Abstract
Emerging infectious disease (EID) events have the potential to cause devastating impacts on human, animal and environmental health. A range of tools exist which can be applied to address EID event detection, preparedness and response. Here we use a case study of rabies in Southeast Asia and Oceania to illustrate, via nearly a decade of research activities, how such tools can be systematically integrated into a framework for EID preparedness. During the past three decades, canine rabies has spread to previously free areas of Southeast Asia, threatening the rabies-free status of countries such as Timor Leste, Papua New Guinea and Australia. The program of research to address rabies preparedness in the Oceanic region has included scanning and surveillance to define the emerging nature of canine rabies within the Southeast Asia region; field studies to collect information on potential reservoir species, their distribution and behaviour; participatory and sociological studies to identify priorities for disease response; and targeted risk assessment and disease modelling studies. Lessons learnt include the need to develop methods to collect data in remote regions, and the need to continuously evaluate and update requirements for preparedness in response to evolving drivers of emerging infectious disease.
Highlights
Priorities for epidemiologic investigation of disease are dynamic: they change continuously on global and local scales, as well as over the short and long term
By the early 2000s, it was clear that the incidence of emerging infectious disease (EID) had increased during the previous decades [6] and that EIDs would likely remain a focus of epidemiologic research
We evaluate a program of research conducted between 2012 and 2019 in response to changes in the distribution of rabies in Southeast Asia, in the context of this systematic, integrated approach to disease preparedness
Summary
Priorities for epidemiologic investigation of disease are dynamic: they change continuously on global and local scales, as well as over the short and long term. The approach gathers information inputs—generated via tools such as environmental scanning, horizon scanning and surveillance—in a cycle in which information is collected and assessed, threats are prioritised, and risk assessment and disease simulation modelling are used to generate key information for policy makers By systematically integrating these components, the goal is to reduce the probability of an EID event and to mitigate its impact, should it occur, and to identify gaps in current preparedness strategies and provide opportunities to reassess evolving drivers of disease emergence. In some circumstances, such changes would require re-assessment and subsequent re-alignment or updating of preparedness strategies to continue to meet the needs of a region. The annual human death burden in Southeast Asia has been estimated to be 5,823 (10% of the global burden [16])
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