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Emerging Infectious Diseases PowerPoint Presentation

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This medical is about Emerging Infectious Diseases, diseases that have recently appeared in a population or have existed but are rapidly increasing in incidence or geographic range. These diseases may be caused by previously unknown or newly evolved pathogens, or they may be caused by known pathogens that have acquired new virulence factors or have adapted to a new host or environment.

Examples of emerging infectious diseases include the current COVID-19 pandemic caused by the SARS-CoV-2 virus, Ebola virus disease, Zika virus disease, and Middle East Respiratory Syndrome (MERS). These diseases often have a high potential for causing epidemics or pandemics, as they can easily spread from person to person and may be difficult to control.

Factors that contribute to the emergence of infectious diseases include changes in land use, climate change, globalization and international travel, urbanization, population growth, and the overuse of antibiotics. It is important to monitor and identify emerging infectious diseases early, implement effective control measures, and develop new treatments and vaccines to prevent their spread and minimize their impact on public health.

Tags : Emerging Infectious Diseases, COVID-19 pandemic, SARS-CoV-2 virus, Ebola virus disease, Zika virus disease, Middle East Respiratory Syndrome, MERS, Infectious Disease, Infectious Disease

Published on : Jun 01, 2023 | Views : 1115 | Downloads : 2

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Slide 1-

Global Health Security Emerging and Re-EmergingInfectious Diseases Felice M Apter, PhD OLLI Part II 2018
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Emerging Infectious Diseases: MultisectoralEverything is Inter-related
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Part IQuick Review of Class I
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Basic Definitions Emerging Infectious Disease- disease recognized in a human host for the first time Re-emerging Infectious Disease- disease that have historically occurred in human hosts, but are now: New geographical area New resistance to medical countermeasures (AMR) Reappear after apparent control or elimination (VPD)
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Animal Amplification C A S E S TIME Emerging Threats Program Human Cases Wild Animal Domestic Animal Early Detection and Control Opportunities Wildlife Surveillance/ Forecasting One Health – Public health as part of the “ecosystem”
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Source: WHO, The World Health Report 2007. A Safer Future: global public health security in the 21st century Early Detection and Mitigation is Crucial
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Part IIPrevent, Detect, Respond
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Response and Solutions: At the start of an EID Outbreak: WHO – Is Sick – Index Case WHAT – Is causing the illness – Pathogen + Other Impacting Dimensions: Stochastic Process HOW – Is it spreading WHERE – Did it come from? How – is it spread? epi curve, epi map, R0, finding cases WHY – Did the Pathogen Emerge
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Prevent Infrastructure – Safe Water Food Safety Nutritional Status Immune Status Vaccines 3 Dimensions of the Immune System – Recognizes Self from Other Attacks Other Has Memory
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- The Challenge - Communicating the Miracle of Vaccines: Myths and Misinformation
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Detection Early Days – Differential Diagnosis based on Symptoms, usually advanced symptoms TB (consumption), Syphilis, Plague (Yersinia Pestis), Whooping Cough (Pertussis) Visual Identification of Pathogen and Differential Media Bacteria (light microscopes), Viruses (electron microscopes) Immunological Identification Antibodies Molecular Diagnostics
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Cholera in London Birth of Public Health: John Snow Coordination Response Communication Response Epidemiology – mapping the epidemic and acting on information Medical Response A continuum of Basic to Sophisticated Medical Care Quarantine, Isolation Drugs Vaccines – special case of Emerging Disease ***Link to Local, National and International Decision Makers***
Slide 13-

Part IIIEvolution of Global Health Security
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Evolution of International Sanitary Regulations Table by Fidler
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Frameworks for infectious disease control Frameworks for EID
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IHR revision process (1995-2005)The Balancing Act “…to prevent, protect against, control and provide a public health response to the international spread of disease in ways that are commensurate with and restricted to public health risks and which avoid unnecessary interference with international traffic and trade’’ All 196 Member States have Signed On!
Slide 17-

International Health Regulations (2005) Goal: Respond to events effectively before they become international public health crises.
Slide 18-

Source: WHO, The World Health Report 2007. A Safer Future: global public health security in the 21st century Early Detection and Mitigation is Crucial
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What did States Parties agree to do? (Articles 4, 5, 13, 44 and Annex 1)
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Annex 1 defines IHR (2005) core capacity requirements National Detect unexpected disease or deaths Assess reports within 48 hours Notify WHO Support or implement control measures Intermediate Detect unexpected disease or deaths Assess and confirm reported events Report to national level Support or implement control measures Local Detect unexpected disease or deaths Assess events immediately Report essential information to appropriate level Implement preliminary control measures Epidemiological, laboratory, logistical support Containment and control measures Coordination with other ministries Information sharing Operational national public health emergency response plan Deployable rapid response teams
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Event detected by national surveillance system A case of the following diseases has serious public health impact and is unusual or unexpected, and thus shall be notified: Smallpox Poliomyelitis due to wild-type polio virus Influenza with pandemic potential Severe acute respiratory syndrome (SARS) Any event of potential international public health concern, including those involving other events or diseases than those listed in the box on the left and the box on the right shall lead to utilization of the algorithm. An event involving the following diseases shall always lead to utilization of the algorithm, because they have demonstrated the ability to cause serious public health impact and to spread rapidly internationally: Cholera Pneumonic plague Yellow fever Viral hemorrhagic fevers (Ebola, Lassa, Marburg) Other diseases that are of special national or regional concern, e.g. dengue fever, West Nile fever, Rill Valley fever, and meningococcal disease. Is the public health impact of the event serious? OR OR Event shall be notified to WHO under the International Health Regulations Yes No Yes No No Yes No Yes Not notified at this stage. Reassess when more information becomes available. No No Yes Yes Is the event unusual or unexpected? Is the event unusual or unexpected? Is there a significant risk of international spread? Is there a risk for international trade restrictions? Is there a significant risk of international spread?
Slide 22-

Slide from HHS/ASPR
Slide 23-

PHEIC’s to Date
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IHR (2005) – new strategies Goal Respond to events effectively before they become international public health crises.
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Declared PHEICs
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*=Emergency Committee Meeting ** * * * * * * *
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Meetings of IHR Emergency Committee Concerning MERS-CoV 9 July 2013 (more info needed) 17 July 2013 (serious, but not a PHEIC) 25 September 2013 (no change, Hajj prep) 4 December 2013 (camels, Hajj review, no change) 14 May 2014 (worsening situation, but no PHEIC because no sustained human to human) 17 June 2014 (drop in cases, no PHEIC, prep for Hajj) 1 October 2014 (MERS might be seasonal, no PHEIC) 5 Feb 2015 (need more surveillance, no PEHIC) 17 June 2015 (no sustained transmission, under control, no PHEIC)
Slide 28-

2005 Adopted by States Parties Entered into force 2007 2009 2012 2014 Request extension States report meeting all core capacity requirements OR States assess core capacities Plan/implement capacity building Request 2nd extension States report meeting all core capacity requirements OR
Slide 29-

IHR Status as of 2016
Slide 30-

Core Challenges Nations have not built core capacities under the IHR Need for better metrics; external evaluations Need for technical and financial resources Transparency and better decision making at WHO Stronger and faster response capacity Sustainability
Slide 31-

Biological Weapons Convention
Slide 32-

Biological and Toxin Weapons Convention (BWC)
Slide 33-

Key provisions of the BWC Prohibition International Assistance and Cooperation
Slide 34-

The Convention has no monitoring or verification agency, no governing council, and no permanent secretariat. Biological agents are inherently dual-use, know no borders, and are evolutionary, thus cannot be captured in a traditional treaty mechanism. Benefits of its membership are not always apparent to non-State parties. This “weapons” treaty actually provides entrée to many inter-connected communities which together provide greater security against bio threats, whether natural, accidental or deliberate. The BWC Implementation Support Unit (ISU) consists of three people who serve as a highly efficient clearing house. The BWC “community” includes national security, health, law enforcement, preparedness, academia, industry and NGO members.
Slide 35-

The BWC: An Integrated Approach Professional Associations Industry Scientific Organizations BWC Intersessional Work Program 1540 Law Enforcement BWC WHO OIE FAO Emergency Preparedness
Slide 36-

In the News Lifting the Ban on Making Lethal Organisms https://www.nytimes.com/2017/12/19/health/lethal-viruses-nih.html
Slide 37-

Evolution of Frameworks to meet Common NeedsGlobal Health Security Agenda
Slide 38-

Accelerating progress toward a world safe and secure from infectious disease threats Global Health Security Agenda IHR Regional frameworks Specific technical guidance Animal health, food safety, environment OIE Performance of Veterinary Services Pathway, AMR, etc. Biosecurity BWC, UNSCR 1540
Slide 39-

Overlap Between GHSA and IHR Legislation, Policy & Financing Risk communication Coordination and NFP Communication Points of Entry Food Safety Chemical Events Radiological Emergencies Prevent AMR Vaccination Programs Nosocomial infection control Regional biosurveillance hubs Sample sharing Novel diagnostics Sharing medical countermeasures and personnel Surveillance Laboratory Preparedness Response Zoonotic diseases Human Resources GHSA IHR
Slide 40-

11 action packages define specific GHSA targets
Slide 41-

Each GHSA Action Package includes milestones and targets for national use 5-year targets (as measured by) Desired national impact Country commitments Baseline Assessment and Planning Activities Monitoring and Evaluation Activities
Slide 42-

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Slide 43-

Funding Sources for JEE and Country Plans
Slide 44-

USG Response: Ebola and Zika
Slide 45-

2017 Status: Secretary of State Rex Tillerson In October 2017, Secretary of State Rex Tillerson called the Global Health Security Agenda “one of the most vital initiatives for building global capacity to prevent, detect, and respond to infectious disease threats.” Yet the administration hasn’t set aside money to sustain the program after the grant expires next year. And President Trump’s budget proposals have included heavy cuts to global infectious disease programs. According to the Wall Street Journal, the CDC has picked the 10 countries it will continue to support through the Global Health Security Agenda— India, Thailand, Vietnam, Kenya, Uganda, Liberia, Nigeria, Senegal, Jordan and Guatemala—on the basis of “strategic or regional importance.”
Slide 46-

Part VOur Modern World
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Slide 48-

Human
Slide 49-

Global Examples of Emerging and Re-Emerging Infectious Diseases Enterovirus D68 Cryptosporidiosis Ebola virus disease West Nile E.coli O104:H4 Antimicrobial- r: ;:nt threats -MRSA Qii : C. difficile N. gonorrhoeae H3N2v influenza Cyclosporiasis E. coliO 15 7: H_ 7- _,l. -_-_-_-_-_:.:-::$5 Human monkeypox Listeriosis Bourbon virus 2009 H1N1 influenza Adenovirus 14 Anthrax bioterrorism MERS-CoV Akhmeta virus Rift Valley fever Typhoid fever SFTSV bunyavirus E.coli O157:H7 - - -==- - - - - ---+-- H10N8 influenza H7N9 influenza Hantavirus pulmonary syndrome Human African trypanosomiasis MDR / XDR tuberculosis Marburg hemorrhagic fever Hendra virus Enterovirus 71 Human monkeypox Ebola virus disease Zika virus Plague Newly emerging Re-emerging/resurging "Deliberately emerging" December 2016 CJj • Georgetown University Medical Ccntct J 7 8.9 https://youtu.be/xOFH57Do2EM https://youtu.be/xOFH57Do2EM
Slide 50-

Source: WHO, The World Health Report 2007. A Safer Future: global public health security in the 21st century Early Detection and Mitigation is Crucial
Slide 51-

Underpinning All of These Efforts:Systems, Capacities, Communication
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