Lecture 5: Emerging infectious disease

Question 1

Which factors are attributed to emergence of infectious disease?

Answer 1

Deforestation
Agricultural development
Urbanisation
Habitat fragmentation
Road construction
Air and water pollution
Road construction
Climate change (see BS127)
Hydrological changes, dam building
Population movement
Drug resistance
Better detection/diagnosis

Question 2

How do we define emerging?

Answer 2

• Newly emerging (newly appeared in a population)
• Existing but rapidly increasing in incidence or geographic range
• Re-emerging/new epidemics of old pathogens

Question 3

Emergence (or re-emergence) or better detection?

Answer 3

• Improved diagnostic sensitivity
• Or new diagnostics entirely
• Improved education/reporting
• Modified/improved classification
• Is there a decrease in under-reporting?
• Yes probably, but there will always be under-reporting.

Question 4

Can tracking the movement of populations/individuals allow for contact tracing?

Answer 4

Yes

Question 5

Can movement introduce the index case of an infection?

Answer 5

Yes

Question 6

Can migration replenish suceptibles?

Answer 6

Yes, although this is more relevant to persistance

Question 7

Is it true that for more than 200,000 years of humans, they didn’t move much?

Answer 7

Yes

Question 8

Are 25% of emerging infectious disease linked to our increased use of the land?

Answer 8

Yes

Question 9

Talk about the Cahora Bassa Dam

Answer 9

• Downstream - reduced flooding; reduced free standing water; reduced breeding sites; reduced irrigation issues
• Upstream- fast flowing water was replaced by a stagnant lake, the perfect breeding ground for mosquitoes

Question 10

Give an example of a re-emerging virus

Answer 10

Measles

Question 11

What is the R0 for measles?

Answer 11

approximately 18, one of the highest (non-VB)

Question 12

How is measles transmitted?

Answer 12

Through droplets and air

Question 13

Measles death rate…

Answer 13

The death rate varies (and varied) considerably dependent on healthcare access

Question 14

Is this statement about the aftermath of measles true: ‘1 in 5 infected develop complications such as ear infections, Pneumonia, Encephalitis’?

Answer 14

Yes

Question 15

What is the cheap and highly effective vaccine that is available for measles?

Answer 15

MMR

Question 16

What haappened to meases cases beween 2016 and 2019?

Answer 16

There was an increase in the number of measles cases. This was because the vaccination threshold wan’t reahed and so this led to re-emergence.

Question 17

World Health Organisation (WHO) ‘priority pathogens’

Answer 17

• An update of perceived threats of emerging infectious disease.
  To prevent Public Health Emergencies of International Concern (PHEICs).
  Over 30 pathogens
  Mostly viruses (including multiple influenzas)

Question 18

What is a prototype pathogen?

Answer 18

• an additional list to act as model species for scientific study and the development of therapies and vaccines – to encourage research.
• To better prepare for emerging infecions

Question 19

Has monkeypox recently been added to World Health Organisation (WHO) ‘priority pathogens’ list ?

Answer 19

Yes

Question 20

What causes monkeypox?

Answer 20

The monkeypox virus

Question 21

Did the eradication of smallpox lead to the emergence of smallpox?

Answer 21

Yes

Question 22

Are smallpox and monkeypox very similar pathogens?

Answer 22

Yes

Question 23

There’s a vaccine for monkeypox but no proven…

Answer 23

antiviral treatment

Question 24

Is monkeypox proving to me an unpredictable emerging infectious disease?

Answer 24

Yes

Question 25

Describe the May 2022 outbreak of smallpox

Answer 25

- In May 2022, an outbreak of clade IIb mpox appeared suddenly and rapidly spread across Europe, the Americas and then the rest of the world. Declared a public health emergency of international concern (PHEIC). - The outbreak affected primarily (but not only) gay, bisexual, and other men who have sex with men and has spread person-to-person through sexual networks

Question 26

Describe the August 2024 outbreak of monkeypox

Answer 26

August 2024, clade Ib has also been detected beyond Africa, another PHEIC declared. Higher virulence, higher mortality.

Question 27

When was the first case of monkeypox clade Ib detected in the uk?

Answer 27

UK case on 20 January 2025.