  A climate of irrational fear has been a common feature of responses to infectious diseases for many centuries ( before and after the role of microorganism as a causative agents).  Germ theory: Theory that all contagious diseases are cause by microorganism ( 1870)  Control of infectious disease became through the work of Robert Koch and Louis Pasteur and the isolation and identification of the etiological agent
  • 8.  Nature of infectious diseases changing not only in magnitude but also inability of science to provide all answers because of:  New disease notably HIV/AID, SARS  Ancient and re-emerging diseases such as tuberculosis, diptheria ( these had disappeared in some parts of the world)
  • 9.  New agents are being implicated in the causation of a number of clinical syndromes;  Parvovirus B19 (causes a childhood rash called fifth disease or erythema infectiosum which is commonly called slapped cheek syndrome)  Herpes viruses; herpes type 1 (oral herpes) and herpes type 2 (genital herpes).  HPV (warts, anal lesions, genital cancer, oro pharyngeal cancers, oral papillomas, etc
  • 10. Many new drug resistant organisms, unresponsive to anti microbial agents have emerged over the last 60 years  Multidrug resistant organisms such as M. Tuberculosis, Staph. Aureus and Salmonella species  Bovine spongiform encephalitis decimated the British beef industry and cost $40 billion.
  • 11. Population growth and Poverty: more than 2 billion suffer from under nutrition or malnutrition.  Population movement ( 150million, 2.5%, people live outside their country of birth),more migrants live in overcrowded conditions  Human behavior: Changes including sexual behavior and IV drug use
  • 12. Non compliance by health care workers....drug resistance  Technological development: Bovine Spongiform Encephalopathy (BSE; Mad Cow Disease) spread has been attributed to technological changes in animal and food chain dating back to the 1980s. BSE are transmissible  Economic development and land use e.g malaria in newly agricultural area
  • 13. Microbial adaptation and change...Antigenic shifts and drifts. Major epidemic are caused by antigenic drifts  Breakdown of public infrastructure and public policy due to war or political change.  Climate change: Vectors will be able survive in areas where they had not.
  • 14. Warfare/ terrorism/conflict: British in 18th Century Distributed small pox infected blankets to North American Indians.  Countries have sought to produce an Anthrax bomb and increasing concern about biological weapons
  • 15. Involves going beyond the focus on host and organism to socioeconomic, cultural, and political necessary  Globalization has challenged infectious diseases in a way that has become starker.  The role of the state has become more important
  • 16. Tension between the individual and the state: compulsory HIV test for employment and travel, compulsory immunization, Quarantine e.g H1NI.  Many borders in African serve as semi- permeable membranes; open to disease and yet closed to cure.
  • 17. What qualifies as emerging infectious diseases?  Why do some persons constitute ‘risk group’ while others are ‘individuals’ at risk?  Can standard epidemiology, (sometimes short on critical theory) help us to take hold of deep socio-economic issues relating to disease emergence?
  • 18.  Modern epidemiology is oriented to explaining and quantifying the bobbing of corks on the surface waters, while largely disregarding the strong undercurrents that determine where, on the average, the cluster of corks end up along the shoreline of risk’ -McMichael 1995
  • 19. Ancient trade route and early globalization  WHO in 1948 became responsible for International Health Regulation, binding member states regarding cholera, plague, yellow fever and smallpox. (IHR has now been revised enhancing timeliness and reporting)
  • 20. IHR does not provide legal framework for other diseases including threats of emerging diseases  Enforcement of IHR depends on the cooperation of governments and there are no resources to ensure compliance such as punitive measures
  • 21. Good health is both essential and instrumental to achieving human security’ (illness and death are critical threat to human life)-The Commission on Human Security.  Violence, infections and poverty are the three health challenges that critically impact human security  Bioterrorism  The potential to cause mass casualty  HIV/AIDS risk to population, military and peacekeepers... Uganda soldiers in Somalia
  • 22.  Development of global surveillance networks...surveillance remains fundamentally a local activity so collaboration is needed across borders  International mechanism for control of infectious diseases depends heavily on government institutions  While globalizations creates new risks it also offers new opportunities for enhancing communicable disease response e.g facilitating surveillance and reporting