Responding to emerging diseases: reducing the risks through understanding the mechanisms of emergence.

Abstract

Over the past two decades, increasing concern and attention have been directed at the potential problems and threats associated with new and emerging diseases. This has been driven by fears arising from the rapid emergence, spread and public health impact of several recent outbreaks, such as the international spread of severe acute respiratory syndrome coronavirus (SARS-CoV) (2003), the potential of avian influenza H5N1 to emerge as a highly lethal pandemic as increasing numbers of human cases are reported (2003 and continuing), and the very rapid global spread of pandemic H1N1 influenza in 2009– 2010. The emergence of SARS-CoV, in particular, demonstrated the considerable economic, political and psychological effects–in addition to the impact on public health–of an unexpected epidemic of a highly infectious, previously unknown agent in a highly connected and interdependent world. These examples clearly highlight the necessity and importance of global outbreak surveillance for the early detection and response to new potential threats. They also demonstrate clearly that these emergent diseases can move rapidly between countries and continents through infected travellers so that surveillance needs to be transparent and authorities made aware of international disease events elsewhere around the globe. Some of the specific threats to the Asian Pacific region have been reviewed elsewhere.1–4