Docstoc

Global Human _ Biological Epidemics in a Changing World A report

Document Sample
Global Human _ Biological Epidemics in a Changing World A report Powered By Docstoc
					               Epidemics in a Changing World
               Presentation to PMSEIC Lecture
               Parliamentary Library




24 June 2009                  Epidemics in a Changing World:   Parliamentary Library lecture
Epidemics

• Professor Anne Kelso AO
          – Director, WHO Collaborating Centre
            for Reference and Research on
            Influenza
          – Member: Expert Working Group on
            Epidemics in a Changing World




24 June 2009                Epidemics in a Changing World:   Parliamentary Library lecture   1
The first 21st century pandemic




Dr Margaret Chan and Dr Keiji Fukuda at the press conference
to announce the start of the 2009 influenza pandemic, 11 June 2009
     24 June 2009                     Epidemics in a Changing World:   Parliamentary Library lecture   2
A devastating disease eradicated



Frank Fenner announcing the eradication
of smallpox to the World Health Assembly
on 8 May 1980




                        http://epress.anu.edu.au/

     24 June 2009                           Epidemics in a Changing World:   Parliamentary Library lecture   3
A changing world

• Disease agents constantly evolve

• New agents emerge

• Our environment is changing more
  rapidly than ever before


   24 June 2009        Epidemics in a Changing World:   Parliamentary Library lecture   4
Members of the Expert Working Group
Professor Brian Kay AM         Australian Centre for International & Tropical
Chair                          Health, QIMR

Professor Stephen Prowse       CEO, Australian Biosecurity CRC for
Deputy Chair                   Emerging Infectious Disease

Professor John Horvath AO      Principal Consultant, Department of Health
                               and Ageing
Professor Anne Kelso AO        Director, WHO Collaborating Centre for
                               Reference and Research on Influenza
Professor John Mackenzie AO Australian Biosecurity CRC for Emerging
                               Infectious Disease
Professor Adrian Sleigh        National Centre for Epidemiology and
                               Population Health, ANU
Professor Jonathan Carapetis   Director, Menzies School of Health Research

Dr Andy Carroll                Chief Veterinary Officer, Department of
                               Agriculture, Fisheries and Forestry
Expert Advisor

     24 June 2009                         Epidemics in a Changing World:   Parliamentary Library lecture   5
               Influenza

               Dengue

               Bluetongue



24 June 2009            Epidemics in a Changing World:   Parliamentary Library lecture   6
The spread of influenza




   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   7
Origin of new influenza viruses

    Mutation                                                     “Drift”




Reassortment
when two viruses                                                 “Shift”
mix in one animal




     24 June 2009     Epidemics in a Changing World:   Parliamentary Library lecture   8
          Seasonal influenza in Australia
Notified influenza cases




                                  2003   2004   2005   2006             2007                   2008               2009


                                                                                Australian Influenza Surveillance Report,
                                                                                Dept Health & Ageing (May 2009)

                   24 June 2009                               Epidemics in a Changing World:   Parliamentary Library lecture   9
             Seasonal influenza in Hong Kong
% Influenza viruses




                       1998          1999   2000   2001   2002      2003             2004               2005              2006


                                                                                                       Yang et al, PlosOne (2008)


                      24 June 2009                               Epidemics in a Changing World:   Parliamentary Library lecture   10
Origin of new influenza viruses
                                                          Seasonal strains
    Mutation                                              Tamiflu resistance
                                                          1918 pandemic
                                                          Equine influenza




Reassortment                                              1957 pandemic
when two viruses                                          1968 pandemic
mix in one animal                                         2009 H1N1 swl




     24 June 2009     Epidemics in a Changing World:   Parliamentary Library lecture   11
Origin of new human H1N1 virus

                                                             Eurasian
swine
                                                            swine H1N1




avian


                          1998                                                         2009
                         North                                                        human
human                   American                                                       H1N1
                       swine H1N1


        24 June 2009                Epidemics in a Changing World:   Parliamentary Library lecture   12
Equine influenza 2007


         Narrabri




                      Maitland                                                    NSW DPI (2007)

                    Centennial Park


                                                      DAFF (2008)

   24 June 2009               Epidemics in a Changing World:   Parliamentary Library lecture   13
Equine influenza 2007

• ~80,000 horses infected
• No NSW and QLD racing for 3 months
• Cost to Government: >$350 million
• Cost to industry: ~$1 billion



   24 June 2009           Epidemics in a Changing World:   Parliamentary Library lecture   14
Mortality in the 1918 pandemic


                                                          Children in a remote
                                                          Alaskan village
                                                          survived the 1918-19
                                                          pandemic while most
                                                          of their parents and
                                                          grandparents
                                                          succumbed.




                                                          Ahmed et al,
                                                          Nature Immunol. (2007)



   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   15
                                     Flinders St Station, Melbourne

The way we live




World Youth Day, Sydney 2008



                               MCG
      24 June 2009                         Epidemics in a Changing World:   Parliamentary Library lecture   16
Spread of the new H1N1 influenza




 24 June 2009     Epidemics in a Changing World:   Parliamentary Library lecture   17
Spread of H5N1 avian influenza




                                    www.pandemicflu.gov/

 24 June 2009     Epidemics in a Changing World:   Parliamentary Library lecture   18
Changes for the better

•   Knowledge and technology
•   Vaccines
•   Antiviral drugs
•   Global surveillance and cooperation
•   Communication systems
•   Pandemic planning and response

     24 June 2009         Epidemics in a Changing World:   Parliamentary Library lecture   19
Dengue viruses




  24 June 2009   Epidemics in a Changing World:   Parliamentary Library lecture   20
Dengue viruses

• Dengue fever:                50 million infections p.a.

• Dengue haemorrhagic fever:                                        500,000 p.a.

• No vaccines or drugs

• Transmitted by mosquitoes:                                Aedes aegypti
                                                   Aedes albopictus

   24 June 2009          Epidemics in a Changing World:   Parliamentary Library lecture   21
Control of dengue virus: water storage




                                                                www.who.int

   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   22
Areas at risk of dengue transmission




  24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   23
Bluetongue viruses




   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   24
Bluetongue viruses

• Mainly affect sheep

• Spread depends on:
        - midge vector
                                                            Saegerman et al. (2008)

        - susceptible animals
        - warm weather


   24 June 2009                 Epidemics in a Changing World:   Parliamentary Library lecture   25
Bluetongue viruses




                                                 Saegerman et al. (2008)




                                                        Colours represent
                                                        different virus types

   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   26
Influenza, dengue and bluetongue

• Mobility

• Demographic change

• Animal management and trade

• Climate change


   24 June 2009        Epidemics in a Changing World:   Parliamentary Library lecture   27
Epidemics

• Professor Stephen Prowse
          – CEO of the Australian Biosecurity
            Cooperative Research Centre for
            Emerging Infectious Disease
          – Deputy Chair: Expert Working Group
            on Epidemics in a Changing World




24 June 2009                Epidemics in a Changing World:   Parliamentary Library lecture   28
An emerging disease SARS - 2003




  24 June 2009    Epidemics in a Changing World:   Parliamentary Library lecture   29
What is an emerging infectious disease?
A disease that:
Causes more serious illness – bluetongue virus in Europe
Changes geographic region – rabies in Bali
Changes host – Ebola-Reston in Philippines




     24 June 2009               Epidemics in a Changing World:   Parliamentary Library lecture   30
Mortality associated with global
influenza outbreaks




                                                                      WHO (2005)

24 June 2009       Epidemics in a Changing World:   Parliamentary Library lecture   31
Impacts of recent disease events




24 June 2009     Epidemics in a Changing World:   Parliamentary Library lecture   32
Foot and mouth disease - UK




             Burning foot and mouth disease infected animals, UK 2001

   24 June 2009                          Epidemics in a Changing World:   Parliamentary Library lecture   33
Emerging infectious diseases are
increasing




Jones et al. (2008)

     24 June 2009     Epidemics in a Changing World:   Parliamentary Library lecture   34
Climate change

  Temperature

  Rainfall

  Water use

  Extreme weather events

   24 June 2009       Epidemics in a Changing World:   Parliamentary Library lecture   35
Water storage




   24 June 2009   Epidemics in a Changing World:   Parliamentary Library lecture   36
Movement of people




   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   37
Movement of livestock and commodities




   24 June 2009        Epidemics in a Changing World:   Parliamentary Library lecture   38
Prosperity


                                    Shanghai skyline




   24 June 2009   Epidemics in a Changing World:   Parliamentary Library lecture   39
Intensive livestock production




   24 June 2009       Epidemics in a Changing World:   Parliamentary Library lecture   40
Poverty




   24 June 2009   Epidemics in a Changing World:   Parliamentary Library lecture   41
Nipah outbreak in pigs in Malaysia


105
deaths


$US 276
million

                                               Culling pigs
   24 June 2009       Epidemics in a Changing World:   Parliamentary Library lecture   42
Urban infrastructure




   24 June 2009        Epidemics in a Changing World:   Parliamentary Library lecture   43
Livestock at the urban-rural interface




    24 June 2009          Epidemics in a Changing World:   Parliamentary Library lecture   44
Vaccination




   24 June 2009   Epidemics in a Changing World:   Parliamentary Library lecture   45
Complex inter-related factors




   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   46
Risks to Australia


  •Entry through
  northern borders

  •Entry through ports
  and airports

  •Disease emerging
  within Australia
   24 June 2009          Epidemics in a Changing World:   Parliamentary Library lecture   47
Our northern neighbours




   24 June 2009     Epidemics in a Changing World:   Parliamentary Library lecture   48
Ports and airports




   24 June 2009      Epidemics in a Changing World:   Parliamentary Library lecture   49
“Home grown” diseases




   24 June 2009    Epidemics in a Changing World:   Parliamentary Library lecture   50
Summary




                 Uncertainty and inevitability
  24 June 2009            Epidemics in a Changing World:   Parliamentary Library lecture   51
Summary

• We are changing the world
• This is changing the emergence and
  spread of human and animal diseases
• We need preparedness and agility to
  tackle the “unknown unknowns”


24 June 2009       Epidemics in a Changing World:   Parliamentary Library lecture   52

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:18
posted:7/5/2011
language:English
pages:53