Spread of Infections and Global Health Security

Abstract

The resurgence and rapid spread of Ebola in Africa, and the Enterovirus (EV-D68) respiratory infection among U.S. children, have heightened concerns of policy makers and medical communities. Ebola, spread only through direct contact with body fluids, results in a high fatality rate. EV-D68, causes mild respiratory distress, especially in children with asthma, and can require hospital admissions for supportive therapy. Both infections were identified some 40 years ago, but only recently evolved into a perceived serious global treat (Li & Chen, 2014). Reservoirs, mode of transmission, and preventive measures were studied for both viruses, but many uncertainties still remain, as exemplified by the discovery of bats as a source for Ebola, and motor taxis (World News Report, 2014) as a potential long-distance vector for transmission. In both cases a major concern is the imposed strain on the existing medical infrastructure, and the ability to mount a rapid response within communities at risk to respond to the challenges. Since their discoveries, both viruses have continued to evolve and spread globally (Li & Chen, 2014). Modern technology allows us to rapidly identify potential strains and “hot areas” responsible for the spread of infections. Technology helps us devise novel vaccines, but can also act as a vector, as in the case of transportation, to seed infections around the globe. Proper hygiene and regular decontamination of transport are not readily offered in many developing-economy countries. Other important contributors to the spread of infections include: socioeconomic instability, migration, and malnutrition. Urban disparities; poor sanitation; and crowding in dwellings, schools, religious and sporting events, and at work, all act as amplifiers for infection transmission. Homelessness, poverty, and poor nutrition are potential foci for sexually transmitted infections, mental problems; and metabolic disorders promoting poor health outcomes and increase risks for epidemics (Amiri et al., 2014; Fekadu et al., 2014; Johnson et al., 2014; Kerker et al., 2011; Medlow, Klineberg, & Steinbeck, 2014; Thompson, Wall, Greenstein, Grant, & Hasin, 2013). Alcoholism and other “recreational substances” are associated with the loss of immunosuppression and vulnerability to infections, such as HIV/AIDS, tuberculosis, and hepatitis among others (Friedman, Newton, & Klein, 2003). Our global security is dependent on preserving population health and reducing the impacts on national health-care infrastructure. Human activities, socioeconomic inequalities, and uncertain funding for inquiries into the complex interplay between the use of technology, sanitation, livability, and the environment put us on a collision course with possible biological disasters. Protecting against the rising threat of infection, implementing proper environmental and health policies, and supporting research are necessary to ensure a healthy future. On August 28, 2014, the World Medical Association (WMA) released a statement about the “serious deficiencies in the working conditions of junior doctors dealing with the Ebola virus in West Africa.” The statement expresses concern for the rising morbidity and mortality among physicians caring for patients, which has the potential to aggravate the already weakened public health infrastructure. The Editors support the U.S. and WHO response to the Ebola threat, to improve public health and medical care infrastructure in African nations, and reduce suffering and loss of life. The Editors wish to express our sincere gratitude to our readers, contributors, peer reviewers, and Board Members, and wish you a joyful 2014 holiday season and a prosperous 2015.