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Emerging and Re-emerging Disease of Global Importance PowerPoint Presentation

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Description : In 20th century, infectious diseases remains leading cause of death worldwide. With the emergence of new infections re-emergence of old infectious diseases, persistence of intractable infectious diseases has became an urgent issue. In India due to existing environmental, socio-economic, and demographic factors problem has disproportionately increased.

Tags : Emerging diseases, Re emerging diseases, antibiotic Resistance,diseases,antibiotic

Published on : Sep 19, 2023 | Views : 447 | Downloads : 1

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EMERGING AND RE‐EMERGING DISEASES OF GLOBAL IMPORTANCE GUIDED BY: Dr. Salil Sakalle Sir Dr. Priyanka Mahawar Mam PRESENTED BY: Yugesh Soni (126) Yusuf Kagzi (127) Ajay Yadav (128) Ashish Chouhan (129) Gajendra Sisodiya (130)
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•INTRODUCTION •EMERGING DISEASES •RE-EMERGING DISEASES •FACTORS AFFECTING •RECENT TRENDS (WORLDWIDE & IN INDIA) •VARIOUS EMERGING & RE-EMERGING DISEASES •ANTIBIOTIC RESISTANCE •MEASURES TO COMBAT ANTIBIOTIC RESISTANCE
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INTRODUCTION  20th century, infectious diseases remains leading cause of death worldwide.  With the emergence of new infections  re‐emergence of old infectious diseases persistence of intractable infectious diseases In India due to existing environmental, socio‐ economic, and demographic factors problem has disproportionately increased.
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EMERGING DISEASES  are diseases that‐ not occurred in humans before occurred previously but affected only small numbers of people in isolated places (Eg. AIDS and Ebola) occurred throughout human history but have only recently been recognized as distinct diseases due to an infectious agent (Eg. Lyme disease and gastric ulcers) •Eg: Nipah Virus, Influenza A H1N1 (2009 strain), Ebola virus, SARS Coronavirus etc.
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RE‐EMERGING DISEASES • These are the infectious diseases that have been known for some time, had fallen to such low levels that they were no longer considered public health problems & are now showing upward trends in incidence or prevalence worldwide. • These diseases were previously easily controlled by chemotherapy and antibiotics but now these have developed anti‐microbial resistance and are often appearing in epidemic form. • These are “COMEBACK”. • Eg: Resistant strains of M.tuberculosis, Streptococci, Enterococci etc.
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FACTORS RESPONSIBLE FOR EMERGENCE AND RE‐EMERGECE OF INFECTIOUS DISEASES
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Unplanned and Under-planned Urbanization ECOLOGICAL DISRUPTION AND HUMAN INTRUSION TO NEW ECOLOGICAL SYSTEM INCREASES THE EXPOSURE TO DISEASE VECTORS AND RESERVOIRS OF INFECTION IN NATURE.
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CLIMATIC CHANGE THAT SHIFTS ECOLOGICAL NICHE. LONG TERM IMPACT OF GLOBAL WARMING CAUSED DISEASE OUTBREAKS IN AREA THAT NOT HAVE EXPERIENCED THE DISEASE BEFORE.
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RAPID AND INTENSE INTERNATIONAL TRAVEL FACILITATE THE SPREAD OF INTERNATIONAL DISEASES BY BRINGING PATHOGEN TO NEW AREAS Increased Exposure of Humans to Disease Vectors and Reservoirs of Infection in Nature
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•RESISTANCE TO ANTIBIOTICS Overcrowding POOR SANITATION & MUTATIONS IN BATCTERIAL GENES INADEQUATE PUBLIC HEATH INFRASTRUCTURE MULTI DURG‐RESISTANT & EXTREMELY DRUG RESISTANT STRAINS OF PATHOGENS
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Newly Discovered Microbes of Public Health Importance
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•Over 30 new infectious agents have been detected worldwide in the last three decades; 60 per cent of these are of zoonotic origin, and more than two‐thirds of these have originated in the wildlife •SARS (severe acute respiratory syndrome), is the first severe infectious diseases to emerge in the twenty‐first century in Guandong province of China in 2003. SARS outbreak occurred in Madhya Pradesh in year 2003.
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•According to WHO, 440,000 new cases of multi‐ drug resistant tuberculosis (MDR‐TB) and extensively drug‐resistant tuberculosis (XDR‐TB) emerge annually, causing at least 150,000 deaths. •Falciparum malaria resistant to artemisinin combination therapy (ACT) emerging at the Cambodia‐Thai border which has a potential to spread across countries.
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TRENDS IN INDIA
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•Cholera outbreak occurred in India along coast line of Bay of Bengal, O1 and O139. •Reports of cholera outbreak O139 • Bengal in Calcutta, •June‐August, 1997 in Yavatmal (Maharashtra) • March‐August, 1998 in Ludhiana (Punjab) • 1998 and 2002 in Nagpur (Maharashtra),
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•Outbreaks of plague in India in 1994, 2002 and 2004 in Surat Gujrat, pneumonic plague outbreak in Himachal Pradesh, bubonic plague •warmer springs and wetter outbreak in Uttar Kashi summers increase the prevalence •NCDC IDENTIFIED four sylvatic foci in India; the tri‐junction of Karnataka, Andhra Pradesh and Tamil Nadu, later Beed belt in Maharashtra, Rohru in Himachal Pradesh and Uttarakhand. As a result, our country incurred direct economic losses to the tune of US $ 1.7 billion.
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•The Nipah virus (Henipavirus) was first recognized in 1999 during an outbreak among pig farmers in Malaysia. •A food borne disease from eating dates, infected fruits, toddy juice contaminated with urine or saliva of infected bats. •C/F= Subclinical case to Acute Respiratory infection and fatal encephalitis. IP= 4‐14 days. •outbreak occurred recently in Kerela causing 19 cases 17 deaths. NO VACCINE AVAILABLE.
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• There has been a sudden increase in diphtheria cases in the past two decades. •National Family Health Surveys (NFHS) show that DPT 3 coverage during 1992‐2006 was only 52‐55% • Persistence or resurgence is mainly due to low coverage of primary immunization as well as boosters. • An epidemiological age shift has been noted, with the disease affecting older children (5‐19 yr) and adults.
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Chandipura (CHP) virus • new virus belonging to family Rhabdoviridae was isolated in 1965 in the Chandipura (Nagpur) region named Chandipura (CHP) virus. • India was attributed to CHP virus in 2003 with a case fatality rate of 55 per cent. •Sandflies‐ main vector and maintainence host of the virus. •Paediatric age group of 9 months to 14 years is involved.
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•Chikungunya fever, caused by chikungunya virus, •After quiescence of three decades, a resurgence of infection in the country was reported in 2006. •East African genotype was involved. •22 States and Union Territories reported cases.
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•Avian influenza, Influenza A (H5N1) viruses Cases of bird flu reported in Navapur tehsil of Nandurbar district of Maharashtr India has not reported any cases H5N1). •Vietnam reported first human case due to H5N1 in 2003. Till dat 346 deaths from 15 countries.
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•The pandemic HINI influenza virus emerged in humans in Mexico and California. •In India, till August 8,2010‐ 1833 deaths had been reported. •Transmission was intense in Maharashtra and Gujarat. •On August 10, 2010, the WHO Director announced that H1N1 virus has moved into the post‐pandemic period.
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•Crimean‐Congo haemorrhagic fever (CCHF) was first described 1945 in Crimea during World War II. Crimean‐Congo haemorrhagic fever (CCHF) • An outbreak in Gujarat in 2011 by a zoonotic origin and a person‐to‐person spread in hospital setting. •enzootic tick‐vertebrate‐tick cycle. •Changes in climatic conditions has facilitated the survival of a large number of Hyalomma spp. Ticks •CCHF Vaccine project is to develop and deliver a vaccine.
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ACUTE ENCEPHALITIS SYNDROME (AES) •AES characterized by fever and seizures especially in children below the age of 10 years. •Recent outbreak in Of the five States reporting, during 2011, most cases in Uttar Pradesh, Bihar, Assam and West Bengal. Muzzaffarpur district of Bihar, which began during late May 2012 had 160 deaths
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EBOLA •Also Called Ebola hemorrhagic fever •It appeared for the 1st time in Zaire and Sudan 1976 •member of Filoviridae family and comprises of 5 speicies. •Recent epidemic occurred in Guinea and South Africa 2013. •Incubation Period 2‐21 days (NOT INFECTIVE IN THIS).
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An Indian resident who tested positive for Ebola—and was cured—has landed in Delhi from Liberia. •Asymptomatic cases NOT infective. •TRANSMISSION‐ DIRECT CONTACT (blood, body secretions, organ, fluids etc. ) of symptomatic cases (Humans & Animals both). NOT by air, water, food. •FDA formally approved the first vaccine to prevent the Ebola virus‐ rVSV‐ZEBOV. (20dec,19)
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Zika Virus Disease  a Flavivirus associated with- Gullian Barre Syndrome in Adults Microcephaly,   Chorioretinal Scarring Hydrops Fetalis in Newborns of Infected Mothers.  Few cases were reported in India in Gujarat & Tamil Nadu in 2017.  There is no specific treatment for Zika Virus Disease.
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Antimicrobial Drug Resistance  MAKING infections virtually untreatable, both in hospital and in general community. It is having a deadly impact on the control of diseases like TB, Cholera, Dysentery, Pneumonia etc.  because the development of new antibiotics has slowed down while prevalence of resistance has grown at an alarming rate. It widens the gulf between infection and control.  It has led to re‐emergence of many diseases. Eg: Malaria, TB, MRSA/VRSA etc.
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Antiviral (HIV), Antiprotozoal (Malaria),
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 Consequences of Antimicrobial Resistance  Prolonged hospital admissions Higher death rates from infections Requires more expensive, more toxic drugs Higher health care costs   
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 Antimicrobial Resistance in Different Bacteria  M.tuberculosis – Due to poor prescribing practices    poor patient compliance (MDR) strains have emerged 
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Malaria – •resistance of plasmodium parasites (esp. falciparum) to antimalarials (e.g. Chloroquine) is now spread to all endemic countries •Anopheles mosquitoes have also become resistant to insecticides like DDT and some are becoming resistant to Pyrethroids further increasing the problem.
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 Staphylococci – § previously susceptible to all β‐ lactams but have now become resistant. § § Led to use of Vancomycin ,which is more expensive and also had more side effects. If Vancomycin resistant strains (VRSA) emerge, S.aureus will become virtually untreatable & only drug available for control will be Linezolids.  Enterococci – Strains resistant to    β‐ lactams Aminoglycosides now for these IV Vancomycin is being used.
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H. influenzae & Pneumococci : •responsible for most cases of childhood pneumonia. •resistant to Ampicillin, Co‐trimoxazole etc. • Pneumococci developed resistance to penicillins. •So, doctors worldwide are losing some of the most useful and affordable drugs agains which are a major cause of childho mortality.
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  S.typhi – In South East Asia, 50% strains now resistant to many antibiotics.  Due to globalization of food supply & international travel, antibiotic resistance in animal bacteria can affect its consumers around the world.
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MEASURES TO COMBAT DRUG RESISTANCE  Use of right antibiotics, in right amounts, in right patients and for right duration is essential.  Practice of Evidence based Medicine  Counselling to improve patient compliance.  Avoidance of self‐prescription. Avoidance of use of antibiotics  indiscriminately in animals/humans.
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CHOOSE YOUR ANTIBIOTICS WISELY
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Strategy for controlling re-emerging diseases available cost-effective interventions such as : •Early response •Prompt treatment •Vector control measures •Strengthening epidemiological surveillance •Appropriate lab support •Expanding research for new diseases and new problems.
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ANY QUERIES?