1. mmmmm Mohamed M. B. Alnoor CHP400 COMMUNITY HEALTH PROGRAM-II

2. mmmmm Emerging and Re-emerging Infectious Diseases Major Factors Contributing to the Emergence of Infectious Diseases 1. Ecological changes & agricultural development 2. Human demographics and behavior 3. Technology and industry 4. Economic development and land use 5. International travel and commerce 6. Microbial adaptation and change 7. Breakdown of public health measures mmmmm

3. Emerging and Re-emerging Infectious Diseases mmmmm More Factors Contributing to the Emergence of Infectious Diseases 8. Human vulnerability 9. Climate and weather 10. Poverty and social inequality 11. War and famine 12. Lack of political will 13. Intent to harm

4. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 1. Ecology & agriculture Placing people in contact with a reservoir of an infection (zoonotic or arthropod-borne) either by: -Increasing proximity -Changing conditions microbe natural host

5. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 1. Ecology & agriculture Reforestation in USA Increased the number of deer & deer ticks Human affection by Lyme disease Increased Human contact with deers Deer tick

6. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases Conversion of grassland to maise cultivation Rodents & people come together Rodent Argentine Haemorrhagic fever in humans 1. Ecology & agriculture

7. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases Mixing vessels Influenza 1. Ecology & agriculture Pig Farm Duck farm C h i n a

8. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases Introduction of Korean haemorrhagic fever in Humans Increased human contact with Field mouse 1. Ecology & agriculture Increased Rice cultivation in South East Asia. Field mouse

9. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases Dengue fever in Asia Inflation of population size Insufficient infrastructures Use open containers for water Breading mosquitos 2. Human demographics and behavior

10. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 2. Human demographics and behavior Urbanization More people concentrated in cities-often without adequate infrastructure Increases in the elderly populations

11. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 2. Human demographics and behavior Urbanization Increases in children in daycare: working woman with kids under 5 was 30% in 1970, became 75% in 2000. Fast paced Lifestyles- increase in convenience items and more stress. High-risk behavior- Drug use and unprotected sex Urbanization

12. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 3. Technology and industry Modern mass production increases the chance of accidental contamination and amplifies the effect of such contamination. -Contamination of hamburger meat by E.coli strains causing haemolytic uraemic syndrome. -Feeding cattle by byproducts of sheep causing bovine spongiform encephalitis.

13. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases New diagnostics lead to identification of previously unknown microbes for known diseases e.g. Helicobacter pylori and peptic ulcer. Medical technology - People living longer, but have weaker immune systems. - Blood & organ transplantation transmit infections. 3. Technology and industry

14. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 4. Economic development and land use Changing ecology influencing waterborne, vectorborne disease transmission (e.g. dams, deforestation) More exposure to wild animals and vectors (Lyme disease, ehrlichiosis, babesiosis, HPS,…)

15. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases Circumnavigation: 365 days, now 36 hours International travelers: 400 millions Increased incidence of both Tuberculosis and Influenza transmission on long flights 5. International travel and commerce Transportation of products - Rapid transport of disease harboring fresh products. - Transport of livestock facilitates transport of viruses and arthropods (esp. ticks)

16. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 5. International travel and commerce Travel and HIV/AIDS. Historically: - Silk route and plague. - Slaves trade and yellow fever. - Migration to new world and smallpox. Cholera and Hajj.

17. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 6. Microbial adaptation and change Lateral transfer is common: shown by genome sequencing. Rapid adaptation: due to high mutation rates in RNA viruses. Rapid build up of rare mutations: because of quick reproduction Resistance: Antimicrobials used in livestock growth enhancement and over-prescription of antimicrobials by doctors.

18. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 7. Breakdown of public health measures Decrease in chlorine in water supplies lead to rapid spread of cholera in South America. Non functioning water plant in Wisconsin, USA lead to outbreak of waterborne cryptosporidium

19. mmmmm Emerging and Re-emerging Infectious Diseases mmmmm Major Factors Contributing to the Emergence of Infectious Diseases 7. Breakdown of public health measures Inadequate vaccinations and Diphtheria in former USSR independent countries. Discontinued mosquito control efforts and dengue and re-emergence of malaria.