(Re-) Emerging Infectious Diseases

History

1. Infectious disease deaths declined steadily until ~ 1982
2. Since then a small but significant rise has occurred

Emerging and reemerging diseases

1. COVID-19
2. AIDS
3. Tuberculosis
4. Hantavirus pulmonary syndrome
5. Ebola
6. Lyme Disease
7. Cryptosporidiosis
8. Shiga-toxin producing E. coli (STEC)
   • E. coli O157:H7
   • E. coli O145
   • E. coli O104
9. Hepatitis C/Hepatitis E
10. Influenza
    1. Avian influenza (bird flu)
    2. H1N1 influenza (swine flu)
11. variant Creutzfeldt-Jakob Disease
12. Staphylococcus infections
    • MRSA
    • food intoxication
13. Dengue fever
14. Yellow fever
15. Malaria
16. Cholera
17. Typhoid fever
18. Diphtheria
19. Plague
20. Lassa fever
21. Rift Valley fever
22. West Nile
23. Hendra & Nipah viruses
24. Marburg
25. Crimean-Congo Hemorrhagic Fever
26. M-pox
27. Bourbon Virus

• Disproportionately viral infections
• Predominantly zoonotic
• Many RNA viruses
• Frequently associated with changes in human activity
• Resource: https://wwwnc.cdc.gov/eid/

Contributing Factors

1. Population growth and shifts
   • Overcrowding (influenza)
2. Urbanization
   • Crowding, public health issues (plague, cholera)
3. International Travel
4. Global commerce (including animals)
5. Food processing, handling techniques (Listeria, Salmonella)
6. Social factors
   • Changes in human behavior (HIV, Hepatitis)
   • Attitudes, beliefs (Polio)
7. Economic factors
   • Distribution of health care (HIV)
   • Vaccine availability
8. Encroachment on wilderness
   • New pathogens, vectors (Ebola)
   • Elimination of predators (Lyme)
9. Microbial evolution
   • antibiotic resistance (MDR-TB)
   • virulence factors (E. coli O157:H7)
10. Climatic changes
    • Pathogen reservoirs (Malaria)
11. Political factors
    • Wars, civil wars, social unrest (cholera)
    • Distribution of medicine, vaccines, basic goods
12. Bioterrorism (Anthrax, tularemia)
13. Technology
    • Modern medicine/hospitalization (Nosocomial infections)
    • Immunosuppression

Nosocomial Infections (Health care associated infections, HAI)

https://www.cdc.gov/hai/organisms/organisms.html

1. Pseudomonas aeruginosa
2. Staphylococcus aureus (40% are MRSA)
3. Enterococcus faecium (25% are VRE)
4. E. coli
5. Streptococcus pneumoniae
6. Klebsiella pneumoniae
7. Clostridium difficile
8. Acinetobacter baumannii
9. Burkholderia cepacia
10. Clostridium sordellii

References & Links

1. http://www.cdc.gov/ncidod/eid/
2. http://www.cdc.gov/ncidod/diseases/eid/disease_sites.htm
3. http://www.cdc.gov/HAI