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EMERGING and RE-EMERGING INFECTIOUS DISEASES

Susilowati Andajani,dr,MS

Tujuan perkuliahan Setelah perkuliahan mhsw.diharapkan 1.memahami emerging infections 2.memahami factors contributing to emerging infections 3.memahami penanggulangan DBD 4.memahami penanggulangan Malaria

Manfaat Perkuliahan

Emerging Infections
(The Institute of Medicine of the National Academy of Science,1902) : Emerging infections as New, reemerging or drug resistant infections whose incidence in human has increased within the past two decades or whose incidence threatens to increase in the near future

EMERGING INFECTIONS
1.New Infectious diseases Misal :Flu burung,Yellow fever Meningitis meningococcus 2.Emerging Infectious diseases Misal :DBD, PMS,TB paru*, diare 3.Re-emerging Infectious Diseases Misal :- Malaria -Measles - TB paru (Eropa)

Leading infectious causes of death worldwide, 1995


Diseases category Number of Death ARI 4,4 million Diarrheal dis. 3,1 million Tuberculosis 3,1 million Malaria 2,1 million Measles 1,1 million

Six Majors Factors Contributing to Emerging Infections (WHO,1996)


1.Changes in Human Demographic & behaviour 2.Industrial & technologic development 3.Economic development & changes in the patern of land use

4.Expanding international commerce & travel 5.Microbial adaptability 6.Failure to implement PH measures

More Factors Contributing to Emerging Infections


7. Human vulnerability 8. Climate & weather 9. Changing ecosystems 10. Poverty & social inequality 11. War & famine 12. Lack of political will 13. Intent to harm

Emerging Infections :
Human Demographics, Behavior, Vulnerability

More people, more crowding Changing sexual mores (HIV, STDs) Injection drug use (HIV, hepatitis C) Changing eating habits : out more, more produce (foodborne infections) More populations with weakened immune system : elderly, HIV/AIDS, cancer patients & survivors, persons taking antibiotics & other drugs

Emerging Infections :
Technology & Industry

Mass food production (Campylobacter, E.Coli 157:H7,etc.) Use of antibiotics in food animals (antibiotic-resistant bacteria) More organs transplant & blood transfusions (hepatitis C, etc) New drugs for humans (prolonging immunosuppression)

Emerging Infections :
Economic Development, Land Use, Changing Ecosystems

Changing ecology influencing waterborne, vectorborne disease transmission (e.g. dams,deforestation) Contamination of watershed areas by cattle (Cryptosporidium) More exposure to wild animals & vectors (Lyme disease, erhlichiosis, babesiosis, HPS,)

Emerging Infections :
International Commerce & Travel

Persons infected with an exotic disease anywhere in the world can be into major US city within hours (SARS, VHF,) Foods from other countries imported routinely into US (Cyclospora,) Vectors hitchhiking on impoted products (Asian tiger, mosquitos on lucky bamboos, )

Emerging Infections :
Microbial Adaptation & Change

Increased antibiotic resistance with increased use of antibiotics in humans & food animals (VRE, VRSA, penicillin & macrolide-resistant Strep.pneumonia, multidrug-resistant Salmonella) Increase virulence (Group A Strep?) Jumping species from animals to humans (avian influenza, HIV, SARS)

Emerging Infections :
Poverty, Social Inequality, Failure to implement Public Health Measures

Lack of basic hygienic infrastructure (safe water, safe foods, etc.) Inadequate vaccinations (measles, diphtheria) Discontinued mosquito control efforts (dengue, malaria) Lack of monitoring & reporting (SARS)

Emerging Infections : Intent to Harm - Bioterrorism :Anthrax in US 2001 - Bio-crimes :Shigella in Tx - Potential agents : Smallpox, Botulism toxin etc

Daftar Pustaka
Fauzi AS,2005.Emerging and Reemerging Infectious Diseases: The Perpetual Challenge. Academic Medicine, 80:20 Fauzi As,1998. New and Reemerging Infectious Disease:the Importance of Biomedical Research. Emerg of infect Dis. Maxcy et al,2008.Public Health & Preventive Medicine.15th Ed. Appleton & Lange, stamford, Connecticut Maxcy et al,1998.Public Health & Preventive medicine. 14th Ed.Appleton & Lange, Stamford, Conecticut Morse SS,1998.Factors in The Emergence of Infectious Disease. Emerg of Infect dis.