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World Health Day 2014
Vector-borne diseases
#Just1Bite
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Vector-borne diseases
• Caused by pathogens in human populations
• Transmitted by vectors: living organisms that can transmit pathogens between human beings or from animals to humans
• Transferring the pathogens received during a blood meal from an infected host into a new host during the next blood meal
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Key facts – global
• Vector-borne diseases account for 17% of the estimated global burden of all infectious diseases.
• Malaria caused an estimated 627 000 deaths in 2012: more than any other vector-borne disease.
• The fastest growing vector-borne disease is dengue fever, with a thirtyfold increase in disease incidence over the last 50 years.
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Examples of vector-borne diseases in the WHO European Region
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Mosquito-borne
• Dengue fever• Chikungunya• Malaria• West Nile fever (WNF)
Sandfly-borne
• Leishmaniasis
Tick-borne
• Lyme disease• Tick-borne encephalitis (TBE)• Crimean–Congo haemorrhagic fever
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Key facts – WHO European Region
• 77 000 Europeans on average fall sick from vector-borne diseases every year.
• Mosquito species, such as Aedes aegypti, are re-emerging, and Ae. albopictus is emerging.
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Aedes aegypti distribution, October 2013
Ae. albopictus distribution, October 2013
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“There is a clear warning signal to the European Region that diseases carried by vectors may spread and intensify in the years ahead. This is not the time to lower our guard.”
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– Zsuzsanna Jakab WHO Regional Director for Europe
Message from the Regional Director
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Increasing and decreasing trends
Lyme disease Malaria WNF TBE Crimean Leishmania0
10000
20000
30000
40000
50000
60000
Number of cases: 1990, 2000, 2010
1990 2000 2010
Source: WHO centralized information system for infectious diseases (CISID) (http://data.euro.who.int/cisid).
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Growing public health concern
A combination of factors increases the threat of vector-borne diseases in the WHO European Region:
• changing social and economic conditions;
• globalized travel and trade;
• increased urbanization;
• climate change;
• environmental and ecosystem changes.
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Malaria in Europe
• Dramatic fall in locally acquired cases
• 3 countries reporting locally acquired cases in 2013: Greece, Tajikistan and Turkey
• Imported cases in Europe in 2013: 5000
Source: WHO centralized information system for infectious diseases (CISID) (http://data.euro.who.int/cisid).
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Dengue in Europe
• Viral infection transmitted by Aedes mosquitoes
• In Europe, second only to malaria in causing hospitalizations after travellers return from abroad
© Francis Schaffner/IPZ
• More than 3000 cases reported in the last three years
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Lyme disease in Europe
• Bacterial disease transmitted to human beings through bites from infected ticks
• Most common vector-borne disease in the WHO European Region, with the highest incidence reported in central Europe
• Over 360 000 cases in Europe in the last two decades
© CDC/ James Gathany
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Tick-borne encephalitis (TBE)
• Viral infectious disease transmitted by the bites of infected ticks
• 5000–12 000 cases reported in Europe each year
• Safe and effective vaccine against the TBE virus
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Average TBE incidence
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Leishmaniasis in Europe
• Leishmania is a parasitic protozoan transmitted through the bite of infected female sandflies.
• It causes three main forms of disease.
• Leishmaniasis is neglected and poorly reported.
Endemic leishmaniasis in the European Region
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Public health action
3 phases of vector and disease prevention and control
•Control the vector
•Prevent the disease
•Limit the spread
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Phase 1. Control the vector (1)
• Integrated vector control to prevent the introduction, establishment and spread of the vector
• Measures for early detection and containment• Robust methods for monitoring and evaluation • Social mobilization for vector control• Information for the public on how to
reduce vectors in the environment through risk communication and community mobilization
• Increased capacity for vector control
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Phase 1. Control the vector (2)
Advice on:•long-lasting insecticide-treated bed nets (where necessary)•indoor residual spraying•outdoor spraying•environmental management (reduction of breeding habitats, biological control, genetic control and waste management)•housing modifications
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Phase 2. Prevent the disease
Action needed where the introduction of vectors could not be avoided•Coordination of disease surveillance in the population at risk is with vector surveillance, to prevent outbreaks •Advice on personal protection measures (clothing, insect repellents, etc.), prevention, and vaccines (e.g. for TBE)•Blood and body fluid safety•Food safety
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Phase 3. Limit the spread
Measures to avoid large outbreaks, particularly in newly affected areas
• Inform and educate the public• Raise awareness among health professionals• Ensure laboratories are equipped
for early diagnosis • Ensure early detection and case
management
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Individuals and families can contribute•Know which vectors carry disease
•Use proven vector-control tools
•Be informed about vaccination and disease prevention
•Cooperate with local authorities in vector control
•Take part in health education in the community•Ensure environmental management around and in homes
© Francis Schaffner/IPZ
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Current challenges
• Emerging insecticide resistance
• Lack of expertise in vector control
• Integrated surveillance
• Sanitation
• Pesticide safety
• Environmental change
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WHO response
European and global commitments
•Regional framework for surveillance and control of invasive mosquito vectors and re-emerging vector-borne diseases, 2014–2020• World Health Assembly resolution WHA60.13 on control of leishmaniasis•Regional strategy: from malaria control to elimination in the WHO European Region 2006–2015.
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WHO Regional Office for Europe response• Working with partners including the European
Commission, the European Centre for Disease Prevention and Control (ECDC) and the European Mosquito Control Association (EMCA)
• Assisting countries in disease surveillance, prevention and control, following the International Health Regulations
• Providing training and guidelines on case management and vector control
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World Health Day 2014
Protect yourself from diseases carried by vectors
Hashtag: #Just1Bite
Website: www.euro.who.int/WHD2014
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