WELCO

ME
 EMERGING AND RE-
EMERGING INFECTIOUS
DISEASES

CAPT SHAHARUL
INTRODUCTION
 AIM

To introduce major concepts related

to emerging and re-emerging
infectious diseases.
 SCOPE

Emerging and Re-emerging infectious

diseases
Factors contributing to emerge
Basic concept of the infectious diseases
Challenges to prevent the emergence
Recommendation
Conclusion
 “Emerging” & “Re-Emerging”

Emerging Re-emerging
Diseases that Diseases that once were
have not major health problems
occurred in globally or in a particular
country, and then declined
humans before dramatically, but are again
or becoming health problems
that occurred for a significant proportion of
only the population.
in small numbers
in isolated Diseases thought to be
places. adequately controlled
making a “comeback” are
 CONT..

NEW DISEASE EMERGE

&
OLD DISEASE RE-EMERGE
DRIVING FORCES TO ENERGE
Ecological disruption and human
intrusion into new ecological
system increases the exposure of
human to new infectious agents.
Usually tropical & Developing
countries are HOT SPOT of
outbreak
of diseases
Climate change is another potential
driver that shifts the ecological niche
or range of the diseases.

Long-term impact of global warming, some

major climatic events caused disease
outbreaks in the areas that have not
experienced the disease before.
 Urbanization and Industrialization
impact the prevalence and scope of
both infectious and chronic diseases.
High risked sexual practices, multiple
sexual partners and use of substances
directly transmit the diseases

Overcrowding causes person to person rapid

spreading of diseases.
Poor housing quality, poor sanitation and
water supply infrastructure.
 International trade of goods and services through
international border facilitate the spread of diseases
by bringing pathogen to new geographical areas.

Travelers are exposed to variety of pathogen, many

of them have never encountered and no immunity to
many diseases.
 EVOLUTION OF THE INFECTIOUS
AGENT

Mutations in bacterial genes that confer

resistance to antibiotics – 20%
Multidrug-resistant & extremely drug-
resistant TB
Multi drug resistant P.falciparum
 REDUCED HUMAN IMMUNITY
Immunization failure
(breakdowns in public
health measures)

Increased number
of
immunocompromise
d hosts.
War & Political conflict
cuase breakdown of
public health
infrastructure has role
in emergence of
diseases.

Poor primary health

care services may not
be equipped to deal
with some
infectious outbreaks
 EMERGING DISEASES
Year recognized Disease Infectious agent
New viral strain Pandemic Influenza Influenza virus
emerge periodically
1967 Murburg hemorrhagic Marburg virus
fever
Before 1976 Salmonellosis Salmonella entertidis
1976 Ebola hemorrhagic Ebola virus
fever
1983 AIDS Human Immuno-deficiency
Virus
1983 Gastric ulcers Helicobacter pylori
1989 Hepatitis C Hepatitis C virus (HCV)
1998 Nipah encephalitis Nipah encephalitis
2002 VRSA infection Vancomycin resistant
S. aureus
2003 SARS (severe acute SARS-associated
respiratory syndrome) coronavirus
2015 Zika Zika virus
 RE-EMERGING DISEASES
DISEASE AGENT
DENGUE FEVER Dengue virus

MALARIA Plasmodium species

(protozoan)
MENINGITIS Group A Streptococcus
(bacterium)
SCHISTOSOMIASIS Schistosoma species (helminth)

RABIES Rabies virus

CHOLERA Vibrio cholerae 0139

(bacterium)
POLIO Poliovirus

YELLOW FEVER Yellow fever virus

TUBERCULOSIS Mycobacterium tuberculosis

 SARS
(Severe Acute Respiratory Syndrome)

Total 8429 cases; 824 deaths

SARS: The First Emerging 30 countries in 7-8 months
Infectious Disease Of The 21st in 2003
Century (China, 2003)
The 2014 Ebola outbreak is the largest in
history.
Primarily affecting Guinea, Northern Liberia,
and Sierra Leone.

Ebola virus disease (EVD), previous known as

Ebola hemorrhagic fever (Ebola HF)

Fatality rate of up to 90%

Transmitted by direct contact with the blood,

body fluids and tissues of infected animals or
people
More than 11,000 deaths only in Africa
 TUBERCULOSIS
Tuberculosis or TB is an infectious
bacterial disease caused by
Mycobacterium tuberculosis, which
most commonly affects the lungs.

In the 18th and 19th centuries, a

tuberculosis epidemic rampaged
throughout Europe and North America.

In 1993 the World Health Organization

(WHO) declared that TB was a Global
Emergency; the first time that a
disease had been labeled as such.
Approximately 390 million people worldwide infected
with the dengue virus each year.
 SWINE FLU (H1N1 Virus)

Since December
2014, swine flu
has claimed the
lives of over
1,300 people in
India, making it
the worst
outbreak of the
virus in the
country since
Highly Pathogenic Avian Influenza
(H5N1)
 Epidermodysplasia Verruciformis
(Tree Man)
GENETICS
The cause of this condition is an inactivating PH mutation in the
EVER1 or EVER2 genes which are located adjacent to one
another on Chromosome 17
 MALARIA

Infectious agent is Plasmodium species

Malaria is transmitted among humans by female
mosquitoes of the genus Anopheles.
LEPTOSPIROSIS
 CHOLERA

Causative agent is
Vibrio cholera

Water borne diseas

 MURBURG VIRUS
(Murburg Hemorrhagic Fever)
Varying pathogenicity (mortality ranging from
21-80%).
Responsible for 1967 outbreak in Europe.
Outbreaks in 2000 in Democratic Republic of
the Congo and 2005 in Angola.

Currently no vaccine or treatment.

 Tlea (Ceratophyllus faciatus)
BUBONIC PLAGUE

PNEUMONIC PLAGUE SEPTICEMIC PLAGUE

 EID IN SEA REGION
EID – a leading cause of death globally
17 m die annually from ID – SEA accounts for 41%
or 7 m deaths
EID cause suffering & impose financial burden on
society
Plague outbreak in 1994 cost India over 1.5 B USD
due to loss in trade, employment & tourism
In Thailand cost of one AIDS patient more than 5000
USD
Overall costs for India on account of AIDS
estimataed at 11 b USD
Increasing or persistent poverty & poor living
conditions continue to expose millions of people to
the hazards of infectious diseases.
The low priority & support given to public health
 MANAGEMENT OF EID
A proactive and planned approach to ensure the
appropriate prevention and control of the spread
of disease. Strategic planning should include:
Phase I (non-alert) is a routine, preparatory state;
Phase II (alert) is the detection, confirmation and
declaration of changes identified during non-alert
conditions;

Phase III (response) includes the ongoing assessment

of information and the planning and implementation of an
appropriate response, which includes the coordination
and mobilization of resources to support intervention
activities

Phase IV (follow-up) activities include re-evaluation,

 RECOMMENDATION
Strengthening epidemiological surveillance &
laboratory capabilities and services .
Establishment of a rapid response team.
Monitoring antimicrobial resistance.
Establishment of international disease
surveillance. networking and advocacy.
Screening on International travels and trades.
Networks of laboratories that link countries and
regions need to be established.
Strong national and regional public health
systems.
CONCLUSION
Thank You!!!