New Pathogens
Emerging and Re-emerging infectious
diseases
Ayşe Kalkancı
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What is new ?
• Pathogens newly recognized
• What is newly ?
• 1 year, 2 years, 5 years, past two decades ?
• Emerging and re-emerging pathogens
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Emerging infectious diseases (EIDs)
Re-emerging infectious diseases
(REIDs)
•EIDs are infectious diseases that have not occurred in humans before, have
occurred previously in humans but affected only small populations in
isolated areas, or have occurred in the past but were only recently
recognized as distinct diseases caused by infectious agents
• REIDs are infectious diseases that constituted significant health problems
in a particular geographic area or globally during a previous time period,
then declined greatly, but are now again becoming health problems of
major importance
• Remarkably, specific infectious pathogens, such as influenza viruses,
continuously emerge and re-emerge.
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• Most EIDs and REIDs have a zoonotic origin, denoting that the disease
has emerged from an animal and crossed the species barrier to infect
humans
• The majority of these zoonoses come from wildlife, while others
originate from domesticated animals and intensive animal farming
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Emerging Infectious Diseases
Diseases whose incidence in humans have either increased in the
past 30 years or threaten to increase in the near future.
These diseases had previously been unseen in humans or had
been seen only rarely.
These had been previously recognized but whose cause was
unknown until recently.
Some diseases also diseppear over time.
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Emerging Infectious Diseases
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Re-emerging Infectious Diseases
• Previously controlled but now have returned
• Resistant to treatment
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Re-emerging Infectious
Diseases
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Factors Contributing To Emergence
AGENT
• Evolution of pathogenic infectious agents
(microbial adaptation & change)
• Development of resistance to drugs
• Resistance of vectors to pesticides
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Factors Contributing To Emergence
HOST
• Human demographic change (inhabiting new areas)
• Human behaviour (sexual & drug use)
• Human susceptibility to infection (Immunosuppression)
• Poverty & social inequality
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Factors Contributing To Emergence
ENVIRONMENT
• Climate and changing ecosystems
• Economic development and Land use (urbanization, deforestation)
• Technology and industry (food processing, handling)
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OTHER
• International travel & commerce
• Breakdown of public health measure (war, unrest, overcrowding)
• Deterioration in surveillance systems (lack of political will)
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Novel Swine origin Influenza
A (H1N1)
• Swine flu causes respiratory disease in pigs – high level of illness, low
death rates
• Pigs can get infected by human, avian and swine influenza virus
• Occasional human swine infection reported
• In US from December 2005 to February 2009, 12 cases of human
infection with swine flu reported
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Swine Flu
Influenza A (H1N1)
• March 18 2009 – outbreak reported in Mexico
• April 15th CDC identifies H1N1 (swine flu)
• April 25th WHO declares public health emergency
• April 27th Pandemic alert raised to phase 4
• April 29th Pandemic alert raised to phase 5
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Influenza A (H1N1)
• By May 5th more than 1000 cases confirmed in 21 countries
• Screening at airports for flu like symptoms (especially passengers
coming from affected area)
• Schools closed in many states in USA
• May 16th India reports first confirmed case
• Stockpiling of antiviral drugs and preparations to make a new effective
vaccine
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Pandemic H1N1 (Swine flu)
• Worldwide- 162,380 cases
1154 deaths
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Chikungunya
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Arthralgia, fever and rash
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MERS
• Middle East Respiratory Syndrome (MERS) is an illness
caused by a virus (more specifically, a called Middle East
Respiratory Syndrome Coronavirus (MERS-CoV).
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MERS-Co
• Health officials first reported the disease in Saudi Arabia
in September 2012.
• All cases of MERS have been linked through travel to, or
residence in, countries in and near the Arabian
Peninsula.
• The largest known outbreak of MERS outside the
Arabian Peninsula occurred in the Republic of Korea in
2015.
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MERS-Co
• Most people confirmed to have MERS-CoV infection have had severe
acute respiratory illness with symptoms of:
• fever
• cough
• shortness of breath
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Zika Virus
• Zika is spread mostly by the bite of an infected Aedes
species mosquito (Ae. aegypti and Ae. albopictus).
These mosquitoes bite during the day and night.
• Zika can be passed from a pregnant woman to her
fetus. Infection during pregnancy can cause certain
birth defects (microcephaly)
• There is no vaccine or medicine for Zika.
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SARS-CoV-2 / COVID-19
• Beginning in December 2019, a number of patients with
pneumonia of unknown aetiology emerged in Wuhan City, Hubei
Province, Central China.
• Genome sequencing has demonstrated that this pneumonia,
named coronavirus disease 2019 (COVID-19), is caused by a novel
CoV, namely severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2), previously known as 2019 novel coronavirus (2019-
nCoV) .
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Epidemiology
• First cases shared a history of exposure to the Huanan
seafood market in Wuhan and the disease was been
confirmed to be an acute respiratory infection caused by
a novel CoV.
• Later on human to human transmission
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Transmission route of SARS-CoV-2
• via respiratory droplets
• Close contact is also a source of transmission
of SARS-CoV-2.
• SARS-CoV-2 can be transmitted through direct or
indirect contact with mucous membranes in the eyes,
mouth or nose.
• There is also a possibility of aerosol transmission in a
relatively closed environment with continuous exposure
to high concentrations of aerosol.
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Cases / Deaths
• Coronavirus Cases: 687 225 609
• Deaths: 6 856 733
• Recovered: 659 731 745
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Monkeypox
• Monkeypox is an illness caused by the monkeypox virus.
• It is a viral zoonotic infection, meaning that it can spread from
animals to humans.
• It can also spread from humans to other humans and from the
environment to humans.
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How does monkeypox spread from
person to person?
• Monkeypox spreads from person-to-person through close contact with
someone who has a monkeypox rash.
• Close contact can mean being face-to-face (such as talking, breathing or singing
close to one another which can generate droplets or short-range aerosols);
skin-to-skin (such as touching or vaginal/anal sex); mouth-to-mouth (such as
kissing); or mouth-to-skin contact (such as oral sex or kissing the skin).
• The virus can also spread during pregnancy to the fetus, during or after birth
through skin-to-skin contact, or from a parent with monkeypox to an infant or
child during close contact.
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