Emerging And Re-emerging Infectious Diseases

Outline
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 Introduction
 Emerging & Re-emerging Diseases
 Factors Responsible
 Responses to Emerging Infections
 Control Measures
 IDSP
 References
Emerging & Re-emerging Infectious Diseases 19/10/2024
1. Introduction
 Burden of Infectious diseases
 Definitions of Emerging & Re-emerging
infectious diseases

Emerging & Re-emerging Infectious Diseases 19/10/2024

 Introduction
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 Trends of some infectious diseases amounts to crises for

today and a challenge for the future.

 World Health Day Theme (1997) :

“ Emerging infectious diseases –
Global Alert : Global Response “

Emerging & Re-emerging Infectious Diseases 19/10/2024

 Introduction (Contd…)
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 Burden : 1/3rd of all deaths in the world is due to infectious

diseases.

Other causes 67%

33% (34.6 million)
Other Causes (34.6 million)

Infectious Diseases (17.3 million)

67%

Emerging & Re-emerging Infectious Diseases 19/10/2024

A new public health threat?
 Introduction (Contd…)
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 Emerging infections disease:

 An emerging infectious disease is one that is caused by a
newly discovered infectious agent or by a newly identified
variant of a known pathogen, which has emerged and
whose incidence in humans has increased during the last
two decades and is threatened to increase in the near
future.

Emerging & Re-emerging Infectious Diseases 19/10/2024

 Introduction (Contd…)
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 Re-emerging infectious diseases:

 A re-emerging infectious disease is a one which was
previously controlled by chemotherapy and antibiotics, but
now they have developed antimicrobial resistance and are
often appearing in epidemic form.

 This term also refers to that disease which was formerly

confined to one geographical area, has now spread to
others areas.

Emerging & Re-emerging Infectious Diseases 19/10/2024

2. Emerging & Re-emerging Diseases

 Emerging Infectious diseases

 Re-emerging Infectious Diseases

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 New Infectious diseases since -1973
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Year Agent Viral Diseases

1973 Rotavirus Infantile diarrhoea
1975 Parvovirus Aplastic Crisis in chronic Hemolytic
B19 anaemia
1977 Ebola Virus Haemorrhagic fever
1977 Hanta virus Haemorrhagic fever with Renal
Syndrome
1980 HTLV-1 T-cell Lymphoma - Leukaemia
1982 HTLV-2 Hairy cell Leukaemia

Emerging & Re-emerging Infectious Diseases 19/10/2024

 New Infectious diseases since -1973
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Year Agent Viral Diseases

1983 HIV AIDS
1988 Hepatitis E Virus Non-A, Non-B, Hepatitis
1989 Hepatitis C virus Parenterally transmitted Non-A,
Non-B, Hepatitis
1997 H5N1 Avian flu
1999 Nipah virus Encephalitis
2003 Corona Virus SARS
2009 H1N1 Swine Flu

Emerging & Re-emerging Infectious Diseases 19/10/2024

 New Infectious diseases since -1973
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Year Agent Bacterial Diseases

1977 Campylobacter Jejuni Enteric Pathogen

1977 Legionella Pneumophila Legionnaires Diseases
1981 Staphylococcus aureus Toxic Shock Syndrome
1982 Borrelia burgdoferi Lyme Diseases
1983 Helicobacter Pylori Peptic ulcer
1992 Vibrio Cholerae 0139 Epidemic cholera

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 New Infectious diseases since -1973
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Year Agent Parasitic Diseases

1976 Cryptosporidium parvum Acute & chronic Diarrhoea

1986 Cyclospora cayctanensis Persistent diarrhoea

1991 Encephalitozoon hellem Conjunctivitis

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 Re-emerging infectious diseases
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 Dengue/DHF  Typhoid
 Malaria  Tuberculosis
 Chikungunya  Kala azar
 Japanese Encephalitis  Plague
 Cholera

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3. Factors Responsible
 Factors Responsible
 Anti-microbial Resistance
 Major Challenges

Emerging & Re-emerging Infectious Diseases 19/10/2024

 Factors Responsible
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 Improper planning of township

 Population explosion, poor living conditions with over
crowding
 Uncontrolled Industrialisation and Urbanisation
 Lack of health care services
 Intense international travel
 Indiscriminate use of antibiotics and development of
resistance
 Increase in contact with animals
 Environmental degradation with changing weather pattern

Emerging & Re-emerging Infectious Diseases 19/10/2024

 Antimicrobial Resistance
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 Not a new pathogen but emerging as a public health problem

 AMR increasing at alarming rate
 Examples
 TB, E coli, S aureus, Salmonella, etc..

 Causes
 Indiscriminate use of antibiotics
 Use of antimicrobial substances in food and animal productions

Emerging & Re-emerging Infectious Diseases 19/10/2024

 Major Challenges
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 Building core capacities for surveillance and response at all

levels – national, intermediary, local (technical challenge)

 Mobilization of resources to meet core capacities

requirements (financial challenge)

 National Commitment to rapid sharing of information,

materials and inter-country collaboration (political challenge)

 Disease control strategies - not one size fits all

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4. Response to Emerging Infections
 Key task in dealing with Infectious Diseases
 Surveillance Networks

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 Key tasks in dealing with emerging diseases
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 Surveillance at national, regional, global level

 Epidemiological Ecological
 Laboratory Anthropological

 Investigation and early control measures

 Implement prevention measures
 Behavioural, political & environmental
 Monitoring & evaluation

Emerging & Re-emerging Infectious Diseases 19/10/2024

 Surveillance Networks
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 Global Project on Anti-tuberculosis Drug Resistance

Surveillance
Started in 1944 to measure the prevalence of anti-
TB drug resistance and to study the correlation between the
level of drug resistance and treatment policies in those
countries

 Global Influenza Surveillance Network

 Estd 1952
 More than 100 virus labs in 83 countries

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 Surveillance Networks (Contd…)
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 Laboratory Response Network (LRN)

Estd by CDC in 1999 to respond quickly to acts of
chemical and biological terrorism, emerging infectious
diseases, and other public health emergencies, >120 labs
have network . The value of LRN was demonstrated during
SARS epidemic.

 Global Laboratory Network for Poliomyelitis eradication

Estd in 2000-01

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 Surveillance Networks (Contd…)
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 Global Salmonella Surveillance System

Started in 2000 to carry out surveillance, sero-typing
and antimicrobial testing

 Global Outbreak Alert and Response Network (GOARN)

• Launched in 2000 to ensure rapid deployment of technical
assistance to affected areas.
• Links more than 120 partner institutions and surveillance
networks which possess expertise, skills & resources for
rapid outbreak detection, verification and response.

Emerging & Re-emerging Infectious Diseases 19/10/2024

5. Control Measures
 Control of reservoir and source of infection
 Block channel of communication
 Protection of susceptible population

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 Control Measures
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A. Control of reservoir and source of infection

 Early detection of cases

 Notification

 Isolation

 Treatment

 Quarantine

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 Control Measures (Contd…)
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B. Block channel of communication

 Environment control
 Safe water supply
 Sanitary disposal of waste
 Food Hygiene
 Personal Hygiene
 Proper ventilation
 Vector control
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 Control Measures (Contd…)
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C. Protection of susceptible population

 Immunization
 Chemoprophylaxis
 Good nutrition
 Health education

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6. Integrated Disease Surveillance Project
Organisational structure
Functions

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 IDSP
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 Its called integrated –

 Public sector
 Private sector
 Community participation
 Communicable & Non-communicable
 Urban & rural
 International health agencies

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 IDSP
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 Organisational structure
 CSU – Central
 SSU – state
 DSU - district

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 IDSP (Contd…)
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 Types of surveillance
 Syndromic : suspected cases – sub-centre level
 Presumptive : probable cases – PHC level
 Laboratory : confirmed cases – CHC & District

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 IDSP (Contd…)
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 Diseases conditions covered under IDSP:

 Malaria
 Acute diarrhoeal diseases
 Tuberculosis
 Measles & Polio Regular Surveillance
 Road traffic accidents
 Plague
 Meningoencephalitis
 Hemorrhagic fevers

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 IDSP (Contd…)
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 Diseases conditions covered under IDSP:

 HIV
 HBV
 HCV Sentinel Surveillance
 Water quality
 Out door air quality

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 IDSP (Contd…)
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 Diseases conditions covered under IDSP:

 Non – communicable risk factors
 Anthropometry
 Physical activity
 Blood pressure
 Tobacco
Regular periodic survey
 Nutrition
 Blindness

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 IDSP (Contd…)
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 Diseases conditions covered under IDSP:

 Public health emergency
 Anotherunusual condition may be included during publuc
health emergencies

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 WHO’s vision for the 21st Century
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 Strong national disease surveillance and control programmes

 Global networks of centres, organisations and individuals to

monitor diseases
 Rapid information exchange through electronic links to guide
policies, international collaboration, trade and travel
 Effective national and international preparedness, and rapid
response to contain epidemics of international importance

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 Take home message
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 Emerging : New diseases; New problems (New threats)

 Re-emerging : Old diseases; New Problems (New Threats)

 Strengthening of the disease surveillance system

 Encouraging research

 Up-gradation of International Health Regulation

Emerging & Re-emerging Infectious Diseases 19/10/2024

 References
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 Park text book of preventive & social medicine by K.Park – 22 nd edition

 Community medicine with recent advances by AH Suryakantha – 2 nd edition
 WHO (1996) , The World Health Report 1996
 WHO (1999) , Removing Obstacles to Healthy Development, WHO report on
Infectious Diseases
 WHO (2003) , World Health Report 2003, Shaping the future.
 ICMR Bulletin. Emerging Infectious Diseases in South East Asia. Research Priorities,
ICMR, New Delhi 2004; 34: 5-6
 WHO emerging Infectious Diseases – Global Response, Global Alert. Backgrounder
World Health Day; Geneva 7th April 1997
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 Any queries ???
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Emerging & Re-emerging Infectious Diseases 19/10/2024