PUBLIC HEALTH CONCERNS IN EPIDEMICS AND PANDEMICS by Dr.T.V.Rao MD

1. PUBLIC HEALTH CONCERNS IN
EPIDEMICS AND PANDEMICS
DR.T.V.RAO MD
Dr.T.V.Rao MD
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2. REASONS DISEASE OUTBREAKS ARE ERUPTING
AROUND THE WORLD
•MERS, H1N1, swine flu,
chikungunya, Zika: Another virus
with a peculiar name always
seems to be right around the
corner, threatening to become a
pandemic.
Dr.T.V.Rao MD
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3. WHO IDENTIFIES FOUR EMERGENCIES
• Over the past decade, the World
Health Organization has declared
four global health emergencies.
Two of them were in the past two
years: the Ebola epidemic in West
Africa and the Zika outbreak that's
spread through the Americas.
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4. MANY OF THE PANDEMICS WERE PRESENT
IN THE PAST AND JUST COMING OUT OF
THE PAST
• Many of the pathogens that
spark deadly outbreaks aren't
new. Researchers have known
about Zika since the 1940s and
Ebola since the 1970s. Some of
these viruses have evolved with
humans for hundreds or
thousands of years.
Dr.T.V.Rao MD
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5. HERE ARE KEY REASONS WE'RE SEEING
AN UPRAISE IN INFECTIOUS DISEASES
AROUND THE WORLD:
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6. MORE TRAVEL, TRADE,
AND CONNECTIVITY
• For most of history, humans lived in
small, disparate bands that were
relatively isolated from each other.
"Only comparatively recently has there
been extensive contact between
peoples, flora and fauna from both old
and new worlds," write researchers in a
paper on global transport and
infectious disease spread.
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7. GRWOING CHALLENGES WITH
URBANIZATION
• More people in cities can "put a strain on
sanitation," said David Heymann, head of the
Centre for Global Health Security at the think tank
Chatham House. Beyond people's close proximity,
"this is a second source of infection," he said, and a
third is increased food demand, causing farmers to
grow more food, with more animals, making them
likely to live closer to those animals as well.
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8. ENCROACHING INTO NEW
ENVIRONMENTS
• As numbers of people grow, so
does the amount of land needed
to house them. Populations
expand into previously
uninhabited territories, such as
forests. With new territories
comes contact with new animals
and, inevitably, new infections
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9. AIR TRAVEL CHANGED THE
WORLD AND INFECTIOUS SPREAD
FASTER
• Air travel changed all that. "The jet plane
took off in the '70s and accelerated during
the '80s and '90s," said Duane Gubler, an
infectious diseases specialist and former
director of the division of vector-borne
disease at the Centers for Disease Control
and Prevention. "So now we have this
modern transportation or globalization
that is moving animals, humans,
commodities, and pathogens around the
world."
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10. FASTER TRAVEL CHANGED HOW THE INFECTIONS
SPREAD FASTER
• The movement of people and goods is
happening at a faster rate and greater
volume than at any other time.
• You can now travel pretty much
anywhere in the world in a day. And
unlike the plague lurching across
Europe in the 1300s, a traveler can now
bring a deadly strain of bird flu from
China to Europe within 24 hours.
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11. HOW THE EBOLA SPREAD
• When a pathogen is introduced to a
new place, people are biologically more
susceptible to the disease, since their
immune systems have probably never
been exposed and have no experience
fending it off. Doctors and health
systems can also be caught off guard.
• This is one of the factors that helped
the recent Ebola epidemic in West
Africa spiral out of control: the three
most affected countries had never
experienced an outbreak of the virus
before.
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12. THE TRUTH ABOUT MANY NEWER
EPIDEMICS AND PANDEMICS NEVER
DIAGNOSED EARLY
• Clinicians had never managed
cases," the World Health
Organization reported. "No
laboratory had ever diagnosed a
patient specimen. No government
had ever witnessed the social and
economic upheaval that can
accompany an outbreak of this
disease. Populations could not
understand what hit them or why."
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13. A SUCCESS STORY OF UGANDA
• Contrast that with East Africa, which has had plenty of experience
dealing with Ebola outbreaks over several decades. In Uganda, for
example, as soon as an Ebola case is identified, public health officials
overwhelm all streams of media with messages about how to stay
safe. People won't leave their houses out of fear of infection, and
they immediately report suspected cases to surveillance officials. It's
one of the reasons Uganda has successfully stamped out about half
a dozen Ebola outbreaks.
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14. URBANIZATION —
"AN EMERGING HUMANITARIAN
DISASTER"
CAN WE STOP?
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15. LIVING IN URBAN AREAS
INCREASES THE IMPACT OF
INFECTIONS
• Not only are people and
goods traveling farther
and at a greater volume
and speed than any
other time in history, but
people are also more
likely to live in densely
populated urban
environments.
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16. URBANIZATION
A GREAT CHALLENGE
AND THREAT
• More than half of the world's
population now lives in cities,
and just about every country
on the planet is becoming
more urbanized. Global
health researchers have called
the trend "an emerging
humanitarian disaster."
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17. CITIES BECOMING A BREEDING PLACES FOR
INFECTIOUS DISEASES
• Cities can be perfect breeding
grounds for disease to spread.
Consider the ongoing Zika
outbreak in Brazil. Not only was this
an old virus in a new country that
caught health officials off guard but
Brazil's many cities also happened
to be extremely hospitable to the
virus.
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18. AEDES AEGYPTI MOSQUITO
SPREAD MANY VIRAL
INFECTIONS
• The Aedes aegypti
mosquito, which carries
Zika, thrives alongside
people., "[It's] a highly
domesticated urban
mosquito that prefers to
live with humans in their
homes, feed on humans
and lay eggs in artificial
containers made by
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20. GROWING POPULATION ATTRIBUTING
TO FASTER SPREAD OF INFECTIONS
• Globally, unprecedented
population growth following
World War II has meant that not
only are more people living in
cities than ever before but
populations are also exploding
into areas that were once
inhabited only by other animals.
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21. ZOONOTIC CONTACT CONTINUES TO
GENERATE MANY EPIDEMICS
• Anytime humans interact with
animals, there's a chance that a
pathogen could make the leap
across species and sicken them.
Today about three-quarters of new
emerging infectious diseases are
spread to humans by animals — a
health threat that came with the rise
of agriculture.
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23. Dr.T.V.Rao MD
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24. PERVASIVE POVERTY MEANS OUTBREAKS WILL BE WORSE
• When new viruses strike impoverished or
weakened health systems, they have a
much greater chance of thriving and
killing people.
• The 2014-'15 Ebola epidemic offers
another illustrative example here. Every
American infected with Ebola during that
period survived. The same wasn't true
for the affected West Africans, 11,000 of
whom died.
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25. POLITICS AND SOCIAL
FACTORS INFLUENCE THE
PANDEMICS
• Politics and social factors
play a determining role in
whether or not you have one
or two cases — and whether
or not you have an outbreak
or pandemic," . "We
probably can't prevent the
one to two cases. But we
sure as heck can prevent the
pandemic."
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26. WARMING CLIMATE IS HELPING
FUEL MORE DISEASE OUTBREAKS
• When we think about health,
experts say, we need to start
thinking about how
environmental factors like
climate change can matter as
much as — or sometimes even
more than — our personal
behaviors.
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27. GLOBAL WARMING INFLUENCES MANY NATIONS
AND EVERY LIVING ON THE PLANET
• In a report released in June 2015, The
Lancet brought together the world’s
leading experts on environmental
health. They argue that "[t]he
implications of climate change for a
global population of 9 billion people
threatens to undermine the last half
century of gains in development and
global health," including the spread of
disease vectors.
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28. AEDES MAY BE REACHING
NEW PLACES —
• Zika, dengue, and chikungunya
are all spread by the Aedes
mosquito. And one of the
reasons researchers think
Aedes may be reaching new
places —and more people —
lately is climate change.
(Mosquitoes thrive in warm and
moist environments.)
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29. BIRD FLU, CHOLERA, LYME DISEASE —
RESEARCHERS BELIEVE ALL ARE BEING MADE
WORSE BY CLIMATE CHANGE.
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30. MANY ORGANIZATION
HELPING TO STOP
SPREAD OF INFECTIOUS
DISEASE
• In his decades as a disease
detective for the CDC, witnessed
the expansion of vector-borne
diseases in the US. "It’s already
happening now," . "And it's only
going to continue to accelerate
as our climate continues to get
warmer, as we continue to have
these extremes in rain fall, and
weather events."
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31. DESPITE ALL THIS, WE'RE GETTING
BETTER AT STOPPING OUTBREAKS
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32. WE ARE SUCCEEDING TO
CONTROL EPIDEMICS AND
PANDEMICS
• The researchers who published on the
rise of infectious disease outbreaks in
The Royal Society also found that while
the number of outbreaks was increasing
globally, the number of outbreak cases
per capita was actually declining over
time: "Our data suggest that, despite an
increase in overall outbreaks, global
improvements in prevention, early
detection, control and treatment are
becoming more effective at reducing
the number of people infected."
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33. LESS MONEY INVESTED FOR SURVEILLANCE AND
CONTROL OF INFECTIOUS DISEASES
• Health authorities couldn't see any sense in
continuing to spend a lot of money to
control diseases that weren't occurring, so
the programs were disbanded," he
explained. "At the same time, many
countries disbanded their public health
infrastructure to deal with vector-borne
diseases." This is another reason mosquito-
borne diseases like yellow fever, dengue,
and Zika are on the rise.
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34. IMPORTANCE OF ISOLATION OF
INFECTIOUS PATIENTS – A GREAT
CONCERN
• Isolation is most commonly used when a patient
is known to have a contagious (transmissible
person-to-person) viral or bacterial illness
Special equipment is used in the management
of patients in the various forms of isolation.
These most commonly include items of personal
protective equipment (gowns, masks, and
gloves) and engineering controls (positive
pressure rooms, negative pressure rooms,
laminar air flow equipment, and various
mechanical and structural barriers. ( Wikipedia )
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35. DEDICATED ISOLATION
WARDS SERVES TO
CONTAIN SPREAD OF
INFECTIONS
• Dedicated isolation wards
may be pre-built into
hospitals, or isolation units
may be temporarily
designated in facilities in
the midst of an epidemic
emergency.
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36. PUBLIC HEALTH MEASURES REDUCES THE
EPIDEMICS AND PANDEMICS
• Yet what stopped the SARS
and Ebola outbreaks from
truly going global were
simple, old-fashioned public
health measures like contact
tracing and quarantines
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37. INVESTING IN PUBLIC HEALTH
SERVES TO CONTROL THE
SPREAD OF INFECTIOUS
DISEASES
• investing in public health means having
strong disease surveillance systems and
lab networks in place, public health
officials ready to coordinate emergency
health responses, and research capacity
to quickly develop outbreak
countermeasures like medicines and
vaccines.
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38. FILE RESOURCE
• 4 reasons disease outbreaks are erupting around the world By Julia
Belluz@juliaoftorontojulia.belluz@voxmedia.com May 31, 2016,
• Online resources from CDC, WHO and Google resoruces
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39. • Program file created by Dr.T.V.Rao MD for benefit of
Nursing and Health care givers in the Developing world
• Email
• doctortvrao@gmail.com
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