Reported Lyme Disease Cases by Year United States, 1982-2002 5,000 10,000 15,000 20,000 25,000 1982 1984 1986 1988 1990 1992 1994 1996 1998 2000 2002 Year Cases Overall picture is not good. Number of cases continues to increase, with particularly large increase last year when number of cases jumped from ~ 17,000 to >23,000. Portion of this trend is due to greater awareness and better reporting of cases that were always there, but also evidence of a true increase in endemic areas as well as spread to new areas.

Reported Cases of Lyme Disease by Year, United States, 1995-2012 Probable cases* Confirmed cases *National Surveillance case definition revised in 2008 to include probable cases; details at http://www.cdc.gov/ncphi/disss/nndss/casedef/lyme_disease_2008.htm

Nipah Encephalitis

Nipah Virus

Nipah Encephalitis Misdiagnoised as Japanese Encephalitis Clinical Epidemiologic Laboratory

Microbial Threats to Health

Chain of transmission among guests at Hotel M—Hong Kong, 2003 2 family members 2 close contacts Guangdong Province, China 4 family members 10 HCWs 4 HCWs* Hospital 2 Hong Kong F Canada A A F G † G † 3 HCWs K † K † 156 close contacts of HCWs and patients Ireland Hospital 3 Hong Kong A H H I Hotel M Hong Kong L§ J I 99 HCWs (includes 17 medical students) E United States J D Hospital 1 HK B M§ C C D E B Germany 0 HCWs Singapore HCW HCW Hospital 4 Hong Kong B Vietnam 34 HCWs 28 HCWs 2 family members HCW 37 HCWs 37 close contacts 4 other Hong Kong Hospitals Unknown number close contacts HCW * Health-care workers; † All guests except G and K stayed on the 9th floor of the hotel. Guest G stayed on the 14th floor, and Guest K stayed on the 11th floor; § Guests L and M (spouses) were not at Hotel M during the same time as index Guest A but were at the hotel during the same times as Guests G, H, and I, who were ill during this period. Bangkok Data as of 3/28/03

Global SARS Cases (Probable) WHO 26 September 2003 Country Cases Deaths Case fatality Canada 251 43 15.3% China 5327 349 6.5% Hong Kong 1755 299 16.9% Singapore 238 33 15.5% Taiwan 346 37 12.5% Thailand 9 2 22% U.S. 75 0% Vietnam 63 5 7.9% Other 81 6.2% Total 8098 774 9.6%

SARS Corona Virus

                                            Tuesday, Oct 16, 2012 The Armageddon virus: Why experts fear a disease that leaps from animals to humans could devastate mankind in the next five years Warning comes after man died from a Sars-like virus that had previously only been seen in bats Earlier this month a man from Glasgow died from a tick-borne disease that is widespread in domestic and wild animals in Africa and Asia http://www.dailymail.co.uk/science

12/9/2018 gubler2

52,160 cases 231 deaths CFR-0.44% 93 countries 12/9/2018 gubler2

Avian Influenza

What did These Epidemic Diseases have in Common? All were zoonotic pathogens Jumped species Most had Asian origin Clinical and laboratory diagnosis problematic Poor communication Transmission & spread as result of demographic and societal changes Major economic impact