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Emerging infectious disease

January 01, 1970

For the medical journal, see Emerging Infectious Diseases (journal).

An emerging infectious disease (EID) is an infectious disease whose incidence has increased recently (in the past 20 years), and could increase in the near future.[2][3] The minority that are capable of developing efficient transmission between humans can become major public and global concerns as potential causes of epidemics or pandemics.[4] Their many impacts can be economic and societal, as well as clinical.[5] EIDs have been increasing steadily since at least 1940.[6]

When Anthony Fauci became director of the NIAID, he drew a map of the world for presentation at a congressional hearing that showed a single notable emerging infectious disease threat: HIV. Since then, he has continually updated the map, now showing the emergence of numerous infectious disease threats to illustrate the experiences of his years in office as well as highlighting certain infections that had emerged before HIV.[1]

For every decade since 1940, there has been a consistent increase in the number of EID events from wildlife-related zoonosis. Human activity is the primary driver of this increase, with loss of biodiversity a leading mechanism.[7]

Emerging infections account for at least 12% of all human pathogens.[8] EIDs can be caused by newly identified microbes, including novel species or strains of virus[9] (e.g. novel coronaviruses, ebolaviruses, HIV). Some EIDs evolve from a known pathogen, as occurs with new strains of influenza. EIDs may also result from spread of an existing disease to a new population in a different geographic region, as occurs with West Nile fever outbreaks. Some known diseases can also emerge in areas undergoing ecologic transformation (as in the case of Lyme disease[10]). Others can experience a resurgence as a re-emerging infectious disease, like tuberculosis[11] (following drug resistance) or measles.[12] Nosocomial (hospital-acquired) infections, such as methicillin-resistant Staphylococcus aureus are emerging in hospitals, and are extremely problematic in that they are resistant to many antibiotics.[13] Of growing concern are adverse synergistic interactions between emerging diseases and other infectious and non-infectious conditions leading to the development of novel syndemics.

Many EID are zoonotic,[4] deriving from pathogens present in animals, with only occasional cross-species transmission into human populations.[14] For instance, most emergent viruses are zoonotic[4] (whereas other novel viruses may have been circulating in the species without being recognized, as occurred with hepatitis C[15]).

History of the concept of emerging infectious diseases edit

The French doctor Charles Anglada (1809–1878) wrote a book in 1869 on extinct and new diseases.[16] He did not distinguish infectious diseases from others (he uses the terms reactive and affective diseases, to mean diseases with an external or internal cause, more or less meaning diseases with or without an observable external cause). He writes in the introduction:

A widely held opinion among physicians admits the invariability of pathologies. All the illnesses which have existed or which have an outbreak around us are categorized according to arrested and preconceived types, and must enter one way or the other into the frameworks established by the nosologists. History and observation protest wildly against this prejudice, and this is what they teach: Diseases which have disappeared and whose traces are confined to the archives of science, are followed by other diseases, unknown to the contemporary generation, and which come for the first time to assert their rights. In other words, there are extinct and new diseases.

Charles Nicolle, laureate of the Nobel Prize in Physiology or Medicine elaborated the concept of emergence of diseases in his 1930 book Naissance, vie et mort des maladies infectieuses (Birth, Life and Death of Infectious Diseases), and later in Destin des maladies infectieuses (Fate of Infectious Diseases)[17] published in 1933 which served as lecture notes for his teaching of a second year course at the Collège de France. In the introduction of the book he sets out the program of the lectures:

It is this historical existence, this destiny that will be the subject of our talks. I will have to answer, to the extent that our current knowledge allows, questions that you have asked yourself, that every thoughtful or simply curious mind asks: have the infectious diseases that we observe today always existed? Or have some of them appeared in the course of history? Can we assume that new ones will appear? Can we assume that some of these diseases will disappear? Have some of them already disappeared? Finally, what will become of humanity and domestic animals if, as a result of more and more frequent contacts between people, the number of infectious diseases continues to increase?

The term emerging disease has been in use in scientific publications since the beginning of the 1960s at least[18] and is used in the modern sense by David Sencer in his 1971 article "Emerging Diseases of Man and Animals"[19] where in the first sentence of the introduction he implicitly defines emerging diseases as "infectious diseases of man and animals currently emerging as public health problems" and as a consequence also includes re-emerging diseases:

Infectious diseases of man and animals currently emerging as public health problems include some old acquaintances and some that are new in respect to identity or concept.

He also notes that some infectious agents are newly considered as diseases because of changing medical technologies:

But there are also many familiar organisms formerly considered nonpathogenic that are now associated with nosocomial infections, use of artificial kidneys, and the acceptance or rejection of organ transplants, for example.

He concludes the introduction with a word of caution:

And so infectious disease, one of man's oldest enemies, survives as an adversary that calls forth our best efforts.

However, to many people in the 1960s and 1970s the emergence of new diseases appeared as a marginal problem, as illustrated by the introduction to the 1962 edition of Natural History of Infectious Disease by Macfarlane Burnet:[20]

to write about infectious disease is almost to write of something that has passed into history

as well as the epilogue of the 1972 edition:[21]

On the basis of what has happened in the last thirty years, can we forecast any likely developments for the 1970s? If for the present we retain a basic optimism and assume no major catastrophes occur [...] the most likely forecast about the future of infectious disease is that it will be very dull. There may be some wholly unexpected emergence of a new and dangerous infectious disease, but nothing of the sort has marked the past fifty years.

 
Throughout the 20th century until 1980, with the exception of the 1918 Spanish flu pandemic, the death rate from infectious diseases in the United States was steadily decreasing. However, because of the AIDS epidemic, the death rate from infectious diseases increased by 58% between 1980 and 1992.

The concept gained more interest at the end of the 1980s as a reaction to the AIDS epidemic. On the side of epistemology, Mirko Grmek worked on the concept of emerging diseases while writing his book on the history of AIDS[22] and later in 1993 published an article[23] about the concept of emerging disease as a more precise notion than the term "new disease" that was mostly used in France at that time to qualify AIDS among others.

Also under the shock of the emergence of AIDS, epidemiologists wanted to take a more active approach to anticipate and prevent the emergence of new diseases. Stephen S. Morse from The Rockefeller University in New York was chair and principal organizer of the NIAID/NIH Conference "Emerging Viruses: The Evolution of Viruses and Viral Diseases" held 1–3 May 1989 in Washington, DC. In the article summarizing the conference the authors write:[24]

Challenged by the sudden appearance of AIDS as a major public health crisis [...] jointly sponsored the conference "Emerging Viruses: The Evolution of Viruses and Viral Diseases" [...] It was convened to consider the mechanisms of viral emergence and possible strategies for anticipating, detecting, and preventing the emergence of new viral diseases in the future.

They further note:

Surprisingly, most emergent viruses are zoonotic, with natural animal reservoirs a more frequent source of new viruses than is the sudden evolution of a new entity. The most frequent factor in emergence is human behavior that increases the probability of transfer of viruses from their endogenous animal hosts to man.

In a 1991 paper[25] Morse underlines how the emergence of new infectious diseases (of which the public became aware through the AIDS epidemic) is the opposite of the then generally expected retreat of these diseases:

The striking successes achieved with antibiotics, together with widespread application of vaccines for many previously feared viral diseases, made it appear to many physicians and the public that infectious diseases were retreating and would in time be fully conquered. Although this view was disputed by virologists and many specialists in infectious diseases, it had become a commonplace to suggest that infectious diseases were about to become a thing of the past [...].

As a direct consequence of the 1989 conference on emerging viruses, the Institute Of Medicine convened in February 1991 the 19-member multidisciplinary Committee on Emerging Microbial Threats to Health, co-chaired by Joshua Lederberg and Robert Shope, to conduct an 18-month study. According to the report produced by the committee in 1992,[26] its charge "was to identify significant emerging infectious diseases, determine what might be done to deal with them, and recommend how similar future threats might be confronted to lessen their impact on public health." The report recommended setting up a surveillance program to recognize emerging diseases and proposed methods of intervention in case an emergent disease was discovered.

A well-designed, well-implemented surveillance program can detect unusual clusters of disease, document the geographic and demographic spread of an outbreak, and estimate the magnitude of the problem. It can also help to describe the natural history of a disease, identify factors responsible for emergence, facilitate laboratory and epidemiological research, and assess the success of specific intervention efforts.

The proposed interventions were based on the following: the U.S. public health system, research and training, vaccine and drug development, vector control, public education and behavioral change. A few years after the 1989 Emerging Viruses conference and the 1992 IOM report, the Program for Monitoring Emerging Diseases (ProMED) was formed by a group of scientists as a follow-up in 1994[27] and the Centres for Disease Control (CDC) launched the Emerging Infectious Diseases journal in 1995.[18]

A decade later the IOM convened the Committee on Emerging Microbial Threats to Health in the 21st Century which published its conclusions in 2003.[28]

In April 2000 the WHO organized a meeting on Global Outbreak Alert and Response,[29] which was the founding act of the Global Outbreak Alert and Response Network.

In 2014, the Western African Ebola virus epidemic demonstrated how ill-prepared the world was to handle such an epidemic. In response, the Coalition for Epidemic Preparedness Innovation was launched at the World Economic Forum in 2017 with the objective of accelerating the development of vaccines against emerging infectious diseases to be able to offer them to affected populations during outbreaks.[30] CEPI promotes the idea that a proactive approach is required to "create a world in which epidemics are no longer a threat to humanity".[31]

Classification edit

One way to classify emerging infections diseases is by time and how humans were involved in the emergence:[32]

  • Newly emerging infectious diseases – diseases that were not previously described in humans, such as HIV/AIDS
  • Re-emerging infectious diseases – diseases that have spread to new places or which previous treatments no longer control, such as methicillin-resistant Staphylococcus aureus
  • Deliberately emerging infectious diseases – diseases created by humans for bioterrorism
  • Accidentally emerging infectious diseases – diseases created or spread unintentionally by humans, such as vaccine-derived poliovirus

Contributing factors edit

The 1992 IOM report[26] distinguished 6 factors contributing to emergence of new diseases (Microbial adaptation and change; Economic development and land use; Human demographics and behavior; International travel and commerce; Technology and industry; Breakdown of public health measures) which were extended to 13 factors in the 2003 report[28] (Chapter 3 of the report detailing each of them)

  • Microbial adaptation and change
  • Human susceptibility to infection
  • Climate and weather
  • Changing ecosystems
  • Human demographics and behavior
  • Economic development and land use
  • International travel and commerce
  • Technology and industry
  • Breakdown of public health measures
  • Poverty and social inequality
  • War and famine
  • Lack of political will
  • Intent to harm

Their classification serves as a basis for many others. The following table gives examples for different factors:

Factor of emergence Example
Microbial adaption genetic drift and genetic shift in Influenza A
Changing human susceptibility mass immunocompromisation with HIV/AIDS
Climate change diseases transmitted by animal vectors such as mosquitoes (e.g. West Nile fever) are moving further from the tropics as the climate warms
Changes in human demographics and travel facilitating rapid global spread SARS-related coronaviruses
Economic development use of antibiotics to increase meat yield of farmed cows leads to antibiotic resistance
War and famine Clearing of animal habitats that increase the range of diseases such as ebola
Inadequate public health services
Poverty and social inequality tuberculosis is primarily a problem in low-income areas
Bioterrorism 2001 Anthrax attacks
Land use Dam construction and irrigation systems can encourage malaria and other mosquito-borne diseases
Use of indiscriminate pesticides in industrial farming reduces/eliminates biological controls (e.g. dragonflies, amphibians, insectivorous birds, spiders) of known disease vectors (e.g. mosquito, tick, biting midge)
Anti-vaccination or Vaccine hesitancy Re-emergence of measles[33][34]
Wildlife trade Has been linked to zoonotic emergence and spread of new infectious diseases in humans, including Nipah virus and COVID-19.[35][36] Crowded and unhygienic wet markets and wildlife farms have been implicated in animal-human transmission of emergent viruses, including novel coronaviruses and influenza viruses[37] Complex issues surrounding the commerce and consumption of bushmeat are also of particular concern.[38][39][40]

Emerging Infectious Diseases between Humans and Animals edit

Emerging infectious diseases between human, animal have become a significant concern in recent years, playing a crucial role in the occurrence and spread of diseases.[41][42] Human population growth, increased proximity to wildlife, and climate change have created favorable conditions for the transmission of zoonotic diseases, leading to outbreaks such as Zika, Ebola, and COVID-19. The One Health approach, which integrates animal, human, and environmental health, has emerged as a crucial tool for monitoring and mitigating the spread of infectious diseases.[43]

Zoonotic diseases, originating from animal sources, pose a significant threat to human health. Up to 75% of emerging infectious diseases are zoonotic, originating from viruses and other pathogens that are transmitted from animals to humans. Understanding the mechanisms of transmission, the role of wildlife trade, and the importance of surveillance and early detection is crucial for mitigating the impact of zoonotic diseases on human health. Surveillance efforts involving wastewater have been identified as valuable tools for detecting early warning signs of disease emergence and providing timely interventions.[41][42]

List edit

NIAID list of Biodefense and Emerging Infectious Diseases edit

The U.S. National Institute of Allergy and Infectious Diseases (NIAID) maintains a list of Biodefense and Emerging Infectious Diseases. The list is categorized by biodefense risk, which is mostly based on biological warfare and bioterrorism considerations. As of 2004, it recognized the following emerging and re-emerging diseases.[44]

Newly recognized (since the 1980s):

Re-emerging:

Diseases with bioterrorism potential, CDC category A (most dangerous):

Diseases with bioterrorism potential, CDC category B:

Diseases with bioterrorism potential, CDC category C (least dangerous):

Since 2004, NIAID has added to its biodefense emerging pathogen list:[45]

NIAID also monitors antibiotic resistance, which can become an emerging threat for many pathogens.

WHO list of most important emerging infectious diseases edit

In December 2015, the World Health Organization held a workshop on prioritization of pathogens "for accelerated R&D for severe emerging diseases with potential to generate a public health emergency, and for which no, or insufficient, preventive and curative solutions exist."[46] The result was a list containing the following six diseases:

These were selected based on the following measures:

  1. Human transmissibility (including population immunity, behavioural factors, etc.)
  2. Severity or case fatality rate
  3. Spillover potential
  4. Evolutionary potential
  5. Available countermeasures
  6. Difficulty of detection or control
  7. Public health context of the affected area(s)
  8. Potential scope of outbreak (risk of international spread)
  9. Potential societal impacts

Newly reported infectious diseases edit

In 2007 Mark Woolhouse and Eleanor Gaunt established a list of 87 human pathogens first reported in the period between 1980 and 2005.[47] These were classified according to their types.

Numbers of pathogen species by taxonomic category
Number of species

known in 2005

Number of species

reported from 1980 to 2005

TOTAL 1399 87
Bacteria 541 11
Fungi 325 13
Helminths 285 1
Prions 2 1
Protozoa 57 3
Viruses 189 58
DNA viruses 36 9
RNA viruses 153 49

Major outbreaks edit

The following table summarizes the major outbreaks since 1998 caused by emerging or re-emerging infectious diseases.[48]

Disease Country or region Year of start of outbreak
Ngari virus[49] Kenya, Tanzania, Somalia 1998
Nipah virus Malaysia 1998
West Nile virus US 1999
Itaya virus[50] Peru 1999
Rift Valley fever Saudi Arabia and Yemen 2000
EBLV-2 Scotland 2002
SARS-CoV 2002
Influenza A virus subtype H7N2 2002
Monkeypox US 2003
Chapare virus Bolivia 2003
Plague Algeria 2003
HTLV-3, HTLV-4 Cameroon 2005
Melaka virus Malaysia 2006
LuJo virus southern Africa 2008
Multi-drug resistant P. falciparum South-East Asia 2008
Candida auris 2009
Heartland virus US 2009
Bas-Congo virus DRC 2009
Lassa fever Mali 2009
Pandemic H1N1/09 virus Global pandemic 2009
Huaiyangshan banyangvirus 2009
Plague Libya 2009
Cholera Haiti 2010
Lassa fever Ghana 2011
Plasmodium cynomolgi[51] Malaysia 2011
H3N2v 2011
MERS -CoV 2012
Mojiang paramyxovirus[52] 2012
H7N9 2013
Sosuga pararubulavirus 2013
H10N8[53] 2013
Chikungunya Caribbean 2013
Variegated Squirrel Bornavirus 1 [de] 2013
Colpodella sp. Heilongjiang[54] China 2013
Ebola virus disease[55] West Africa 2014
H5N6 2014
Lassa fever Benin 2014
Bourbon virus US 2014
Zika virus[56] Americas 2015
Crimean–Congo hemorrhagic fever Spain 2016
Chikungunya Pakistan 2016
Lassa fever Togo 2016
Ntwetwe virus[57] Uganda 2016
Monkeypox Nigeria 2017
Yellow fever Brazil 2017
Rat hepatitis E virus[58] 2017
Guinea worm Chad 2018
Lyme disease 2018
H7N4 2018
Monkeypox Liberia, UK 2018
Nipah virus India 2018
COVID-19[14] Global pandemic 2019

Methicillin-resistant Staphylococcus aureus edit

Methicillin-resistant Staphylococcus aureus (MRSA) evolved from methicillin-susceptible Staphylococcus aureus (MSSA), otherwise known as common S. aureus. Many people are natural carriers of S. aureus, without being affected in any way. MSSA was treatable with the antibiotic methicillin until it acquired the gene for antibiotic resistance.[59] Through genetic mapping of various strains of MRSA, scientists have found that MSSA acquired the mecA gene in the 1960s, which accounts for its pathogenicity, before this it had a predominantly commensal relationship with humans. It is theorized that when this S. aureus strain that had acquired the mecA gene was introduced into hospitals, it came into contact with other hospital bacteria that had already been exposed to high levels of antibiotics. When exposed to such high levels of antibiotics, the hospital bacteria suddenly found themselves in an environment that had a high level of selection for antibiotic resistance, and thus resistance to multiple antibiotics formed within these hospital populations. When S. aureus came into contact with these populations, the multiple genes that code for antibiotic resistance to different drugs were then acquired by MRSA, making it nearly impossible to control.[60] It is thought that MSSA acquired the resistance gene through the horizontal gene transfer, a method in which genetic information can be passed within a generation, and spread rapidly through its own population as was illustrated in multiple studies.[61] Horizontal gene transfer speeds the process of genetic transfer since there is no need to wait an entire generation time for gene to be passed on.[61] Since most antibiotics do not work on MRSA, physicians have to turn to alternative methods based in Darwinian medicine. However, prevention is the most preferred method of avoiding antibiotic resistance. By reducing unnecessary antibiotic use in human and animal populations, antibiotics resistance can be slowed.

Scientific Advisory Group for Origins of Novel Pathogens edit

On 16 July 2021, the Director-General of WHO announced the formation of the Scientific Advisory Group for Origins of Novel Pathogens (SAGO),[62][63][64] which is to be a permanent advisory body of the organisation. The Group was formed with a broad objective to examine emerging infectious diseases, including COVID-19.[62][65] According to the WHO Director-General, "SAGO will play a vital role in the next phase of studies into the origins of SARS-CoV-2, as well as the origins of future new pathogens."[62]

See also edit

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Further reading edit

  • Nathan Wolfe (2012). The Viral Storm: The Dawn of a New Pandemic Age. St. Martin's Griffin. ISBN 978-1250012210.

External links edit

January 01, 1970
emerging, infectious, disease, medical, journal, emerging, infectious, diseases, journal, emerging, infectious, disease, infectious, disease, whose, incidence, increased, recently, past, years, could, increase, near, future, minority, that, capable, developing. For the medical journal see Emerging Infectious Diseases journal An emerging infectious disease EID is an infectious disease whose incidence has increased recently in the past 20 years and could increase in the near future 2 3 The minority that are capable of developing efficient transmission between humans can become major public and global concerns as potential causes of epidemics or pandemics 4 Their many impacts can be economic and societal as well as clinical 5 EIDs have been increasing steadily since at least 1940 6 When Anthony Fauci became director of the NIAID he drew a map of the world for presentation at a congressional hearing that showed a single notable emerging infectious disease threat HIV Since then he has continually updated the map now showing the emergence of numerous infectious disease threats to illustrate the experiences of his years in office as well as highlighting certain infections that had emerged before HIV 1 For every decade since 1940 there has been a consistent increase in the number of EID events from wildlife related zoonosis Human activity is the primary driver of this increase with loss of biodiversity a leading mechanism 7 Emerging infections account for at least 12 of all human pathogens 8 EIDs can be caused by newly identified microbes including novel species or strains of virus 9 e g novel coronaviruses ebolaviruses HIV Some EIDs evolve from a known pathogen as occurs with new strains of influenza EIDs may also result from spread of an existing disease to a new population in a different geographic region as occurs with West Nile fever outbreaks Some known diseases can also emerge in areas undergoing ecologic transformation as in the case of Lyme disease 10 Others can experience a resurgence as a re emerging infectious disease like tuberculosis 11 following drug resistance or measles 12 Nosocomial hospital acquired infections such as methicillin resistant Staphylococcus aureus are emerging in hospitals and are extremely problematic in that they are resistant to many antibiotics 13 Of growing concern are adverse synergistic interactions between emerging diseases and other infectious and non infectious conditions leading to the development of novel syndemics Many EID are zoonotic 4 deriving from pathogens present in animals with only occasional cross species transmission into human populations 14 For instance most emergent viruses are zoonotic 4 whereas other novel viruses may have been circulating in the species without being recognized as occurred with hepatitis C 15 Contents 1 History of the concept of emerging infectious diseases 2 Classification 3 Contributing factors 4 Emerging Infectious Diseases between Humans and Animals 5 List 5 1 NIAID list of Biodefense and Emerging Infectious Diseases 5 2 WHO list of most important emerging infectious diseases 5 3 Newly reported infectious diseases 5 4 Major outbreaks 6 Methicillin resistant Staphylococcus aureus 7 Scientific Advisory Group for Origins of Novel Pathogens 8 See also 9 References 10 Further reading 11 External linksHistory of the concept of emerging infectious diseases editThe French doctor Charles Anglada 1809 1878 wrote a book in 1869 on extinct and new diseases 16 He did not distinguish infectious diseases from others he uses the terms reactive and affective diseases to mean diseases with an external or internal cause more or less meaning diseases with or without an observable external cause He writes in the introduction A widely held opinion among physicians admits the invariability of pathologies All the illnesses which have existed or which have an outbreak around us are categorized according to arrested and preconceived types and must enter one way or the other into the frameworks established by the nosologists History and observation protest wildly against this prejudice and this is what they teach Diseases which have disappeared and whose traces are confined to the archives of science are followed by other diseases unknown to the contemporary generation and which come for the first time to assert their rights In other words there are extinct and new diseases Charles Nicolle laureate of the Nobel Prize in Physiology or Medicine elaborated the concept of emergence of diseases in his 1930 book Naissance vie et mort des maladies infectieuses Birth Life and Death of Infectious Diseases and later in Destin des maladies infectieuses Fate of Infectious Diseases 17 published in 1933 which served as lecture notes for his teaching of a second year course at the College de France In the introduction of the book he sets out the program of the lectures It is this historical existence this destiny that will be the subject of our talks I will have to answer to the extent that our current knowledge allows questions that you have asked yourself that every thoughtful or simply curious mind asks have the infectious diseases that we observe today always existed Or have some of them appeared in the course of history Can we assume that new ones will appear Can we assume that some of these diseases will disappear Have some of them already disappeared Finally what will become of humanity and domestic animals if as a result of more and more frequent contacts between people the number of infectious diseases continues to increase The term emerging disease has been in use in scientific publications since the beginning of the 1960s at least 18 and is used in the modern sense by David Sencer in his 1971 article Emerging Diseases of Man and Animals 19 where in the first sentence of the introduction he implicitly defines emerging diseases as infectious diseases of man and animals currently emerging as public health problems and as a consequence also includes re emerging diseases Infectious diseases of man and animals currently emerging as public health problems include some old acquaintances and some that are new in respect to identity or concept He also notes that some infectious agents are newly considered as diseases because of changing medical technologies But there are also many familiar organisms formerly considered nonpathogenic that are now associated with nosocomial infections use of artificial kidneys and the acceptance or rejection of organ transplants for example He concludes the introduction with a word of caution And so infectious disease one of man s oldest enemies survives as an adversary that calls forth our best efforts However to many people in the 1960s and 1970s the emergence of new diseases appeared as a marginal problem as illustrated by the introduction to the 1962 edition of Natural History of Infectious Disease by Macfarlane Burnet 20 to write about infectious disease is almost to write of something that has passed into historyas well as the epilogue of the 1972 edition 21 On the basis of what has happened in the last thirty years can we forecast any likely developments for the 1970s If for the present we retain a basic optimism and assume no major catastrophes occur the most likely forecast about the future of infectious disease is that it will be very dull There may be some wholly unexpected emergence of a new and dangerous infectious disease but nothing of the sort has marked the past fifty years nbsp Throughout the 20th century until 1980 with the exception of the 1918 Spanish flu pandemic the death rate from infectious diseases in the United States was steadily decreasing However because of the AIDS epidemic the death rate from infectious diseases increased by 58 between 1980 and 1992 The concept gained more interest at the end of the 1980s as a reaction to the AIDS epidemic On the side of epistemology Mirko Grmek worked on the concept of emerging diseases while writing his book on the history of AIDS 22 and later in 1993 published an article 23 about the concept of emerging disease as a more precise notion than the term new disease that was mostly used in France at that time to qualify AIDS among others Also under the shock of the emergence of AIDS epidemiologists wanted to take a more active approach to anticipate and prevent the emergence of new diseases Stephen S Morse from The Rockefeller University in New York was chair and principal organizer of the NIAID NIH Conference Emerging Viruses The Evolution of Viruses and Viral Diseases held 1 3 May 1989 in Washington DC In the article summarizing the conference the authors write 24 Challenged by the sudden appearance of AIDS as a major public health crisis jointly sponsored the conference Emerging Viruses The Evolution of Viruses and Viral Diseases It was convened to consider the mechanisms of viral emergence and possible strategies for anticipating detecting and preventing the emergence of new viral diseases in the future They further note Surprisingly most emergent viruses are zoonotic with natural animal reservoirs a more frequent source of new viruses than is the sudden evolution of a new entity The most frequent factor in emergence is human behavior that increases the probability of transfer of viruses from their endogenous animal hosts to man In a 1991 paper 25 Morse underlines how the emergence of new infectious diseases of which the public became aware through the AIDS epidemic is the opposite of the then generally expected retreat of these diseases The striking successes achieved with antibiotics together with widespread application of vaccines for many previously feared viral diseases made it appear to many physicians and the public that infectious diseases were retreating and would in time be fully conquered Although this view was disputed by virologists and many specialists in infectious diseases it had become a commonplace to suggest that infectious diseases were about to become a thing of the past As a direct consequence of the 1989 conference on emerging viruses the Institute Of Medicine convened in February 1991 the 19 member multidisciplinary Committee on Emerging Microbial Threats to Health co chaired by Joshua Lederberg and Robert Shope to conduct an 18 month study According to the report produced by the committee in 1992 26 its charge was to identify significant emerging infectious diseases determine what might be done to deal with them and recommend how similar future threats might be confronted to lessen their impact on public health The report recommended setting up a surveillance program to recognize emerging diseases and proposed methods of intervention in case an emergent disease was discovered A well designed well implemented surveillance program can detect unusual clusters of disease document the geographic and demographic spread of an outbreak and estimate the magnitude of the problem It can also help to describe the natural history of a disease identify factors responsible for emergence facilitate laboratory and epidemiological research and assess the success of specific intervention efforts The proposed interventions were based on the following the U S public health system research and training vaccine and drug development vector control public education and behavioral change A few years after the 1989 Emerging Viruses conference and the 1992 IOM report the Program for Monitoring Emerging Diseases ProMED was formed by a group of scientists as a follow up in 1994 27 and the Centres for Disease Control CDC launched the Emerging Infectious Diseases journal in 1995 18 A decade later the IOM convened the Committee on Emerging Microbial Threats to Health in the 21st Century which published its conclusions in 2003 28 In April 2000 the WHO organized a meeting on Global Outbreak Alert and Response 29 which was the founding act of the Global Outbreak Alert and Response Network In 2014 the Western African Ebola virus epidemic demonstrated how ill prepared the world was to handle such an epidemic In response the Coalition for Epidemic Preparedness Innovation was launched at the World Economic Forum in 2017 with the objective of accelerating the development of vaccines against emerging infectious diseases to be able to offer them to affected populations during outbreaks 30 CEPI promotes the idea that a proactive approach is required to create a world in which epidemics are no longer a threat to humanity 31 Classification editOne way to classify emerging infections diseases is by time and how humans were involved in the emergence 32 Newly emerging infectious diseases diseases that were not previously described in humans such as HIV AIDS Re emerging infectious diseases diseases that have spread to new places or which previous treatments no longer control such as methicillin resistant Staphylococcus aureus Deliberately emerging infectious diseases diseases created by humans for bioterrorism Accidentally emerging infectious diseases diseases created or spread unintentionally by humans such as vaccine derived poliovirusContributing factors editThe 1992 IOM report 26 distinguished 6 factors contributing to emergence of new diseases Microbial adaptation and change Economic development and land use Human demographics and behavior International travel and commerce Technology and industry Breakdown of public health measures which were extended to 13 factors in the 2003 report 28 Chapter 3 of the report detailing each of them Microbial adaptation and change Human susceptibility to infection Climate and weather Changing ecosystems Human demographics and behavior Economic development and land use International travel and commerce Technology and industry Breakdown of public health measures Poverty and social inequality War and famine Lack of political will Intent to harm Their classification serves as a basis for many others The following table gives examples for different factors Factor of emergence Example Microbial adaption genetic drift and genetic shift in Influenza A Changing human susceptibility mass immunocompromisation with HIV AIDS Climate change diseases transmitted by animal vectors such as mosquitoes e g West Nile fever are moving further from the tropics as the climate warms Changes in human demographics and travel facilitating rapid global spread SARS related coronaviruses Economic development use of antibiotics to increase meat yield of farmed cows leads to antibiotic resistance War and famine Clearing of animal habitats that increase the range of diseases such as ebola Inadequate public health services Poverty and social inequality tuberculosis is primarily a problem in low income areas Bioterrorism 2001 Anthrax attacks Land use Dam construction and irrigation systems can encourage malaria and other mosquito borne diseases Use of indiscriminate pesticides in industrial farming reduces eliminates biological controls e g dragonflies amphibians insectivorous birds spiders of known disease vectors e g mosquito tick biting midge Anti vaccination or Vaccine hesitancy Re emergence of measles 33 34 Wildlife trade Has been linked to zoonotic emergence and spread of new infectious diseases in humans including Nipah virus and COVID 19 35 36 Crowded and unhygienic wet markets and wildlife farms have been implicated in animal human transmission of emergent viruses including novel coronaviruses and influenza viruses 37 Complex issues surrounding the commerce and consumption of bushmeat are also of particular concern 38 39 40 Emerging Infectious Diseases between Humans and Animals editEmerging infectious diseases between human animal have become a significant concern in recent years playing a crucial role in the occurrence and spread of diseases 41 42 Human population growth increased proximity to wildlife and climate change have created favorable conditions for the transmission of zoonotic diseases leading to outbreaks such as Zika Ebola and COVID 19 The One Health approach which integrates animal human and environmental health has emerged as a crucial tool for monitoring and mitigating the spread of infectious diseases 43 Zoonotic diseases originating from animal sources pose a significant threat to human health Up to 75 of emerging infectious diseases are zoonotic originating from viruses and other pathogens that are transmitted from animals to humans Understanding the mechanisms of transmission the role of wildlife trade and the importance of surveillance and early detection is crucial for mitigating the impact of zoonotic diseases on human health Surveillance efforts involving wastewater have been identified as valuable tools for detecting early warning signs of disease emergence and providing timely interventions 41 42 List editNIAID list of Biodefense and Emerging Infectious Diseases edit The U S National Institute of Allergy and Infectious Diseases NIAID maintains a list of Biodefense and Emerging Infectious Diseases The list is categorized by biodefense risk which is mostly based on biological warfare and bioterrorism considerations As of 2004 it recognized the following emerging and re emerging diseases 44 Newly recognized since the 1980s Acanthamebiasis Australian bat lyssavirus Babesia atypical Bartonella henselae Coronaviruses including SARS coronavirus Ehrlichiosis Encephalitozoon cuniculi Encephalitozoon hellem Enterocytozoon bieneusi Helicobacter pylori Hendra virus equine morbilli virus Hepatitis C Hepatitis E Human herpesvirus 8 Human herpesvirus 6 Lyme borreliosis Microsporidia Parvovirus B19 Re emerging Coccidioides immitis Enterovirus 71 Prion diseases Streptococcus group A Staphylococcus aureus Diseases with bioterrorism potential CDC category A most dangerous Anthrax Clostridium botulinum Tularemia Smallpox and other pox viruses Viral hemorrhagic fevers Arenaviruses Lymphocytic choriomeningitis LCM Junin virus Machupo virus Guanarito virus Lassa fever Bunyaviruses Hantaviruses Rift Valley Fever Crimean Congo hemorrhagic fever virus Flaviviruses Dengue Filoviruses Ebola Marburg Yersinia pestis Diseases with bioterrorism potential CDC category B Brucella species brucellosis Burkholderia pseudomallei melioidosis Burkholderia mallei glanders Coxiella burnetii Q fever Epsilon toxin of Clostridium perfringens Food borne and Water borne Pathogens Bacteria Campylobacter jejuni Diarrheagenic E coli Listeria monocytogenes Pathogenic vibrios Salmonella Shigella species Yersinia enterocolitica Protozoa Cryptosporidium parvum Cyclospora cayetanensis Entamoeba histolytica Giardia lamblia Toxoplasma Fungi Microsporidia Viruses Caliciviruses Hepatitis A Mosquito borne encephalitis viruses California encephalitis Eastern equine encephalitis EEE Japanese encephalitis virus JE Kyasanur Forest virus LaCrosse virus LACV Venezuelan equine encephalitis VEE Western equine encephalitis WEE West Nile virus WNV Yellow fever Ricin toxin from Ricinus communis Staphylococcal enterotoxin B Typhus fever Rickettsia prowazekii Diseases with bioterrorism potential CDC category C least dangerous Influenza Multidrug resistant tuberculosis MDR TB Nipah virus Rabies SARS coronavirus Tick borne encephalitis virus Tick borne hemorrhagic fever viruses Other hantaviruses Other rickettsias Since 2004 NIAID has added to its biodefense emerging pathogen list 45 Yersinia pestis plague category A Chapare virus category A areanavirus Lujo category A arenavirus Chlamydia psittaci category B Naegleria fowleri category B Balamuthia mandrillaris category B St Louis encephalitis virus SLEV category B Tick borne hemorrhagic fever viruses category C Bunyaviruses Severe Fever with Thrombocytopenia Syndrome virus SFTSV Heartland virus Flaviviruses Omsk Hemorrhagic Fever virus Alkhurma virus Kyasanur Forest virus reclassified from B to C Powassan virus Deer Tick virus category C Chikungunya virus category B Coccidioides species category C Human coronavirus HKU1 category C Middle East respiratory syndrome coronavirus category C Anaplasmosis Aspergillus BK virus Bordetella pertussis Borrelia miyamotoi Clostridium difficile Cryptococcus gattii Enterococcus faecium Enterococcus faecalis Enterovirus 68 JC virus Leptospirosis Measles Mucormycosis Mumps virus Poliovirus Zika virus category B NIAID also monitors antibiotic resistance which can become an emerging threat for many pathogens WHO list of most important emerging infectious diseases edit In December 2015 the World Health Organization held a workshop on prioritization of pathogens for accelerated R amp D for severe emerging diseases with potential to generate a public health emergency and for which no or insufficient preventive and curative solutions exist 46 The result was a list containing the following six diseases Crimean Congo hemorrhagic fever Filovirus diseases Ebola virus disease and Marburg virus disease Highly pathogenic emerging Coronaviruses relevant to humans MERS and SARS Lassa fever Nipah virus infection Rift Valley fever These were selected based on the following measures Human transmissibility including population immunity behavioural factors etc Severity or case fatality rate Spillover potential Evolutionary potential Available countermeasures Difficulty of detection or control Public health context of the affected area s Potential scope of outbreak risk of international spread Potential societal impacts Newly reported infectious diseases edit In 2007 Mark Woolhouse and Eleanor Gaunt established a list of 87 human pathogens first reported in the period between 1980 and 2005 47 These were classified according to their types Numbers of pathogen species by taxonomic category Number of species known in 2005 Number of species reported from 1980 to 2005 TOTAL 1399 87 Bacteria 541 11 Fungi 325 13 Helminths 285 1 Prions 2 1 Protozoa 57 3 Viruses 189 58 DNA viruses 36 9 RNA viruses 153 49 Major outbreaks edit The following table summarizes the major outbreaks since 1998 caused by emerging or re emerging infectious diseases 48 Disease Country or region Year of start of outbreak Ngari virus 49 Kenya Tanzania Somalia 1998 Nipah virus Malaysia 1998 West Nile virus US 1999 Itaya virus 50 Peru 1999 Rift Valley fever Saudi Arabia and Yemen 2000 EBLV 2 Scotland 2002 SARS CoV 2002 Influenza A virus subtype H7N2 2002 Monkeypox US 2003 Chapare virus Bolivia 2003 Plague Algeria 2003 HTLV 3 HTLV 4 Cameroon 2005 Melaka virus Malaysia 2006 LuJo virus southern Africa 2008 Multi drug resistant P falciparum South East Asia 2008 Candida auris 2009 Heartland virus US 2009 Bas Congo virus DRC 2009 Lassa fever Mali 2009 Pandemic H1N1 09 virus Global pandemic 2009 Huaiyangshan banyangvirus 2009 Plague Libya 2009 Cholera Haiti 2010 Lassa fever Ghana 2011 Plasmodium cynomolgi 51 Malaysia 2011 H3N2v 2011 MERS CoV 2012 Mojiang paramyxovirus 52 2012 H7N9 2013 Sosuga pararubulavirus 2013 H10N8 53 2013 Chikungunya Caribbean 2013 Variegated Squirrel Bornavirus 1 de 2013 Colpodella sp Heilongjiang 54 China 2013 Ebola virus disease 55 West Africa 2014 H5N6 2014 Lassa fever Benin 2014 Bourbon virus US 2014 Zika virus 56 Americas 2015 Crimean Congo hemorrhagic fever Spain 2016 Chikungunya Pakistan 2016 Lassa fever Togo 2016 Ntwetwe virus 57 Uganda 2016 Monkeypox Nigeria 2017 Yellow fever Brazil 2017 Rat hepatitis E virus 58 2017 Guinea worm Chad 2018 Lyme disease 2018 H7N4 2018 Monkeypox Liberia UK 2018 Nipah virus India 2018 COVID 19 14 Global pandemic 2019 Methicillin resistant Staphylococcus aureus edit Methicillin resistant Staphylococcus aureus MRSA evolved from methicillin susceptible Staphylococcus aureus MSSA otherwise known as common S aureus Many people are natural carriers of S aureus without being affected in any way MSSA was treatable with the antibiotic methicillin until it acquired the gene for antibiotic resistance 59 Through genetic mapping of various strains of MRSA scientists have found that MSSA acquired the mecA gene in the 1960s which accounts for its pathogenicity before this it had a predominantly commensal relationship with humans It is theorized that when this S aureus strain that had acquired the mecA gene was introduced into hospitals it came into contact with other hospital bacteria that had already been exposed to high levels of antibiotics When exposed to such high levels of antibiotics the hospital bacteria suddenly found themselves in an environment that had a high level of selection for antibiotic resistance and thus resistance to multiple antibiotics formed within these hospital populations When S aureus came into contact with these populations the multiple genes that code for antibiotic resistance to different drugs were then acquired by MRSA making it nearly impossible to control 60 It is thought that MSSA acquired the resistance gene through the horizontal gene transfer a method in which genetic information can be passed within a generation and spread rapidly through its own population as was illustrated in multiple studies 61 Horizontal gene transfer speeds the process of genetic transfer since there is no need to wait an entire generation time for gene to be passed on 61 Since most antibiotics do not work on MRSA physicians have to turn to alternative methods based in Darwinian medicine However prevention is the most preferred method of avoiding antibiotic resistance By reducing unnecessary antibiotic use in human and animal populations antibiotics resistance can be slowed Scientific Advisory Group for Origins of Novel Pathogens edit On 16 July 2021 the Director General of WHO announced the formation of the Scientific Advisory Group for Origins of Novel Pathogens SAGO 62 63 64 which is to be a permanent advisory body of the organisation The Group was formed with a broad objective to examine emerging infectious diseases including COVID 19 62 65 According to the WHO Director General SAGO will play a vital role in the next phase of studies into the origins of SARS CoV 2 as well as the origins of future new pathogens 62 See also edit Disease X Epidemiological transition Globalization and disease Pandemic prevention References edit Paules CI Eisinger RW Marston HD Fauci AS 2017 12 05 What Recent History Has Taught Us 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2000 Global outbreak alert and response PDF WHO Geneva Switzerland hdl 10665 66750 Retrieved 10 September 2020 A brief history of vaccines and how they changed the world World Economic Forum Retrieved 2020 04 30 Creating a world in which epidemics are no longer a threat to humanity PDF WHO Retrieved 27 January 2021 Morens DM Fauci AS 2020 09 03 Emerging Pandemic Diseases How We Got to COVID 19 Cell 182 5 1077 1092 doi 10 1016 j cell 2020 08 021 ISSN 0092 8674 PMC 7428724 PMID 32846157 Plaza M Paladino L Opara I N Firstenberg M S Wilson B Papadimos T J Stawicki S P The use of distributed consensus algorithms to curtail the spread of medical misinformation Int J Acad Med serial online 2019 cited 2020 May 16 5 93 99 Patricia CR Zulay JP Carlos RL et al 2019 The Influence of Antivaccination Movements on the Re emergence of Measles Journal of Pure and Applied Microbiology 13 1 127 132 doi 10 22207 JPAM 13 1 13 Smith KM Anthony SJ Switzer WM et al 2012 Zoonotic viruses associated with illegally imported wildlife products PLOS ONE 7 1 e29505 Bibcode 2012PLoSO 729505S doi 10 1371 journal pone 0029505 PMC 3254615 PMID 22253731 Smith KF Schloegel LM Rosen GE 2012 Wildlife Trade and the Spread of Disease In A Alonso Aguirre Richard Ostfeld Peter Daszak eds New Directions in Conservation Medicine Applied Cases of Ecological Health Oxford University Press pp 151 163 ISBN 978 0 19 990905 6 Chan JF To KK Tse H et al 2013 Interspecies transmission and emergence of novel viruses lessons from bats and birds Trends in Microbiology 21 10 544 55 doi 10 1016 j tim 2013 05 005 PMC 7126491 PMID 23770275 LeBreton M Pike BL Saylors KE et al 2012 Bushmeat and Infectious Disease Emergence In A Alonso Aguirre Richard Ostfeld Peter Daszak eds New Directions in Conservation Medicine Applied Cases of Ecological Health Oxford University Press pp 164 178 ISBN 978 0 19 990905 6 Murray KA Allen T Loh E et al 2015 Emerging Viral Zoonoses from Wildlife Associated with Animal Based Food Systems Risks and Opportunities In Russell MJ Doyle MP eds Food Safety Risks from Wildlife Springer pp 31 57 doi 10 1007 978 3 319 24442 6 2 ISBN 978 3 319 24442 6 S2CID 133576419 Kurpiers LA Schulte Herbruggen B Ejotre I et al 2016 Bushmeat and Emerging Infectious Diseases Lessons from Africa In Angelici F ed Problematic Wildlife A Cross Disciplinary Approach Springer pp 31 57 doi 10 1007 978 3 319 22246 2 24 ISBN 978 3 319 22246 2 S2CID 85916327 a b Leifels M Khalilur Rahman O Sam IC Cheng D Chua FJ Nainani D Kim SY Ng WJ Kwok WC Sirikanchana K Wuertz S Thompson J Chan YF 2022 10 30 The one health perspective to improve environmental surveillance of zoonotic viruses lessons from COVID 19 and outlook beyond ISME Communications 2 1 107 doi 10 1038 s43705 022 00191 8 ISSN 2730 6151 PMC 9618154 PMID 36338866 a b Health Ecology and Disease Transmission PDF Nichol AA 2024 02 01 Emerging Infectious Diseases at the Intersections of Human Animal and Environmental Health AMA Journal of Ethics 26 2 99 102 doi 10 1001 amajethics 2024 99 ISSN 2376 6980 PMID 38306198 NIAID Emerging Infectious Diseases Pathogens NIH National Institute of Allergy and Infectious Diseases Niaid nih gov 2018 07 26 Retrieved 2020 05 24 NIAID Emerging Infectious Diseases Pathogens www niaid nih gov NIH National Institute of Allergy and Infectious Diseases 26 July 2018 Archived from the original on 18 April 2020 Blueprint for R amp D preparedness and response to public health emergencies due to highly infectious pathogens www who int Archived from the original on 28 April 2020 Woolhouse M Gaunt E January 2007 Ecological Origins of Novel Human Pathogens Critical Reviews in Microbiology 33 4 231 242 doi 10 1080 10408410701647560 ISSN 1040 841X PMID 18033594 S2CID 19213392 Emerging infections how and why they arise 27 February 2019 Gerrard SR Li L Barrett AD Nichol ST 2004 08 15 Ngari Virus Is a Bunyamwera Virus Reassortant That Can Be Associated with Large Outbreaks of Hemorrhagic Fever in Africa Journal of 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PMID 27013839 Edridge AW Deijs M Namazzi R Cristella C Jebbink MF Maurer I Kootstra NA Buluma LR van Woensel JB de Jong MD Idro R 2019 01 01 Novel Orthobunyavirus Identified in the Cerebrospinal Fluid of a Ugandan Child With Severe Encephalopathy Clinical Infectious Diseases 68 1 139 142 doi 10 1093 cid ciy486 ISSN 1058 4838 PMC 6293039 PMID 29893821 Andonov A Robbins M Borlang J Cao J Hatchette T Stueck A Deschambault Y Murnaghan K Varga J Johnston L 2019 08 09 Rat Hepatitis E Virus Linked to Severe Acute Hepatitis in an Immunocompetent Patient The Journal of Infectious Diseases 220 6 951 955 doi 10 1093 infdis jiz025 ISSN 0022 1899 PMID 30649379 Witte W Kresken M Braulke C Cuny C 1997 Increasing incidence and widespread dissemination of methicillin resistant Staphylococcus aureus MRSA in hospitals in central Europe with special reference to German hospitals Clinical Microbiology and Infection 3 4 414 422 doi 10 1111 j 1469 0691 1997 tb00277 x PMID 11864151 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link Benson M A Ohneck E A Ryan C Alonzo F Smith H Narechania A Torres V J 2014 Evolution of hypervirulence by a MRSA clone through acquisition of a transposable element Molecular Microbiology 93 4 664 681 doi 10 1111 mmi 12682 PMC 4127135 PMID 24962815 a href Template Cite journal html title Template Cite journal cite journal a CS1 maint multiple names authors list link a b Krishnapillai V 1996 Horizontal gene transfer Journal of Genetics 75 2 219 232 doi 10 1007 bf02931763 S2CID 5989957 a b c Staff 16 July 2021 WHO Director General s opening remarks at the Member State Information Session on Origins World Health Organization Retrieved 27 September 2021 Cohen J 17 July 2021 With call for raw data and lab audits WHO chief pressures China on pandemic origin probe A new team of scientists may replace agency group already probing the start of COVID 19 Science Retrieved 27 September 2021 Kupferschmidt K 25 August 2021 New WHO group aims to improve efforts to find pathogen origins The World Health Organization s Maria Van Kerkhove on the hunt for COVID 19 origins and what s next Science Retrieved 27 September 2021 Staff 8 September 2021 Deadline extension call for experts to join the Scientific Advisory Group for the Origins of Novel Pathogens SAGO World Health Organization Retrieved 27 September 2021 Further reading edit Nathan Wolfe 2012 The Viral Storm The Dawn of a New Pandemic Age St Martin s Griffin ISBN 978 1250012210 External links edit Website of Emerging Infectious Diseases an open access peer review journal published by the Centers for Disease Control and Prevention CDC Retrieved from https en wikipedia org w index php title Emerging infectious disease amp oldid 1211935401, wikipedia, wiki, book, books, library,

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