Emerging and re-emerging

diseases
Prepared by:

Loay fares Yousef khaled

Presented to
Dr. Asad Alramlawi
Introduction
Emerging Infectious Diseases:
• Emerging infectious diseases are “New diseases; new problem
(New threats)”
• An emerging infectious disease is a one that is caused by a
newly discovered infectious agent or
• by a newly identified pathogen, which has emerged and
whose incidence in humans has increased during the last 2
decades and is threatening to increase in the near future.
Re-emerging Infectious Diseases:
• Re-emerging infectious diseases are “old diseases, new
problem. (New threats)”.
• A re-emerging infectious disease is a one which was previously
controlled but once again has risen to be a significant health
problem.
• This term also refers to that disease which was formerly
confined to one geographic area, has now spread to other areas.
Emerging Infectious Disease
Categories according to

National Institute of
Allergy and Infectious
Diseases (NIAID)
 Category A Priority Pathogens
› Category A pathogens are those organisms/biological agents
that pose the highest risk to national security and public
health because they:
Can be easily disseminated or transmitted from person to
person
Result in high mortality rates and have the potential for major
public health impact
Require special action for public health preparedness
 Category B Priority Pathogens
› Category B pathogens are the second highest priority
organisms/biological agents. They:
Are moderately easy to disseminate
Result in moderate morbidity rates and low mortality rates
 Category C Priority Pathogens
Category C pathogens are the third highest priority and include
emerging pathogens that could be engineered for mass
dissemination in the future because of
Availability
Ease of production and dissemination
Potential for high morbidity and mortality rates and major health impact
 Category A Priority Pathogens
› Bacillus anthracis (anthrax)
› Yersinia pestis (plague)
› Variola major (smallpox) and other related pox viruses
› Dengue
› Ebola viruses
› Severe acute respiratory syndrome associated coronavirus
(SARS-CoV), MERS-CoV, and other highly pathogenic human
coronaviruses
 Category B Priority Pathogens
– Brucella species (brucellosis)
– Typhus fever (Rickettsia prowazekii)
– Food- and waterborne pathogens
› Bacteria
– Diarrheagenic E.coli
– Shigella species
– Salmonella
› Viruses
– Hepatitis A
› Protozoa
– Giardia lamblia
– Entamoeba histolytica
 Category C Priority Pathogens
› Tuberculosis, including drug-resistant TB
› Influenza virus
› Other Rickettsias
› Rabies virus
› Antimicrobial resistance pathogens
 EMERGING DISEASES
Year recognized Disease Infectious agent
1967 Murburg hemorrhagic fever Marburg virus
Before 1976 Salmonellosis Salmonella entertidis
1976 Ebola hemorrhagic fever Ebola virus
1983 AIDS HIV
1989 Hepatitis C Hepatitis C virus (HCV)
2002 VRSA infection Vancomycin resistant S.
aureus
2003 SARS (severe acute respiratory SARS-associated coronavirus
syndrome)
2015 Zika Zika virus
2019 COVID-19 pandimic COVID-19 virus
 Re-emerging diseases
DISEASE AGENT

DENGUE FEVER Dengue virus

MALARIA Plasmodium species (protozoan)

RABIES Rabies virus

CHOLERA Vibrio cholerae 0139 (bacterium)

POLIO Poliovirus

YELLOW FEVER Yellow fever virus

TUBERCULOSIS Mycobacterium tuberculosis (bacterium)

  Swine Flu (H1N1)
• Swine flu causes respiratory disease – high level of illness, low death rates
• Causative agent- Influenza A
• RNA virus- highly mutagenic
• Pigs can get infected by human, avian and swine influenza virus
• Pandemic outbreak since April 2009
• April 15th 2009 CDC identifies H1N1 (swine flu)
• April 25th 2009 WHO declares public health emergency
• By May 5th 2009 more than 1000 cases confirmed in 21 countries
• From April 12, 2009 to April 10, 2010, CDC estimated there were 60.8
million cases
• CDC estimated that 151,700-575,400 people worldwide died from
(H1N1)pdm09 virus infection during the first year the virus circulated
 Highly Pathogenic Avian Influenza (H5N1)
• Since Nov 2003, avian influenza H5N1 in birds affected 60
countries across Asia, Europe, Middle-East & Africa
• >220 million birds killed by this virus or culled to prevent
further spread
• Majority of human H5N1 infection due to direct contact with
birds infected with virus
 Factors Contributing To The Emergence Or
Re-Emergence Of Infectious Diseases

AGENT:
• Evolution of pathogenic infectious agents (microbial adaptation & change)
• Development of resistance to drugs: -Wrong prescribing practices
-Non-adherence by patients
-Use of anti-infective drugs in
animals & plants

• Resistance of vectors to pesticides

› 5
HOST :
• Human demographic change (inhabiting new areas).
• Human behaviour:
1. Unsafe sexual practices (HIV, Gonorrhoea, Syphilis).
2. Changes in agricultural & food production patterns-
foodborne infectious agents (E. coli).
3. Increased international travel (Influenza).
• Human susceptibility to infection (Immunosuppression).
• Poverty & social inequality.
• Illiteracy.
ENVIRONMENT :

• Climate & changing ecosystems:

* Deforestation forces animals into closer human contact- increase
possibility for agents to breach species barrier between animals &
humans.
* EL Nino- Triggers natural disasters & related outbreaks of infectious
diseases (Malaria, Cholera).
* Global warming.
• Economic development & Land use (urbanization, deforestation).
• Technology & industry (food processing & handling).
• International travel & commerce.
• Deterioration in surveillance systems (lack of political will).
• Breakdown of public health measure:
* WAR.

* Overcrowded cities (e.g. slums).

* Starvation.
 Control of Emerging and Re-emerging Diseases
Remember the
chain of infection

• Controlling the reservoir.

• Interrupting the transmission.
• Protecting the susceptible host.
• Strengthening of the disease surveillance system.
• Encouraging research initiations for treatment regimens and
diagnostics.
• Encouraging research for new methods of control measures.
• Establishment of drug resistance.
Antibiotic resistance
• Emerge in environment due to inappropriate use of antibiotic

• WHO estimates that 10 million people are dying of infectious

diseases related to antibiotic resistance.

• Proper antibiotic guidelines needed to prevent the drug

resistance.
 Role of Doctors in Prevention

• Increase knowledge and skill ; Educate the public

• Encourage partnerships with consumers and other disciplines to
identify needs, set priorities, develop strategies and evaluate
progress
• Support health care legislation
• Involve in research
• Encourage using multidisciplinary efforts.
• Influence local and National economic and political options
• Continue to advance nursing concern
 Role of Public Health Authorities

• National programme for prevention and control of vector borne

diseases
• Legislations for elimination
• Communities awareness of the disease
• Minimizing transmission of infection: By
* Risk communication to the family members
* Minimizing vector population
* Minimizing vector – individual contact
• Reporting to the nearest public health authority
 Public health measures to prevent infectious
diseases

• Safe water
• Sewage treatment and disposal
• Food safety programme
• Animal control programme
• Vaccination programme
• Public health organization
Lesson learnt from SARS

An infectious disease in one country is a threat to all

Important role of air travel in international spread
Tremendous negative economic impact on trade, travel and tourism,
estimated loss of $ 30 to $150 billion
High level commitment is crucial for rapid containment
WHO can play a critical role in catalyzing international cooperation and
support
Global partnerships & rapid sharing of data/information enhances
preparedness and response
The Story of Taiwan and COVID-19
Thank
You