Third Congress for European Society for Emerging Infections Ecole Nationale Veterinaire d'Alfort in Maisons-Alfort, France October 2004 The Third Congress for European Society for Emerging Infections brought together an impressive list of scientists, clinicians, and veterinarians from different fields, including Nobel Prize winner Professor Carlton Gadjusek, and encouraged a dialogue related emerging infections. The theme of this meeting was that, because many infectious diseases have a zoonotic origin, disease processes in animals should be examined, not just considered as models for humans. Various strategies used by viruses and bacteria infect their hosts and subsequently persist were discussed. Deaths attributable infectious diseases are ≈25% of total number of human deaths worldwide annually. Changes in demographics and behavior are main influences on emergence of new diseases. Many existing and emerging diseases arose from animals: 75% of new human diseases are zoonotic in origin. Changes that affect pathogen spectrum include climatic factors, such as global warming, increased volume and speed of international travel, increased trade, deforestation, urbanization, and adaptation of microbes new environments. An example of microbe environmental adaptation is discovery of an African mosquito-borne flavivirus in central Europe. Large numbers of blackbirds and owls in zoological gardens and around Vienna, Austria, had been found dead in summer of 2001. Upon further investigation, they were found have swollen livers and spleens as well as other characteristics of West Nile virus. Reverse transcription–polymerase chain reaction (RT-PCR) determined that flavivirus was Usutu virus from South Africa, which had been carried Europe by migratory swallows. Some spread has occurred 4 countries bordering Austria; however, no human clinical cases have occurred date. On a global scale, most important vector-borne infections are mosquito-transmitted, whereas in Europe tick-transmitted infections are a major concern. An example of a tickborne infection is ehrlichiosis. This disease was first described in United States in 1994 but was described in animals in Europe in 1960s. At least 20 cases in humans have now been reported in Europe. Anaplasma phagocytophilum, causative agent, can be detected by PCR in 2% 45% of Ixodes ricinus ticks. Animals can act as good sentinels for human infection. Erhlichiosis due A. phagocytophilum may also be associated with a high risk of co-infection by Coxiella, Babesia, and Theileria. Therefore, information and education for both veterinarians and general practitioners are important for managing and identifying this widespread zoonosis. The combined broad-range PCR-TTGE (temporal temperature gradient gel electrophoresis) technique can detect several bacterial pathogens in ticks in a single step. Transmissible spongiform encephalopathies, in particular variant Creutzfeldt-Jakob disease (vCJD), are caused by prions, which are able cross species barriers. Relatively little is known about their routes of transmission. Recent experiments for vCJD have shown that intravenous route for infecting Macaque monkeys is as efficient as previously used intracerebral route, which implies a risk for transmission through blood transfusion. Indeed, 2 cases due blood transfusions have been identified in humans. Risk factors for vCJD include dietary exposure infectious agent of bovine spongiform encephalopathy and may be related low mean age (29 years) for death due this disease. In addition, many patients with this disease live relatively close each other; however, implications of this finding are unclear. The meeting concluded with topical subject of emerging respiratory in particular those caused by coronaviruses and influenza viruses. The host range of coronaviruses is greater than initially thought. Feline and canine coronaviruses are closely related porcine gastroenteritis virus and are also able replicate and cause enteric disease in swine. Coronavirus relatedness is well demonstrated by coronavirus associated with severe acute respiratory syndrome (SARS). Like many of new emergent SARS has a zoonotic origin that is as yet unknown. A total of 8,098 cases of SARS and 774 deaths (case-fatality rate of 9.6%) have occurred worldwide; incidence is higher among healthcare workers (case-fatality rate 17%). The spread of SARS was due global travel and was also attributed illegal wildlife trade. Delays in identifying symptoms or clusters of case-patients increased risk of contracting SARS, especially in healthcare workers, and inadequate personal protective equipment played a large role in its spread. The need for global medical and veterinary information systems was emphasized. Strict adherence protective measures for avoiding bird-to-human transmission, in context of avian influenza viruses, was also underscored, particularly since Asian outbreak, which began in December 2003, is still ongoing. In general, conference encouraged participants exchange ideas and consider future collaborations. One suggestion for coordinating such efforts could be a European version of Centers for Disease Control and Prevention. In 1969, then-Surgeon General William H. Stewart stated that the time has come close book on infectious diseases, demonstrating a misinformed and rather optimistic opinion. By contrast, third congress ended with a warning to expect unexpected.
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Oct 1, 2006
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