4 FIGURE 1. Crude death rate for infectious diseases - United States, FIGURE 1. Crude death rate for infectious diseases - United States,
5 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 fevercould 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, vaccinesand antibiotics dramatically reduced the incidence of infectious diseases.
10 EMERGING INFECTIOUS DISEASES 1995-2004 • 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
11 Between 1980 and 2004, EMERGING INFECTIOUS DISEASES The increase in drug resistance in strains of bacteriaforced the US to return to the pre-antibiotic erain the battle against many common organisms,at the same time that new bacterialand viral pathogens were appearing
16 Avian Influenza Infections in Humans 1997: In Hong Kong, avian influenza A (H5N1)infected both chickens and humans18 people were hospitalized and 6 of them died.1999: In Hong Kong, avian influenza A H9N2confirmed in 2 children, recoveredpossibility of person-to-person transmission open ?2003: Two cases of avian influenza A (H5N1)a Hong Kong family that had traveled to ChinaOne person recovered, the other died
17 Avian Influenza Infections in Humans 2003: Avian influenza A (H7N7) ]in the Netherlandsinfections among poultry workersand their families More than 80 cases of H7N7and 1 patient died2003: H9N2 infection in a childin Hong Kong, recovered
18 Recent Influenza A(H5N1) Cases - October 2003, Vietnam reported cases ofsevere respiratory illness in people fromprovinces surrounding Hanoi.On January 26, reported its first confirmed casesin the south of the country,with two cases in Ho Chi Minh City .- January 23, 2004 ,the Government of Thailandbegan reporting casesof avian influenza A(H5N1) infections in humans
19 H5N1 Infections Among Poultry in Asia Outbreaks of avian influenza A (H5N1)have been confirmed among poultryin Cambodia, China, Hong Kong,Indonesia, Japan, Korea, Laos,Thailand, and Vietnam.( H7 has been confirmed in Pakistan)
20 Concept of Epidemiology ไม่เกิดโรคติดเชื้ออุบัติใหม่AgentHostEnvironmental
21 เกิดโรคติดเชื้ออุบัติใหม่ Concept of Epidemiologyเกิดโรคติดเชื้ออุบัติใหม่-เชื้อรุนแรง-กลุ่มใหม่เข้ามาในชุมชนHostAgentEnvironmental
22 เกิดโรคติดเชื้ออุบัติใหม่ Concept of Epidemiologyเกิดโรคติดเชื้ออุบัติใหม่ติดเชื้อในHostที่ภูมิคุ้มกันต่ำสัดส่วน Susceptible host เพิ่มAgentHostEnvironmental
23 เกิดโรคติดเชื้ออุบัติใหม่ Concept of Epidemiologyเกิดโรคติดเชื้ออุบัติใหม่AgentHostสิ่งแวดล้อมเปลี่ยนชุมชนแออัดEnvironmental
24 Factors in Infectious Disease Emergence Ecological ChangesHuman Demographics and BehaviorInternational Travel and CommerceTechnology and IndustryMicrobial Adaptation and ChangeBreakdown in Public Health Infrastructure
25 Human Susceptibility to Infection Economic Development and Land Use Factors in Infectious Disease EmergenceHuman Susceptibility to InfectionEconomic Development and Land UseClimate and WeatherWar and FamineLack of Political WillPoverty and Social InequalityBioterrorism
26 Bioterrorism 11 September 2001 2001-2002 Anthrax: Hoax EMERGING INFECTIOUS DISEASES in ThailandBioterrorism11 September 2001Anthrax: Hoax
27 Intentional or threatened use Bioterrorism “Poor man’s nuclear bomb”Intentional or threatened useof viruses, bacteria, fungi, or toxins from living organismsto produce death or disease in humans, animals, or plants
28 Avian influenza: January-April 2004 EMERGING INFECTIOUS DISEASES in ThailandSARS: November July 2003Avian influenza: January-April 2004
29 Lessons learned for Thailand from SARS & Avian influenza FaithfulnessInfrastructure: National Plan, Manpower, Networking,Information system, Resources,Technology…Crisis response worked and Work on old meritsMulti-sectional cooperationPolitical supportDedication working
30 Preventing Emerging Infectious Diseases Surveillance and ResponsePrevention and ControlHealth Infrastructure and TrainingBasic & Applied Research
31 Preventing Emerging Infectious Diseases Surveillance and ResponseDetect, investigate, and monitoremerging pathogens, the diseases,and the factors influencing their emergence,and respond to problems
33 Preventing Emerging Infectious Diseases Prevention and ControlEnsure prompt implementation of prevention strategies and enhance communication of public health information about emerging diseases.
34 Preventing Emerging Infectious Diseases Infrastructure and TrainingStrengthen 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.
35 Preventing Emerging Infectious Diseases Basic & Applied ResearchIntegrate laboratory sciences and epidemiology to increase the effectiveness of public health practice.