Overview of Infectious Disease Risk in Asia A Short-term Training on Molecular Epidemiology of Infectious Diseases January 12, 2017 Tohoku University Graduate School of Medicine Hitoshi OSHITANI, MD, MPH, PhD What is emerging infectious disease? An emerging disease is one that has appeared in a population for the first time, or that may have existed previously but is rapidly increasing in incidence or geographic range (World Health Organization) Emerging Infectious diseases 1996 to 2004 Multidrugresistant Salmonella E.coli O157 Cryptosporidiosis BSE nvCJD Lyme Borreliosis West Nile Virus Reston virus Venezuelan Equine Encephalitis Lassa fever Yellow fever Buruli ulcer Cholera E.coli non-O157 Legionnaire’s Disease Typhoid Malaria Diphtheria Dengue West Nile Fever haemhorrhagic Echinococcosis fever E.coli O157 SARS Influenza A(H5N1) Nipah Virus Cholera 0139 Ebola haemorrhagic fever Dengue haemhorrhagic fever Influenza A (H7N7) Reston Virus RVF/VHF O’nyong-nyong fever Human Monkeypox Cholera Hendra Virus Equine morbillivirus Ross River Virus Emerging diseases appeared almost every year in different parts of the world Spread of plague (Black death) to Europe http://chssp.ucdavis.edu/programs/historyblueprint/maps/medieval-map#blackdeathanch Emerging diseases are not completely new, but… Increasing risk of emerging infectious diseases in 21st century • Increasing risk of appearance of emerging diseases • Increasing risk of global spread of emerging infectious diseases Increasing human population UNEP Increasing risk of global spread of emerging infectious diseases World airline route map Wikimedia Commons Emerging Infectious Diseases as a Global Issue Major concerns in 1990’ All in 1995 WHO Actions for Emerging Diseases Isolation Isolate all possible cases in appropriate isolation facilities Contact Tracing Actively find all close contacts Quarantine Isolate all close contacts Isolation Isolate all cases in appropriate isolation facilities as soon as close contacts develop symptoms Basic containment strategy for SARS Active Case Finding Case Isolation Case Contact Tracing Quarantine Contact Ebola Virus Disease Outbreak in West Africa（2014～2016） Guinea：3,804 cases（2536 deaths）, Liberia：10,675 cases（4809 deaths）, Sierra Leone14,123（3,956 deaths） Participating WHO Liberia Ebola Response Team • November 14 – December Deputy Technical Coordinator Coordination of County Level Activities • December – December 22 Acting Technical Coordinator Coordination of All Technical Teams Analysis of chain of transmission of EVD in Guinea The Lancet Infectious Diseases 2015 15, 320-326DOI: (10.1016/S1473-3099(14)71075-8) Copyright © 2015 Elsevier Ltd Terms and Conditions Analysis of chain of transmission of EVD in Liberia MMWR May 15, 2015 / 64(18);500-504 Basic containment strategy for EVD Active Case Finding Case Isolation Case Contact Tracing Quarantine Contact MERS outbreak in South Korea (2015) Lee SS & Wong NS Int J Infect Dis 2015 Lessons learnt from major outbreaks in 21st century • A risk of emerging diseases is increasing • We have many new technologies to fight against these emerging disease threats • Conventional and basic approaches such as epidemiological investigations are still critical especially in early stage of outbreak Dr Carlo Urbani on Mekong River ... Increasing risk of emerging infectious diseases in 21st century • Increasing risk of appearance of emerging diseases • Increasing risk of global spread of emerging infectious diseases Increasing... UNEP Increasing risk of global spread of emerging infectious diseases World airline route map Wikimedia Commons Emerging Infectious Diseases as a Global Issue Major concerns in 1990’ All in 1995...What is emerging infectious disease? An emerging disease is one that has appeared in a population for the first time, or that may have existed previously but is rapidly increasing in incidence or