Scourges Old and New: The Burden of Infectious Diseases in the 21st Century - PowerPoint PPT Presentation

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Scourges Old and New: The Burden of Infectious Diseases in the 21st Century

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Population growth and density (measles, chickenpox, influenza) ... of public health measures (tuberculosis, diphtheria, pertussis, meningitis) ... – PowerPoint PPT presentation

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Title: Scourges Old and New: The Burden of Infectious Diseases in the 21st Century


1
Scourges Old and New The Burden of Infectious
Diseases in the 21st Century
  • Joel G. Breman, MD, DTPH
  • Fogarty International Center
  • National Institutes of Health
  • University of Pennsylvania
  • November 1, 2002

2
Global Infectious Diseases Objectives
  • Problem
  • Determinants
  • Diseases
  • Control and eradication
  • Triumphs
  • Tribulations

3
Global Infectious Diseases Objectives
  • Problem
  • Determinants
  • Diseases
  • Control and eradication
  • Triumphs
  • Tribulations

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Infectious Disease Mortality in the United
States, 1980-1996
80
70
60
Deaths per 100,000 population
50
Crude ID Mortality Rate
40
30
20
10
0
Year
Source JAMA 1996275189-193 and unpublished CDC
data
11
Global Infectious Diseases Objectives
  • Problem
  • Determinants
  • Diseases
  • Control and eradication
  • Triumphs
  • Tribulations

12
Determinants of Emergence of Infectious Diseases
  • Population growth and density (measles,
    chickenpox, influenza)
  • Migration and transhumance (cholera, sexually
    transmitted infections)
  • Urbanization (plague, water-borne diseases,
    respiratory diseases)
  • Human behavior and lifestyles (STIs, HIV/AIDS)
  • Contact with animal populations (salmonella,
    anthrax, monkeypox, Ebola/Marburg)
  • International travel and commerce (malaria,
    cholera, food-borne diseases)

13
Determinants of Emergence of Infectious Diseases
(2)
  • Technology and industry (toxic shock syndrome,
    nosocomial infections)
  • Microbial adaptation and change (Staphylococcus
    aureus, influenza, HIV/AIDS, malaria)
  • Breakdown of public health measures
    (tuberculosis, diphtheria, pertussis, meningitis)
  • Global warming (malaria, dengue, yellow fever,
    cholera)
  • Bioterrorism (smallpox, anthrax, plague,
    tularemia, botulinum toxin, hemorrhagic fevers)

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Antimicrobial Resistance
  • Worldwide problem
  • Dramatic increase in antimicrobial-resistant
    community-acquired and nosocomial pathogens
  • Major risk factors
  • Antimicrobial use (misuse)
  • Infection control practices (noncompliance)

16
Evolution of Antimicrobial Resistance
Penicillin ? 1950s
Methicillin ? 1980s
Penicillin-resistant S. aureus
Methicillin-resistant S. aureus (MRSA)
S. aureus
Vancomycin
1997
1990s
Vancomycin-resistant enterococcus (VRE)
Vancomycin (glycopeptide) - intermediate resistant
S. aureus
Vancomycin- Resistant S. aureus
?
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Global Infectious Diseases Objectives
  • Problem
  • Determinants
  • Diseases
  • Control and eradication
  • Triumphs
  • Tribulations

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Label, 2002
36
Blood Safety
  • Units donated in the U.S. are routinely tested
    for evidence of seven infectious agents
  • HTLV I and II
  • HIV 1 and 2
  • Treponema pallidum
  • Hepatitis B and C viruses
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