A Time Line of Emerging Zoonoses and Epidemics of the 21st Century A Global Perspective on the Epidemics of Foot-and-Mouth Disease, BSE, West Nile Encephalitis, SARS, Monkey Pox, and Avian Influenza. FMD. Avian Influenza. West Nile Virus Infections Human cases2003… 9862 (~44% encephalitis) - PowerPoint PPT Presentation
1 A Time Line of Emerging A Time Line of Emerging Zoonoses and Epidemics of Zoonoses and Epidemics of the 21st Century the 21st Century A Global Perspective on the Epidemics of Foot-and-Mouth Disease, BSE, A Global Perspective on the Epidemics of Foot-and-Mouth Disease, BSE, West Nile Encephalitis, SARS, Monkey Pox, and Avian Influenza. West Nile Encephalitis, SARS, Monkey Pox, and Avian Influenza. West Nile Virus West Nile Virus Infections Infections Human cases 2003… 9862 (~44% encephalitis) Human deaths 2003… 264 Human cases 2004… 2535 Human deaths 2004… 98 Equine deaths 1999-2004 Equine deaths 1999-2004 Avian Influenza FMD Monkeypox
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A Time Line of Emerging Zoonoses A Time Line of Emerging Zoonoses and Epidemics of the 21st Centuryand Epidemics of the 21st Century A Global Perspective on the Epidemics of Foot-and-Mouth Disease, BSE,A Global Perspective on the Epidemics of Foot-and-Mouth Disease, BSE,
West Nile Encephalitis, SARS, Monkey Pox, and Avian Influenza. West Nile Encephalitis, SARS, Monkey Pox, and Avian Influenza.
West Nile Virus InfectionsWest Nile Virus InfectionsHuman cases 2003… 9862 (~44% encephalitis)Human deaths 2003… 264Human cases 2004… 2535 Human deaths 2004… 98Equine deaths 1999-2004 15,000Equine deaths 1999-2004 15,000
What are the Driving Forces of Epidemics?What are the Driving Forces of Epidemics?
• Accelerated global trading Accelerated global trading patterns of the late 20patterns of the late 20thth Century Century (brought about in part by (brought about in part by democracy and major trading democracy and major trading blocks) blocks)
• Technical sophistication in food Technical sophistication in food processing masking true originsprocessing masking true origins
• Exposure to new pathogens Exposure to new pathogens through ecosystem disruption through ecosystem disruption (human population pressures)(human population pressures)
NAFTA
Andean Pact
Mecosur
Caricom
EFTA
EU
Europe's Associates
ASEAN
Major trading Blocks
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Driving Forces of Epidemics contd.Driving Forces of Epidemics contd.
• Evolutionary pressures through Evolutionary pressures through overpopulation and change in overpopulation and change in tropismtropism
• Speed of transportationSpeed of transportation• Unique combination of factors that Unique combination of factors that
we truly do not understand (i.e. akin we truly do not understand (i.e. akin to the Hurricanes in Florida in 2004)to the Hurricanes in Florida in 2004)
We need to shift our focus from economy to ecology!
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Speed of Global Travel in Relation toSpeed of Global Travel in Relation toWorld Population GrowthWorld Population Growth
“No city on the earth is now more than 24 hours away from any other”.Economist 2003
“Annually, the world's airlines carry a staggering total approaching some two billion passengers.At any one moment, about half a million people world-wide are flying in commercial aircraft “ Select Committee on Science and Technology Fifth Report UK Parliament 2000
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YearYear EventEvent CommentComment
19991999 West Nile virus arrives in New YorkWest Nile virus arrives in New York Poor state of preparedness of National Public Poor state of preparedness of National Public Health Services in USA realizedHealth Services in USA realized
20012001 Foot-and-mouth disease hits UKFoot-and-mouth disease hits UK Reality check! Is USA equally unprepared?Reality check! Is USA equally unprepared?
West Nile hits FloridaWest Nile hits Florida Surprise at the ferocity of the epidemicSurprise at the ferocity of the epidemic
9-119-11 War on terrorism beginsWar on terrorism begins
Anthrax bioterrorismAnthrax bioterrorism The nation feels vulnerableThe nation feels vulnerable
20032003 SARS pandemicSARS pandemic Canada is hit hard, but we are luckyCanada is hit hard, but we are lucky
MonkeypoxMonkeypox Could it have been smallpox?Could it have been smallpox?
Mad Cow DiseaseMad Cow Disease Did we say we would never get it?Did we say we would never get it?
West Nile impacts the Mid WestWest Nile impacts the Mid West Truly an epidemic now!Truly an epidemic now!
20042004 H5N1 Avian Influenza explodes in H5N1 Avian Influenza explodes in AsiaAsia
Some human cases and deaths. Fear of Some human cases and deaths. Fear of pandemic human influenza risespandemic human influenza rises
20052005 H5N1 Avian Influenza spreads to H5N1 Avian Influenza spreads to more countries in Asiamore countries in Asia
Virus adapts to village poultry, ducks and Virus adapts to village poultry, ducks and wild birds. More human cases.wild birds. More human cases.
Fear of human pandemic persistsFear of human pandemic persists
A Time Line for Zoonoses & Epidemics of A Time Line for Zoonoses & Epidemics of the 21the 21stst Century Century
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Recent Events Have Emphasized the Recent Events Have Emphasized the Importance of Wildlife Species in Importance of Wildlife Species in
Understanding the Epidemiology of ZoonosesUnderstanding the Epidemiology of Zoonoses
19991999 West Nile virus arrives in New YorkWest Nile virus arrives in New York Poor state of preparedness of National Public Poor state of preparedness of National Public Health Services in USA realizedHealth Services in USA realized
20012001 Foot-and-mouth disease hits UK Reality check! Is USA equally unprepared?
West Nile hits FloridaWest Nile hits Florida Surprise at the ferocity of the epidemicSurprise at the ferocity of the epidemic
9-119-11 War on terrorism beginsWar on terrorism begins
Anthrax bioterrorismAnthrax bioterrorism The nation feels vulnerableThe nation feels vulnerable
20032003 SARS pandemicSARS pandemic Canada is hit hard, but we are luckyCanada is hit hard, but we are lucky
MonkeypoxMonkeypox Could it have been smallpox?Could it have been smallpox?
Mad Cow DiseaseMad Cow Disease Did we say we would never get it?Did we say we would never get it?
West Nile impacts the Mid WestWest Nile impacts the Mid West Truly an epidemic now!Truly an epidemic now!
20042004 H5N1 Avian Influenza explodes in H5N1 Avian Influenza explodes in AsiaAsia
Some human cases and deaths. Fear of Some human cases and deaths. Fear of pandemic human influenza risespandemic human influenza rises
20052005 H5N1 Avian Influenza spreads to H5N1 Avian Influenza spreads to more countries in Asiamore countries in Asia
Virus adapts to village poultry, ducks and Virus adapts to village poultry, ducks and wild birds. More human cases.wild birds. More human cases.
Fear of human pandemic persistsFear of human pandemic persists
A Time Line for Zoonoses & Epidemics of the 21A Time Line for Zoonoses & Epidemics of the 21stst Century Century
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Video of FMD in UK 2001Video of FMD in UK 2001
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FMD Progress of an EpidemicFMD Progress of an EpidemicWhat happened February 20 What happened February 20 (first recognition in Essex)(first recognition in Essex) to to April 11 (April 11 (the turning point of the epidemicthe turning point of the epidemic) and thereafter) and thereafter
Welfare : The Cost in AnimalsWelfare : The Cost in Animals&&
The Psychological Trauma on SocietyThe Psychological Trauma on Society
September 30September 30Total outbreaksTotal outbreaks 20302030
But animals were also But animals were also slaughtered on 7,549 premises slaughtered on 7,549 premises because they were either because they were either Contiguous Premises/ Contiguous Premises/ Dangerous Contacts (7,294 ) or Dangerous Contacts (7,294 ) or Slaughtered on Suspicion (255)Slaughtered on Suspicion (255)Slaughtered 3,940,000Slaughtered 3,940,000
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Late Summer 2001Late Summer 2001The Future and FMDThe Future and FMD
Where will the road take us?Where will the road take us?
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YearYear EventEvent CommentComment
19991999 West Nile virus arrives in New YorkWest Nile virus arrives in New York Poor state of preparedness of National Public Poor state of preparedness of National Public Health Services in USA realizedHealth Services in USA realized
20012001 Foot-and-mouth disease hits UKFoot-and-mouth disease hits UK Reality check! Is USA equally unprepared?Reality check! Is USA equally unprepared?
West Nile hits FloridaWest Nile hits Florida Surprise at the ferocity of the epidemicSurprise at the ferocity of the epidemic
9-119-11 War on terrorism beginsWar on terrorism begins
Anthrax bioterrorismAnthrax bioterrorism The nation feels vulnerableThe nation feels vulnerable
20032003 SARS pandemicSARS pandemic Canada is hit hard, but we are luckyCanada is hit hard, but we are lucky
MonkeypoxMonkeypox Could it have been smallpox?Could it have been smallpox?
Mad Cow DiseaseMad Cow Disease Did we say we would never get it?Did we say we would never get it?
West Nile impacts the Mid WestWest Nile impacts the Mid West Truly an epidemic now!Truly an epidemic now!
20042004 H5N1 Avian Influenza explodes in H5N1 Avian Influenza explodes in AsiaAsia
Some human cases and deaths. Fear of Some human cases and deaths. Fear of pandemic human influenza risespandemic human influenza rises
20052005 H5N1 Avian Influenza spreads to H5N1 Avian Influenza spreads to more countries in Asiamore countries in Asia
Virus adapts to village poultry, ducks and Virus adapts to village poultry, ducks and wild birds. More human cases.wild birds. More human cases.
Fear of human pandemic persistsFear of human pandemic persists
A Time Line for Zoonoses & Epidemics of the 21A Time Line for Zoonoses & Epidemics of the 21stst Century Century
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Bioterrorism emerges in the USABioterrorism emerges in the USA
Economist November 2002
Anthrax Oct 2001Anthrax Oct 2001
“If that hideousness (FMD) came here, it wouldn't be any more hideous for the animals -- they are all bound for a ghastly death anyway. But it would wake up consumers...I
openly hope that it comes here.
Ingrid Newkirk President of People for the Ethical Treatment of Animals (PETA) Talking on FMD April 2001
Smallpox
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YearYear EventEvent CommentComment
19991999 West Nile virus arrives in New YorkWest Nile virus arrives in New York Poor state of preparedness of National Public Poor state of preparedness of National Public Health Services in USA realizedHealth Services in USA realized
20012001 Foot-and-mouth disease hits UKFoot-and-mouth disease hits UK Reality check! Is USA equally unprepared?Reality check! Is USA equally unprepared?
West Nile hits FloridaWest Nile hits Florida Surprise at the ferocity of the epidemicSurprise at the ferocity of the epidemic
9-119-11 War on terrorism beginsWar on terrorism begins
Anthrax bioterrorismAnthrax bioterrorism The nation feels vulnerableThe nation feels vulnerable
20032003 SARS pandemicSARS pandemic Canada is hit hard, but we are luckyCanada is hit hard, but we are lucky
MonkeypoxMonkeypox Could it have been smallpox?Could it have been smallpox?
Mad Cow DiseaseMad Cow Disease Did we say we would never get it?Did we say we would never get it?
West Nile impacts the Mid WestWest Nile impacts the Mid West Truly an epidemic now!Truly an epidemic now!
20042004 H5N1 Avian Influenza explodes in H5N1 Avian Influenza explodes in AsiaAsia
Some human cases and deaths. Fear of Some human cases and deaths. Fear of pandemic human influenza risespandemic human influenza rises
20052005 H5N1 Avian Influenza spreads to H5N1 Avian Influenza spreads to more countries in Asiamore countries in Asia
Virus adapts to village poultry, ducks and Virus adapts to village poultry, ducks and wild birds. More human cases.wild birds. More human cases.
Fear of human pandemic persistsFear of human pandemic persists
A Time Line for Zoonoses & Epidemics of the 21A Time Line for Zoonoses & Epidemics of the 21stst Century Century
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Severe Acute Respiratory Syndrome Severe Acute Respiratory Syndrome SARSSARS
A new disease; a new virus! A new disease; a new virus!
SARS Outbreak, Worldwide SARS Outbreak, Worldwide Cases by Country (June 3, 2003)Cases by Country (June 3, 2003)
Australia: 5
New Zealand: 1
Malaysia: 5
Indonesia: 2
Philippines: 12
Taiwan: 684
Hong Kong: 1,746
Rep. Of Korea: 3
China: 5,328
Russian Federation: 1
Mongolia: 9
Kuwait: 1
India: 3
Romania: 1
South Africa: 1
Brazil: 2
Colombia: 1
United States: 66
Canada: 198
Finland: 1
Germany: 10
Sweden: 3
United Kingdom: 4
Ireland: 1
France: 7
Spain: 1
Switzerland: 1
Italy: 9Macao: 1
Vietnam: 63
Thailand: 8
Singapore: 206
According to the World Health Organization (WHO), during the SARS outbreak of 2003, a total of 8,098 people worldwide became sick with SARS; of these, 774 died.
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The first clues that The first clues that SARS may be a SARS may be a zoonotic diseasezoonotic disease
• Food handlers with Food handlers with likely animal contact likely animal contact were over represented were over represented in early cases (9/23, in early cases (9/23, 39%)39%)
• People living near People living near markets were over markets were over represented in early represented in early casescases
Masked Palm CivetsCourtesy AP
Video
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Guangzhou
2000 Km
3200 Km
4900 Km
12,500 Km
The International Trade in Wildlife Slide Courtesy of Dr Billy Karesh Wildlife Conservation Organization
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YearYear EventEvent CommentComment
19991999 West Nile virus arrives in New YorkWest Nile virus arrives in New York Poor state of preparedness of National Public Poor state of preparedness of National Public Health Services in USA realizedHealth Services in USA realized
20012001 Foot-and-mouth disease hits UKFoot-and-mouth disease hits UK Reality check! Is USA equally unprepared?Reality check! Is USA equally unprepared?
West Nile hits FloridaWest Nile hits Florida Surprise at the ferocity of the epidemicSurprise at the ferocity of the epidemic
9-119-11 War on terrorism beginsWar on terrorism begins
Anthrax bioterrorismAnthrax bioterrorism The nation feels vulnerableThe nation feels vulnerable
20032003 SARS pandemicSARS pandemic Canada is hit hard, but we are luckyCanada is hit hard, but we are lucky
MonkeypoxMonkeypox Could it have been smallpox?Could it have been smallpox?
Mad Cow DiseaseMad Cow Disease Did we say we would never get it?Did we say we would never get it?
West Nile impacts the Mid WestWest Nile impacts the Mid West Truly an epidemic now!Truly an epidemic now!
20042004 H5N1 Avian Influenza explodes in H5N1 Avian Influenza explodes in AsiaAsia
Some human cases and deaths. Fear of Some human cases and deaths. Fear of pandemic human influenza risespandemic human influenza rises
20052005 H5N1 Avian Influenza spreads to H5N1 Avian Influenza spreads to more countries in Asiamore countries in Asia
Virus adapts to village poultry, ducks and Virus adapts to village poultry, ducks and wild birds. More human cases.wild birds. More human cases.
Fear of human pandemic persistsFear of human pandemic persists
A Time Line for Zoonoses & Epidemics of the 21A Time Line for Zoonoses & Epidemics of the 21stst Century Century
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Did Smallpox hit the USA Did Smallpox hit the USA in May 2003?in May 2003?
Fortunately not! It was Fortunately not! It was Monkeypox.Monkeypox.
Dr Kurt Zaeske, DVMWauwatosa, WI
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Monkeypox in monkeys and humans Monkeypox in monkeys and humans in West and Central Africain West and Central Africa
Human cases (71) of monkeypox in USA 2003 Human cases (71) of monkeypox in USA 2003 by date of onset by date of onset MMWR MMWR July 11, 2003 / 52(27);642-646July 11, 2003 / 52(27);642-646
19991999 West Nile virus arrives in New YorkWest Nile virus arrives in New York Poor state of preparedness of National Public Poor state of preparedness of National Public Health Services in USA realizedHealth Services in USA realized
20012001 Foot-and-mouth disease hits UKFoot-and-mouth disease hits UK Reality check! Is USA equally unprepared?Reality check! Is USA equally unprepared?
West Nile hits FloridaWest Nile hits Florida Surprise at the ferocity of the epidemicSurprise at the ferocity of the epidemic
9-119-11 War on terrorism beginsWar on terrorism begins
Anthrax bioterrorismAnthrax bioterrorism The nation feels vulnerableThe nation feels vulnerable
20032003 SARS pandemicSARS pandemic Canada is hit hard, but we are luckyCanada is hit hard, but we are lucky
MonkeypoxMonkeypox Could it have been smallpox?Could it have been smallpox?
Mad Cow DiseaseMad Cow Disease Did we say we would never get it?Did we say we would never get it?
West Nile impacts the Mid WestWest Nile impacts the Mid West Truly an epidemic now!Truly an epidemic now!
20042004 H5N1 Avian Influenza explodes in H5N1 Avian Influenza explodes in AsiaAsia
Some human cases and deaths. Fear of Some human cases and deaths. Fear of pandemic human influenza risespandemic human influenza rises
20052005 H5N1 Avian Influenza spreads to H5N1 Avian Influenza spreads to more countries in Asiamore countries in Asia
Virus adapts to village poultry, ducks and Virus adapts to village poultry, ducks and wild birds. More human cases.wild birds. More human cases.
Fear of human pandemic persistsFear of human pandemic persists
A Time Line for Zoonoses & Epidemics of the 21A Time Line for Zoonoses & Epidemics of the 21stst Century Century
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Avian Influenza H5N1 in AsiaAvian Influenza H5N1 in Asia““Enemy at the gateEnemy at the gate””
With thanks to V. Martin, L. Sims, J. Lubroth, With thanks to V. Martin, L. Sims, J. Lubroth, S. Kahn, J. Domenech, C. BenignoS. Kahn, J. Domenech, C. Benignoand Wantanee Kalpravidh of FAOand Wantanee Kalpravidh of FAO
Pandemic threat of human
influenza
Pandemic threat of human
influenza
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H5N1 Influenza virus in Poultry H5N1 Influenza virus in Poultry and Humans in Asiaand Humans in Asia
• New virus, which, if it mutates to easily infect New virus, which, if it mutates to easily infect humans, could infect entire human population.humans, could infect entire human population.
• If were to occur in the USA, 15-35% of the If were to occur in the USA, 15-35% of the population might be affected, at a cost between population might be affected, at a cost between $71 and $167 billion$71 and $167 billion
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The agricultural landscape of Vietnam is based The agricultural landscape of Vietnam is based on rice productionon rice production
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Interactions on the farm and the marketInteractions on the farm and the market
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Influenza AInfluenza AA promiscuous virus!A promiscuous virus!
Why H5N1 is of particular concernWhy H5N1 is of particular concern
The pig is the “Mixing Vessel”
Traditional belief of antigenic shift Traditional belief of antigenic shift leading to pandemics of human leading to pandemics of human influenzainfluenza
H5NI influenza is able to infect H5NI influenza is able to infect humans directlyhumans directly
H5-affected countries with cases in the last 3 monthsH5-affected countries without cases in the last 3 monthsH7-affected countriesH5-affected countries with reported human clinical cases/seropositive
Situation in July, but constantly changing!
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Recent Spread of H5N1and the Recent Spread of H5N1and the Questioned Role of Migratory BirdsQuestioned Role of Migratory Birds
Conclusions & an Agenda for ActionConclusions & an Agenda for ActionZoonoses & Emerging Diseases of the 21Zoonoses & Emerging Diseases of the 21stst Century Century
What have we learned and how are we adapting?What have we learned and how are we adapting?
19991999 West Nile virus arrives in New YorkWest Nile virus arrives in New York Poor state of preparedness of National Public Poor state of preparedness of National Public Health Services in USA realizedHealth Services in USA realized
20012001 Foot-and-mouth disease hits UKFoot-and-mouth disease hits UK Reality check! Is USA equally unprepared?Reality check! Is USA equally unprepared?
West Nile hits FloridaWest Nile hits Florida Surprise at the ferocity of the epidemicSurprise at the ferocity of the epidemic
9-119-11 War on terrorism beginsWar on terrorism begins
Anthrax bioterrorismAnthrax bioterrorism The nation feels vulnerableThe nation feels vulnerable
20032003 SARS pandemicSARS pandemic Canada is hit hard, but we are luckyCanada is hit hard, but we are lucky
MonkeypoxMonkeypox Could it have been smallpox?Could it have been smallpox?
Mad Cow DiseaseMad Cow Disease Did we say we would never get it?Did we say we would never get it?
West Nile impacts the Mid WestWest Nile impacts the Mid West Truly an epidemic now!Truly an epidemic now!
20042004 H5N1 Avian Influenza explodes in AsiaH5N1 Avian Influenza explodes in Asia Some human cases and deaths. Fear of pandemic Some human cases and deaths. Fear of pandemic human influenza riseshuman influenza rises
20052005 H5N1 Avian Influenza spreads to more H5N1 Avian Influenza spreads to more countries in Asiacountries in Asia
Virus adapts to village poultry, ducks and wild Virus adapts to village poultry, ducks and wild birds. More human cases.birds. More human cases.
Fear of human pandemic persistsFear of human pandemic persists
A Time Line for Zoonoses & Epidemics of the 21A Time Line for Zoonoses & Epidemics of the 21stst Century Century
But do not forget Eastern Equine Encephalitis, Lassa, But do not forget Eastern Equine Encephalitis, Lassa, Ebola, Nipah, Hendra, and Rift Valley Fever! All of Ebola, Nipah, Hendra, and Rift Valley Fever! All of which threatened during the same time span.which threatened during the same time span.
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Risk Assessment for Viral ZoonosesRisk Assessment for Viral ZoonosesMinor zoonotic Minor zoonotic potentialpotential
(Social impact of (Social impact of control may be control may be significant) significant)
Significant zoonotic Significant zoonotic potential, but potential, but technology available technology available for control and for control and prevention prevention
Epidemic, even Epidemic, even pandemic, potential pandemic, potential with limitations in with limitations in technology for control technology for control and preventionand prevention
Orf in sheepOrf in sheep RabiesRabies Avian Influenza H5 and H7 Avian Influenza H5 and H7 subtypessubtypes
Foot-and-mouth diseaseFoot-and-mouth disease West Nile West Nile
EbolaEbola
Nipah and HendraNipah and Hendra
Rift Valley FeverRift Valley Fever
The unknown agent
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Today we haveToday we have““Microbial Club MedMicrobial Club Med””
(concept courtesy of Lonnie King)(concept courtesy of Lonnie King)
• 75% of emerging 75% of emerging diseases are zoonotic diseases are zoonotic
• viruses most commonviruses most common• 60% of pathogens are 60% of pathogens are
zoonoticzoonotic(Taylor et al., Proc. Roy. Soc. 2001)(Taylor et al., Proc. Roy. Soc. 2001)
More than 99% of viruses remain to be discovered. Huge potential for future zoonotic emergence
Daszak, 2003
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YearYear EventEvent Lessons Learned/Actions Initiated by eventLessons Learned/Actions Initiated by event
19991999 West Nile virus arrives in West Nile virus arrives in New YorkNew York
Greater coordination of Public Health Services, Greater coordination of Public Health Services, improved research and diagnostics improved research and diagnostics
USA biosecurity is seen as important and food USA biosecurity is seen as important and food supply seen as vulnerable to bioterrorism. The supply seen as vulnerable to bioterrorism. The power of the mediapower of the media
Preparedness for bioterrorism acceleratesPreparedness for bioterrorism accelerates
20032003 SARS pandemicSARS pandemic Global surveillanceGlobal surveillance and international cooperation and international cooperation needs improvement. Increasing awareness of needs improvement. Increasing awareness of wildlife importance in zoonoses wildlife importance in zoonoses
Monkeypox in the USAMonkeypox in the USA Jurisdiction and concerted action clarified for Jurisdiction and concerted action clarified for international trade in wildlifeinternational trade in wildlife
Mad Cow Disease in the Mad Cow Disease in the USAUSA
Awareness of international sensitivity and trade. The Awareness of international sensitivity and trade. The interface of complex biology and complex tradeinterface of complex biology and complex trade
2004/52004/5 H5N1 Avian Influenza H5N1 Avian Influenza explodes in Asiaexplodes in Asia
All of the above.All of the above. Need for $ support for developing Need for $ support for developing countries. The importance of WHO and FAOcountries. The importance of WHO and FAO
A Time Line for Zoonoses & Epidemics of the 21A Time Line for Zoonoses & Epidemics of the 21stst Century Century
Risk assessment is a great approach, but preparedness is all important!Risk assessment is a great approach, but preparedness is all important!
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Society’s role in Society’s role in meeting the challenge meeting the challenge of emerging diseases of emerging diseases
and zoonosesand zoonoses
““I know of no safe depository of the ultimate posers I know of no safe depository of the ultimate posers of society but the people themselves, and if we think of society but the people themselves, and if we think them not enlightened enough to exercise control with them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it a wholesome discretion, the remedy is not to take it from them, from them, but to inform their discretion.”.”
