NEW EMERGING AND REEMERGING DISEASES Definitions New Emerging

NEW EMERGING AND REEMERGING DISEASES •

Definitions • New Emerging infectious diseases newly identified or previously unknown infections • Re-emerging infectious diseases re-appearance of, or increase in number of, infections from a disease previously known 2

New Emerging Infectious Diseases: Definition Diseases of infectious origin whose incidence in humans has increased within the recent past or threatens to increase in the near future, including: previously unknown infectious diseases; known but appearing in new geographic areas; or increase abruptly; 3

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Infectious Diseases: A World in Transition 5

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• The human species Continues to change and to change its surroundings: the ways we live, work, relax; the places we go; the foods we eat. . . • The changing nature of our interactions with each other and with our environment alters the dynamics of disease epidemiology and exposes us to new threats. 8

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ENVIRONTMENT 12

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EMERGING DISEASES ARE NOT NEW TO MANKIND 16

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NEWLY IDENTIFIED PHATOGENS (1973 - 1989) 1973 Rotavirus 1975 Parvovirus B 19 1976 Cryptosporidium parvum 1977 Ebola virus, Legionella pneumophilia, Hantaan virus, Campylobacter jejuni 1980 HTLV-1 1981 Staphylococcus toxin 1982 E. coli O 157, HTLV-2, Borrelia burgdoferi 1983 HIV virus, Helicobacter pylori 1988 HHV-6, Hepatitis E 1989 Ehrlichia chaffeensis, Hepatitis C 18

Newly identified pathogens (1990 - 1999) 1990 Guanarito virus 1991 Encephalitozzon hellem 1992 Vibrio cholerae O 139 1992 Bartonella henselae 1993 Sabia virus 1995 Hepatitis G virus 1995 Human herpesvirus-8 1996 TSE causing agent (nv. CJD) 1997 Avian influenza (Type A H 5 N 1) 1999 Nipah virus, Avian Influenza H 9 N 1, Stealth viruses 19

Newly identified pathogens (1997 – 2009) • 1998 Nipah encephalitis • 2003 SARS • 2004 Avian influenza H 5 N 1 • 2006 Chikungunya- re-emergence • 2009 Pandemic influenza A H 1 N 1 20

Since 1973 39 newly identified pathogens, examples : 1973 Rotavirus 1977 Ebola virus, Hantaan virus 1980 HTLV-1 1983 HIV virus H pylori 1988 Hepatitis E 1992 Vibrio cholerae O 139 1996 Avian influenza A (H 5 N 1) 1999 Nipah virus 2003 SARS Others re-emerged Dengue/DHF Cholera Malaria Chikungunya J. Encephalitis Leptospirosis N. meningitidis 21

�Current estimates 1, 415 microbes are infectious for human. �Of these, 868 (61%) considered zoonotic. � 70% of newly recognized pathogens are zoonoses. 22

�Current estimates 1, 415 microbes are infectious for human. �Of these, 868 (61%) considered zoonotic. � 70% of newly recognized pathogens are zoonoses. 23

Risk factors for emerging zoonoses: close human animal interface in Asia 24

Examples of recent emerging and re-emerging diseases 25

Emergence of HPAI (H 5 N 1) 2003 -June 2008 a total of 385 cases with 243 deaths 26

GEOGRAPHIC DISTRIBUTION OF PROBABLE CASES 27

SARS: THE FIRST EMERGING INFECTIOUS DISEASE OF THE 21 ST CENTURY 28

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EMERGENCY DENGUE FEVER/DENGUE HAEMORRHAGIC FEVER 38

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