Emergence Of New Infectious Diseases Research Articles

Emerging infectious diseases.

Human population growth, technological advances, and changing social behaviors lead to the selection of new microbial pathogens. Antimicrobial drugs, vaccines, diagnostics, and treatments for emerging infectious diseases must be developed. The selective forces that drive the emergence of new infectious diseases, and the implications for our survival, are just beginning to be understood.

An analysis of imported infections over a 5-year period at a teaching hospital in the United Kingdom

Background. Imported infections are an important cause of morbidity and mortality in the United Kingdom. Methods. A 5-year analysis of cases seen in a large teaching and district general hospital in the Eastern Region of the UK was performed using ward records correlated with Hospital coding data and Hospital Episode Statistics from the Department of Health. Results. A surprising number (301) and diversity of imported infections was diagnosed. Prophylactic measures were, where assessable, generally inadequate. Conclusions. These data warrant renewed efforts to educate travellers of the risks of infection acquired abroad. The continued rise in global travel along with emergence of new infectious diseases emphasises further the need for expanded infectious diseases services incorporating accessible travel advice services in the UK which are currently underprovided.

HIV and AIDS: looking ahead.

Although the future of HIV science is uncertain, we need to reappraise HIV diversity, pathogenesis and immunity. The AIDS pandemic threatens the success of existing vaccine programs and may accelerate the emergence of new infectious diseases.

The HIV/AIDS pandemic: a sign of instability in a complex global system.

Intense scientific work on HIV/AIDS has led to the development of effective combination drug therapies and there is hope that effective vaccines will soon be produced. However, the majority of people with HIV/AIDS in the world are not benefiting from such advances because of extreme poverty. This article focuses on the pandemic as a reflection of a complex trajectory of social and economic forces that create widening global disparities in wealth and health and concomitant ecological niches for the emergence of new infectious diseases. While the biomedical approach to HIV/AIDS is necessary, has prolonged the lives of many individuals and could offer much at the level of population health, it cannot, in isolation, improve the health of populations. To achieve the latter will require understanding and addressing the deeper social causes of pandemics. Broadening the discourse on ethics to include public health ethics and the ethics of international relations could contribute to reducing the impact of the pandemic and to preventing the emergence of new infectious diseases in the future.

The new Protection against Infection Act

The emergence of new infectious diseases and, as a result of globalisation, exposure to diseases that had already been largely eradicated in the Federal Republic of Germany show how important it is to put a Protection against Infection Act into place that matches a current requirement profile. A sine qua non for targeted action is a valid data pool on infection epidemiology and its evaluation on the regional, Laender and federal levels. Under the recent Act, more effective use is to be made of laboratory diagnosis technologies, and the co-operation between the medical profession, public health services and scientists intensified to enhance the protection of the general public against infections. Of special importance here are the tasks that fall to the health office as lower health authority with its subsidiary services and in its function as the partner and advisor of the citizens and the inpatient and outpatient health care services. Regulations covering the reporting system, vaccinations and immunizations, hospital hygiene, schools and community facilities, food trade, water for human use, work with pathogens have been rendered more precise and/or updated.

Bacterial genomics as a potential tool for discovering new antimicrobial agents.

The past 30 years have witnessed the emergence of new infectious diseases as well as the re-emergence of those thought to be defeated or under control. It is likely that this threat will continue and that infectious micro-organisms will be found to be responsible for numerous diseases whose etiology had been previously unknown. Compounding this threat is the rapid evolution of drug resistance by micro-organisms that is rendering many existing antimicrobial agents obsolete. Thus, there is an urgent need for the development of new classes of antimicrobial agents and the identification of new drug targets. Over the past decade, advances in high-throughput automated DNA sequencing have delivered a wealth of genetic information in the form of whole genome sequences of microbial pathogens. Coupled with this advancement has been the development of new genetic tools and computational advances capable of selecting genes of particular interest as well as testing for the effects of candidate drugs. While no new drugs have yet been developed, further study into the application and limitations of these new approaches to the identification of novel targets will aid in overcoming the current problem of antimicrobial drug resistance.

CDC on Infectious Diseases in the United States: 1900–99

As part of a series of reports discussing public health achievements in the United States during the twentieth century, the Centers for Disease Control and Prevention (CDC) issued a summary description of the evolution of mortality from infectious diseases, and of public health actions and technological developments shaping that evolution, during the present century. (The CDC is an agency of the US Department of Health and Human Services.) This document, titled “Achievements in public health, 1900–1999: Control of infectious diseases,” appeared in the Morbidity and Mortality Weekly Report (a publication of the CDC), 48 (29), 30 July 1999. It is reproduced below in full. (For an earlier issue in this series, discussing the effect of vaccines on children's health, see the Documents section of the June 1999 issue of PDR.)The report succinctly documents the dramatic reduction of infectious disease mortality during the last 100 years in the United States and the parallel radical transformation of the composition of deaths by cause that occurred during that period. It identifies the main causes responsible for these changes: improvements in sanitation and hygiene, the introduction of antibiotics, and the implementation of universal childhood vaccination programs. Improved capacity for detecting, diagnosing, and monitoring infectious diseases was another underlying factor in the successful reduction of mortality and morbidity from infectious diseases. The emergence of new infectious diseases, notably AIDS, and the reemergence of older diseases in drug‐resistant strains, led to an increase of overall infectious disease mortality in the 1980s and early 1990s. The report stresses the need for continued research into treatment of infectious diseases and for improved capacity for surveillance and appropriate outbreak response as one of the public health challenges of the twenty‐first century.

Foodborne disease control: a transnational challenge.

In the globalized political economy of the late 20th century, increasing social, political, and economic interdependence is occurring as a result of the rapid movement of people, images, values, and financial transactions across national borders. Another consequence of the increase in transnational trade, travel, and migration is the greater risk of cross-border transmission of infectious diseases. As the world becomes more interconnected, diseases spread more rapidly and effectively. With more than one million people crossing international borders every day, and with the globalization of food production, manufacturing, and marketing, the risk of infectious disease transmission is greater. Economic globalization has also increased the need for governmental budget austerity, and consequent national preparedness has been eroded. The emergence of new infectious diseases, as well as the reemergence of old ones, thus represents a crucial transnational policy issue. These problems cannot be resolved by national governments alone; they require international cooperation. This article analyzes the role of foodborne disease surveillance programs, nationally and internationally, in the control of foodborne diseases.

The Big Killers: Mortality Crises in Social Context

The emergence of new infectious diseases and the resurgence of old ones fascinate scholars as well as the public. Before the Ebola virus made the best-seller lists or starred in a feature-length film, the International Commission on Historical Demography (ICHD) had planned a colloquium for its quinquennial meeting in Montreal, “The Big Killers: Epidemics, Famine, and War in Historical Perspective” (27 August–3 September 1995). Twenty-eight papers materialized. Interpretation and synthesis were the principal concerns. Technical obsessions of the guild—methodology, data, quantification, and the like—were banned. Instead, authors were encouraged to focus on the interrelations between mortality crises, on the one hand, and culture, society, economy, and politics, on the other.

The Coming Plague: Newly Emerging Diseases in a World out of Balance

Laurie Garrett Virago, pounds sterling20, pp 750 ISBN 1 85381 764 3 Optimism that followed the development of effective antibiotics, vaccines, and ambitious public health programmes has been confounded by the emergence of new infectious diseases and resurgence of old ones, sometimes in impressive epidemics. The changing nature of infectious disease epidemiology results from the altered balance between host (humans), agent (the microbe), and environment; this is the subject matter of this excellent book by the American journalist Laurie Garrett. The Coming Plague describes for the nonspecialist what several recent official reports in the United States have documented for …

Dynamics of Emergence

I have touched briefly here on the complex matrix of social, economic, political, and ecologic factors that have played a major role in the emergence of microbial diseases. But beyond these factors that contribute to the emergence of new infectious diseases, we must also recognize changes in microbial agents, human populations, insect vectors, and the ecologic relationships among them. Microbes and vectors swim in the evolutionary stream and they swim much faster than we do. Bacteria reproduce every 30 min; for them a millennium is compressed into a fortnight. Microbes were here, learning every trick for survival, 2 billion years before humans arrived, and it is likely that they will be here 2 billion years after we depart. Furthermore, science cannot halt the future occurrence of new microbes, which emerge from the evolutionary stream as a consequence of genetic events and selective pressures that favor the new over the old. It is nature's way. For all of these reasons, old and new infections will occur in the future as they have in the past. Surveillance efforts, both in the United States and other regions of the world, will be needed to blunt the emergence of such infections and to forestall epidemics and pandemics. But surveillance alone cannot detect the unexpected emergence of future microbes or prepare the defense against them. That will require a broadly based research effort to devise new methods of diagnosis, treatment, and prevention. We must swim with the microbes and study their survival and adaptation to new habitats.(ABSTRACT TRUNCATED AT 250 WORDS)

Hantavirus in the southwestern United States: Epidemiology of an emerging pathogen

In May of this year, an outbreak of sudden, unexplained, and highly fatal respiratory illness of unknown etiology was identified in the four-corners region of the southwestern United States. Within 3 weeks after the collaborative response launched by the state and local health agencies in the affected area, laboratory studies from the federal Centers for Disease Control and Prevention suggested that an acute infection with a previously unrecognized Hantavirus species was responsible for the reported cluster of cases. The hantavirus associated with this outbreak has since been isolated in tissue culture, and diagnostic test systems specific for the newly identified hantavirus have been developed. This article summarizes the history of the outbreak as experienced by investigators from the Arizona Department of Health Services and reviews the epidemiologic and clinical aspects of both the current epidemic and hantaviruses in general. The sudden occurrence of acute illnesses in the Southwest due to a previously unrecognized hantavirus reaffirms that the potential for the emergence of new infectious diseases exists at any place or time in the United States. The response to the outbreak also illustrates how community clinicians and federal, state, and local health agencies work together to promptly identify the emergence of new disease threats, rapidly determine new etiologic agents, and develop and swiftly implement appropriate disease prevention and control strategies.