Emerging infectious disease

Source: Wikipedia, the free encyclopedia.
NIAID, he drew a map of the world for presentation at a congressional hearing that showed a single notable emerging infectious disease threat: HIV. Since then, he has continually updated the map, now showing the emergence of numerous infectious disease threats to illustrate the experiences of his years in office as well as highlighting certain infections that had emerged before HIV.[1]

An emerging infectious disease (EID) is an

societal, as well as clinical.[5] EIDs have been increasing steadily since at least 1940.[6]

For every decade since 1940, there has been a consistent increase in the number of EID events from wildlife-related

loss of biodiversity a leading mechanism.[7]

Emerging infections account for at least 12% of all human

non-infectious conditions leading to the development of novel syndemics
.

Many EID are

novel viruses may have been circulating in the species without being recognized, as occurred with hepatitis C[15]
).

History of the concept of emerging infectious diseases

The French doctor Charles Anglada (1809–1878) wrote a book in 1869 on extinct and new diseases.[16] He did not distinguish infectious diseases from others (he uses the terms reactive and affective diseases, to mean diseases with an external or internal cause, more or less meaning diseases with or without an observable external cause). He writes in the introduction:

A widely held opinion among physicians admits the invariability of pathologies. All the illnesses which have existed or which have an outbreak around us are categorized according to arrested and preconceived types, and must enter one way or the other into the frameworks established by the nosologists. History and observation protest wildly against this prejudice, and this is what they teach: Diseases which have disappeared and whose traces are confined to the archives of science, are followed by other diseases, unknown to the contemporary generation, and which come for the first time to assert their rights. In other words, there are extinct and new diseases.

Charles Nicolle, laureate of the Nobel Prize in Physiology or Medicine elaborated the concept of emergence of diseases in his 1930 book Naissance, vie et mort des maladies infectieuses (Birth, Life and Death of Infectious Diseases), and later in Destin des maladies infectieuses (Fate of Infectious Diseases)[17] published in 1933 which served as lecture notes for his teaching of a second year course at the Collège de France. In the introduction of the book he sets out the program of the lectures:

It is this historical existence, this destiny that will be the subject of our talks. I will have to answer, to the extent that our current knowledge allows, questions that you have asked yourself, that every thoughtful or simply curious mind asks: have the infectious diseases that we observe today always existed? Or have some of them appeared in the course of history? Can we assume that new ones will appear? Can we assume that some of these diseases will disappear? Have some of them already disappeared? Finally, what will become of humanity and domestic animals if, as a result of more and more frequent contacts between people, the number of infectious diseases continues to increase?

The term emerging disease has been in use in scientific publications since the beginning of the 1960s at least[18] and is used in the modern sense by David Sencer in his 1971 article "Emerging Diseases of Man and Animals"[19] where in the first sentence of the introduction he implicitly defines emerging diseases as "infectious diseases of man and animals currently emerging as public health problems" and as a consequence also includes re-emerging diseases:

Infectious diseases of man and animals currently emerging as public health problems include some old acquaintances and some that are new in respect to identity or concept.

He also notes that some infectious agents are newly considered as diseases because of changing medical technologies:

But there are also many familiar organisms formerly considered nonpathogenic that are now associated with nosocomial infections, use of artificial kidneys, and the acceptance or rejection of organ transplants, for example.

He concludes the introduction with a word of caution:

And so infectious disease, one of man's oldest enemies, survives as an adversary that calls forth our best efforts.

However, to many people in the 1960s and 1970s the emergence of new diseases appeared as a marginal problem, as illustrated by the introduction to the 1962 edition of Natural History of Infectious Disease by Macfarlane Burnet:[20]

to write about infectious disease is almost to write of something that has passed into history

as well as the epilogue of the 1972 edition:[21]

On the basis of what has happened in the last thirty years, can we forecast any likely developments for the 1970s? If for the present we retain a basic optimism and assume no major catastrophes occur [...] the most likely forecast about the future of infectious disease is that it will be very dull. There may be some wholly unexpected emergence of a new and dangerous infectious disease, but nothing of the sort has marked the past fifty years.

Throughout the 20th century until 1980, with the exception of the 1918 Spanish flu pandemic, the death rate from infectious diseases in the United States was steadily decreasing. However, because of the AIDS epidemic, the death rate from infectious diseases increased by 58% between 1980 and 1992.

The concept gained more interest at the end of the 1980s as a reaction to the AIDS epidemic. On the side of epistemology, Mirko Grmek worked on the concept of emerging diseases while writing his book on the history of AIDS[22] and later in 1993 published an article[23] about the concept of emerging disease as a more precise notion than the term "new disease" that was mostly used in France at that time to qualify AIDS among others.

Also under the shock of the emergence of AIDS, epidemiologists wanted to take a more active approach to anticipate and prevent the emergence of new diseases.

Program for Monitoring Emerging Diseases (ProMED) was formed by a group of scientists as a follow-up in 1994[27] and the Centres for Disease Control (CDC) launched the Emerging Infectious Diseases journal in 1995.[18]

A decade later the IOM convened the Committee on Emerging Microbial Threats to Health in the 21st Century which published its conclusions in 2003.[28]

In April 2000 the WHO organized a meeting on Global Outbreak Alert and Response,[29] which was the founding act of the Global Outbreak Alert and Response Network.

In 2014, the Western African Ebola virus epidemic demonstrated how ill-prepared the world was to handle such an epidemic. In response, the Coalition for Epidemic Preparedness Innovation was launched at the World Economic Forum in 2017 with the objective of accelerating the development of vaccines against emerging infectious diseases to be able to offer them to affected populations during outbreaks.[30] CEPI promotes the idea that a proactive approach is required to "create a world in which epidemics are no longer a threat to humanity".[31]

Classification

One way to classify emerging infections diseases is by time and how humans were involved in the emergence:[32]

  • Newly emerging infectious diseases – diseases that were not previously described in humans, such as HIV/AIDS
  • Re-emerging infectious diseases – diseases that have spread to new places or which previous treatments no longer control, such as methicillin-resistant Staphylococcus aureus
  • Deliberately emerging infectious diseases – diseases created by humans for bioterrorism
  • Accidentally emerging infectious diseases – diseases created or spread unintentionally by humans, such as vaccine-derived poliovirus

Contributing factors

The 1992 IOM report[26] distinguished 6 factors contributing to emergence of new diseases (Microbial adaptation and change; Economic development and land use; Human demographics and behavior; International travel and commerce; Technology and industry; Breakdown of public health measures) which were extended to 13 factors in the 2003 report[28] (Chapter 3 of the report detailing each of them)

  • Microbial adaptation and change
  • Human susceptibility to infection
  • Climate and weather
  • Changing ecosystems
  • Human demographics and behavior
  • Economic development and land use
  • International travel and commerce
  • Technology and industry
  • Breakdown of public health measures
  • Poverty and social inequality
  • War and famine
  • Lack of political will
  • Intent to harm

Their classification serves as a basis for many others. The following table gives examples for different factors:

Factor of emergence Example
Microbial adaption
Influenza A
Changing human susceptibility mass immunocompromisation with HIV/AIDS
Climate change diseases transmitted by animal
mosquitoes (e.g. West Nile fever
) are moving further from the tropics as the climate warms
Changes in human
demographics
and travel facilitating rapid global spread
SARS-related coronaviruses
Economic development use of
antibiotic resistance
War and famine Clearing of animal habitats that increase the range of diseases such as ebola
Inadequate public health services
Poverty and social inequality tuberculosis is primarily a problem in low-income areas
Bioterrorism
2001 Anthrax attacks
Land use Dam construction and irrigation systems can encourage malaria and other mosquito-borne diseases
Use of indiscriminate pesticides in industrial farming reduces/eliminates biological controls (e.g. dragonflies, amphibians, insectivorous birds, spiders) of known disease vectors (e.g. mosquito, tick, biting midge)
Anti-vaccination or Vaccine hesitancy
Re-emergence of measles[33][34]
Wildlife trade Has been linked to zoonotic emergence and spread of new infectious diseases in humans, including Nipah virus and COVID-19.[35][36] Crowded and unhygienic wet markets and wildlife farms have been implicated in animal-human transmission of emergent viruses, including novel coronaviruses and influenza viruses[37] Complex issues surrounding the commerce and consumption of bushmeat are also of particular concern.[38][39][40]

Emerging Infectious Diseases between Humans and Animals

Emerging infectious diseases between human, animal have become a significant concern in recent years, playing a crucial role in the occurrence and spread of diseases.[41][42] Human population growth, increased proximity to wildlife, and climate change have created favorable conditions for the transmission of zoonotic diseases, leading to outbreaks such as Zika, Ebola, and COVID-19. The One Health approach, which integrates animal, human, and environmental health, has emerged as a crucial tool for monitoring and mitigating the spread of infectious diseases.[43]

Zoonotic diseases, originating from animal sources, pose a significant threat to human health. Up to 75% of emerging infectious diseases are zoonotic, originating from viruses and other pathogens that are transmitted from animals to humans. Understanding the mechanisms of transmission, the role of wildlife trade, and the importance of surveillance and early detection is crucial for mitigating the impact of zoonotic diseases on human health. Surveillance efforts involving wastewater have been identified as valuable tools for detecting early warning signs of disease emergence and providing timely interventions.[41][42]

List

NIAID list of Biodefense and Emerging Infectious Diseases

The U.S. National Institute of Allergy and Infectious Diseases (NIAID) maintains a list of Biodefense and Emerging Infectious Diseases. The list is categorized by biodefense risk, which is mostly based on biological warfare and bioterrorism considerations. As of 2004, it recognized the following emerging and re-emerging diseases.[44]

Newly recognized (since the 1980s):

Re-emerging:

Diseases with bioterrorism potential, CDC category A (most dangerous):

Diseases with bioterrorism potential, CDC category B:

Diseases with bioterrorism potential, CDC category C (least dangerous):

Since 2004, NIAID has added to its biodefense emerging pathogen list:[45]

NIAID also monitors
antibiotic resistance
, which can become an emerging threat for many pathogens.

WHO list of most important emerging infectious diseases

In December 2015, the World Health Organization held a workshop on prioritization of pathogens "for accelerated R&D for severe emerging diseases with potential to generate a public health emergency, and for which no, or insufficient, preventive and curative solutions exist."[46] The result was a list containing the following six diseases:

These were selected based on the following measures:

  1. Human transmissibility (including population immunity, behavioural factors, etc.)
  2. Severity or case fatality rate
  3. Spillover potential
  4. Evolutionary potential
  5. Available countermeasures
  6. Difficulty of detection or control
  7. Public health context of the affected area(s)
  8. Potential scope of outbreak (risk of international spread)
  9. Potential societal impacts

Newly reported infectious diseases

In 2007 Mark Woolhouse and Eleanor Gaunt established a list of 87 human pathogens first reported in the period between 1980 and 2005.[47] These were classified according to their types.

Numbers of pathogen species by taxonomic category
Number of species

known in 2005

Number of species

reported from 1980 to 2005

TOTAL 1399 87
Bacteria 541 11
Fungi 325 13
Helminths 285 1
Prions 2 1
Protozoa 57 3
Viruses 189 58
DNA viruses 36 9
RNA viruses 153 49

Major outbreaks

The following table summarizes the major outbreaks since 1998 caused by emerging or re-emerging infectious diseases.[48]

Disease Country or region Year of start of outbreak
Ngari virus[49] Kenya, Tanzania, Somalia 1998
Nipah virus
Malaysia 1998
West Nile virus US 1999
Itaya virus[50] Peru 1999
Rift Valley fever Saudi Arabia and Yemen 2000
EBLV-2
Scotland 2002
SARS-CoV
2002
Influenza A virus subtype H7N2 2002
Monkeypox
US 2003
Chapare virus
Bolivia 2003
Plague Algeria 2003
HTLV-4
Cameroon 2005
Melaka virus Malaysia 2006
LuJo virus
southern Africa 2008
Multi-drug resistant
P. falciparum
South-East Asia 2008
Candida auris 2009
Heartland virus
US 2009
Bas-Congo virus
DRC 2009
Lassa fever Mali 2009
Pandemic H1N1/09 virus Global pandemic 2009
Huaiyangshan banyangvirus
2009
Plague Libya 2009
Cholera Haiti 2010
Lassa fever Ghana 2011
Plasmodium cynomolgi[51] Malaysia 2011
H3N2v
2011
MERS -CoV
2012
Mojiang paramyxovirus[52] 2012
H7N9
2013
Sosuga pararubulavirus 2013
H10N8[53] 2013
Chikungunya Caribbean 2013
Variegated Squirrel Bornavirus 1 [de] 2013
Colpodella sp. Heilongjiang[54] China 2013
Ebola virus disease[55]
West Africa 2014
H5N6
2014
Lassa fever Benin 2014
Bourbon virus US 2014
Zika virus[56] Americas 2015
Crimean–Congo hemorrhagic fever Spain 2016
Chikungunya Pakistan 2016
Lassa fever Togo 2016
Ntwetwe virus[57] Uganda 2016
Monkeypox
Nigeria 2017
Yellow fever Brazil 2017
Rat hepatitis E virus[58] 2017
Guinea worm
Chad 2018
Lyme disease 2018
H7N4
2018
Monkeypox
Liberia, UK 2018
Nipah virus
India 2018
COVID-19[14] Global pandemic 2019

Methicillin-resistant Staphylococcus aureus

Darwinian medicine
. However, prevention is the most preferred method of avoiding antibiotic resistance. By reducing unnecessary antibiotic use in human and animal populations, antibiotics resistance can be slowed.

Scientific Advisory Group for Origins of Novel Pathogens

On 16 July 2021, the Director-General of WHO announced the formation of the Scientific Advisory Group for Origins of Novel Pathogens (SAGO),[62][63][64] which is to be a permanent advisory body of the organisation. The Group was formed with a broad objective to examine emerging infectious diseases, including COVID-19.[62][65] According to the WHO Director-General, "SAGO will play a vital role in the next phase of studies into the origins of SARS-CoV-2, as well as the origins of future new pathogens."[62]

See also

References

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Further reading

  • Nathan Wolfe (2012). The Viral Storm: The Dawn of a New Pandemic Age. St. Martin's Griffin. .

External links