FIGURE 1. Crude death rate for infectious diseases - United States, 1900 - 1996. FIGURE 1. Crude death rate for infectious diseases - United States, 1900 - 1996.
In 1918-9, Influenza pandemic killed more than 20 million people world wide, including over 500,000 people in the US. Following World War II, Humans were winning the war against infectious microbes. Life threatening diseases such as tuberculosis and typhoid fever could be treated with antibiotics, and dreaded childhood diseases (polio, whooping cough, diptheria) could be conquered with vaccination. Coupled with improvements in urban sanitation and water quality, vaccines and antibiotics dramatically reduced the incidence of infectious diseases.
• 1995 Ebola (Zaire) • 1996 variant CJD (United Kingdom) • 1997 H5N1 influenza virus, Vancomycin resistant SA, EV71 (Hong Kong; Japan, USA; Malaysia) • 1998 EV71, Nipah virus (Taiwan, Malaysia, Singapore) • 1999 West Nile (Russia, USA) • 2000 Rift Valley Fever, Ebola (Kenya, Saudi Arabia, Yemen;, Uganda) • 2001 Anthrax, Foot and mouth disease (USA; UK) • 2002 Vancomycin resistant SA (USA) • 2003 Ebola, SARS, Monkey pox (Republic of Congo; global; USA) • 2004 H5N1 Viet Nam, Thailand, etc.; Nipah virus Bangladesh EMERGING INFECTIOUS DISEASES 1995-2004
Between 1980 and 2004, The increase in drug resistance in strains of bacteria forced the US to return to the pre-antibiotic era in the battle against many common organisms, at the same time that new bacterial and viral pathogens were appearing EMERGING INFECTIOUS DISEASES
Resistance to antimalarial drugs 1940 Chloroquine 16 years Fansidar 6 years Mefloquine 4 years Atovaquone 6 months 19501960197019801990
Preventing HIV infections in Thailand เราจะประมาทไม่ได้เด็ดขาด
Avian Influenza Infections in Humans 1997: In Hong Kong, avian influenza A (H5N1) infected both chickens and humans 18 people were hospitalized and 6 of them died. 1999: In Hong Kong, avian influenza A H9N2 confirmed in 2 children, recovered possibility of person-to-person transmission open ? 2003: Two cases of avian influenza A (H5N1) a Hong Kong family that had traveled to China One person recovered, the other died
2003: Avian influenza A (H7N7) ] in the Netherlands infections among poultry workers and their families More than 80 cases of H7N7 and 1 patient died 2003: H9N2 infection in a child in Hong Kong, recovered Avian Influenza Infections in Humans
- October 2003, Vietnam reported cases of severe respiratory illness in people from provinces surrounding Hanoi. On January 26, reported its first confirmed cases in the south of the country, with two cases in Ho Chi Minh City. - January 23, 2004, the Government of Thailand began reporting cases of avian influenza A(H5N1) infections in humans Recent Influenza A(H5N1) Cases
H5N1 Infections Among Poultry in Asia Outbreaks of avian influenza A (H5N1) have been confirmed among poultry in Cambodia, China, Hong Kong, Indonesia, Japan, Korea, Laos, Thailand, and Vietnam. ( H7 has been confirmed in Pakistan)
Concept of Epidemiology Environmental Host Agent ไม่เกิดโรคติดเชื้ออุบัติใหม่
Concept of Epidemiology Environmental Host Agent ชุมชนแออัด สิ่งแวดล้อมเปลี่ยน เกิดโรคติดเชื้ออุบัติใหม่
Factors in Infectious Disease Emergence Ecological Changes Human Demographics and Behavior International Travel and Commerce Technology and Industry Microbial Adaptation and Change Breakdown in Public Health Infrastructure
Human Susceptibility to Infection Economic Development and Land Use Climate and Weather War and Famine Lack of Political Will Poverty and Social Inequality Bioterrorism Factors in Infectious Disease Emergence
EMERGING INFECTIOUS DISEASES in Thailand Bioterrorism 2001-2002 Anthrax: Hoax 11 September 2001
Bioterrorism “ Poor man ’ s nuclear bomb ” Intentional or threatened use of viruses, bacteria, fungi, or toxins from living organisms to produce death or disease in humans, animals, or plants
EMERGING INFECTIOUS DISEASES in Thailand •SARS: November 2002-5July 2003 •Avian influenza: January-April 2004
Lessons learned for Thailand from SARS & Avian influenza •Faithfulness •Infrastructure: National Plan, Manpower, Networking, Information system, Resources, Technology … •Crisis response worked and Work on old merits •Multi-sectional cooperation •Political support •Dedication working
Surveillance and Response Prevention and Control Health Infrastructure and Training Basic & Applied Research Preventing Emerging Infectious Diseases
Surveillance and Response Detect, investigate, and monitor emerging pathogens, the diseases, and the factors influencing their emergence, and respond to problems Preventing Emerging Infectious Diseases
Surveillance in Thailand - รง. 506 - Sentinel surveillance; EID - Laboratory surveillance; Influenza, Antimicrobial-resistance AFP surveillance Outbreak response team ทีมสอบสวนและควบคุมโรคจากส่วนกลาง สำนักระบาดวิทยา, FETP ทีมสอบสวนและควบคุมโรคในส่วนภูมิภาค สำนักควบคุมโรคเขต 1-12 ทีมสอบสวนและควบคุมโรคจากสำนักงานสาธารณสุขจังหวัด, CUP ?
Prevention and Control Ensure prompt implementation of prevention strategies and enhance communication of public health information about emerging diseases. Preventing Emerging Infectious Diseases
Infrastructure and Training Strengthen public health infrastructures to support surveillance, response, and research and to implement prevention and control programs. Provide the public health work force with the knowledge and tools it needs. Preventing Emerging Infectious Diseases
Basic & Applied Research Integrate laboratory sciences and epidemiology to increase the effectiveness of public health practice. Preventing Emerging Infectious Diseases