dr tsang 22 feb
DESCRIPTION
This is presentation by Dr Thomas TSANG, Center of Health Protection Controller on "Emerging Infectious Diseases in the past and present decades" at CUHKSPHPCAA 1st Scientific Meeting at School of Public Health of CUHK on 22 Feb 2011.TRANSCRIPT
CUHKSPH/PCAA Inauguration1st Scientific Symposium
Emerging infectious diseases in the past and present decade
Dr Thomas TsangCentre for Health Protection, Department of Health
Feb 22, 2011
Past decade: Observations
1. Pandemics triggered by pathogens with animal link
• SARS Co-V– ? Bats– ?Palm civets as interm
ediate host
• Pandemic H1N1 (2009)– Reassortment with swi
ne flu virus
2. Pandemics travel much faster than anticipated
• Containment difficult despite theoretical possibility
• Present surveillance methods lag behind epidemic progression
• Sharing of epidemic intelligence vital
• Contingency planning must start well before pandemic
3. Epidemics can be halted by public health measures
• SARS– Quarantine & isolation– Hygiene and social
distancing
• Dengue fever– Anti-mosquito
measures
4. Strengthening of infrastructures vital
• Updated legislation
• Capacity building– e.g., surveillance systems, field epidemiology, infection control,
contingency planning
• New programs– vaccination schemes
• Closer public health / clinical interface
• Scientific Committees to pool expertise
• Open channels with Mainland and regional countries
5. Risk communication is all important
New decade: Trends & predictions
1. Another respiratory pandemic??
• Pandemic flu unpredictable– H2? H5? H9? Swine?
• Zoonotic pathogens– Is stopping at source feasible?
• Laboratory leaks
• Bioterrorism– Flu, smallpox, etc.
1997 2003 2009 2015
Avian influenzaH5N1
SARS Human swine influenza
?
2. Multi-drug resistance of increasing concern
• Global trend
• CA-MRSA, C. difficile, Acinectobacter, NDM-1 and other carbapemenase resistant bacteria, etc.
• World Health Day, April 2011
• New antibiotics lag behind due to R&D resource input
Emergence of New Delhi metallo-β-lactamase (NDM-1) producing Enteroba
cteriaceae
Lancet Infect Dis. 2010 Sep;10(9):597-602
Increasing reports of Clostridium difficile infection in UK
Source: Voluntary surveillance of Clostridium difficile in England, Wales and NorthernIreland, 2009. HPA
Source: ECDC, EMEA. The bacterial challenge: time to react. 2009 Sep
3. Climate change may alter pattern of infectious diseases
World Health Organization 2009
4. Some epidemics may flare up from time to time
• Influenza
• EV71 & other enteroviruses
• Norovirus
• HIV
• HEV
• Dengue fever
• Others ???
EV71 periodicity
Number of EV71 infection, 2001 – 2011 (as of Feb 17)
30
5 1
35
8 16 12
98
31
101
50
20
40
60
80
100
120
2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011
Year
Nu
mb
er o
f ca
ses
Voluntary report Statutory report
Source: Department of Health, Hong Kong
HIV epidemic among MSM in Hong Kong (2000-2010)
Source: HIV reporting system, Department of Health, Hong Kong
5. New vaccines ??
• Vaccines under development– Dengue fever, Malaria, HIV, etc.
• Use of existing vaccines– PCV, rotavirus, HPV, etc.
6. Regional accomplishments
• Measles eradication
• Hepatitis B elimination
• Polio-free status
7. Social networks and search engines find increasing use in
disease surveillance
• Powerful GIS systems• How disease spread
through ‘networks’• Rumor filters
Thank you