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Emergence and Reemergence of Infectious Diseases
Milton Friend Emeritus Scientist
U.S. Department of InteriorU.S. Geological Survey
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“During the last 150 years the Western world has virtually eliminated death due to infectious disease.”
(U.S. Surgeon General, 1975)
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“…it is time to ‘close the book on infectious diseases’.”
(U.S. Surgeon General, 1967)
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Time Magazine
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Number of People Worldwide with HIV/AIDS in 2002
Men 38.8 million
Women 19.6 million
Children <15 yrs 3.2 million
Total 42.0 million
U.S. AIDS-related mortalities (CDC data through 2001)
467,910
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Disease Emergence
multi-pronged assault on humans by infectious disease
exotic diseases
novel diseases
‘resurgence’expanded distri
bution
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“diseases and infections which are naturally transmitted between vertebrate animals and man.”
(World Health Organization, 1959)
Zoonoses =
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DiseaseYear of
EmergenceWildlife Hosts
Monkeypox 2003 Prairie Dog
SARS 2003 Civet Cat
West Nile Virus 1999 Birds
Hantavirus 1993 Small Rodents
AIDS 1981 Nonhuman Primates
Lyme Disease 1975 Small Rodents
Notable Emerging Diseases with Wildlife Origins
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Emerging Infectious Diseases of Wildlife
BirdsMammals – terrestrial and marineReptiles and AmphibiansFish – shellfish and finfishCorals
n=~190
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West Nile Virus – Surveillance Activities
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West Nile Virus – Necropsy Activities
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2000 West Nile Virus Outbreak Timeline
May Jun Jul Aug Sep Oct
First P
ositiv
e W
ild
Bird
First P
ositiv
e M
osquito
es
Onset o
f Firs
t Hum
an
Case
Onset o
f Firs
t Hors
e Cas
e
First P
ositiv
e Sen
tinel
Chicke
n
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West Nile Virus – Mapping
Wild Bird Surveillance
Human Cases
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A Potential Wildlife Disease Surveillance Network
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Specimens Submitted to NWHC (n=74,913)
Dept. of Interior
States
UniversityOthersOther Federal
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Hepatopathy (Mycotoxin?)
Emerging Diseases Identified by NWHC
Inclusion Body Disease
Poxvirus
Nestling Herpesvirus
1970s
1980s
Pentobarbitol Poisoning
Mycotoxin Trichothecine
Woodcock Reovirus
Eastern Equine Encephalitis
Lake Andes Duck Plague
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Hawaii Disease
Biocomplexity
Sea Otter Encephalitis
Avian Myelinopathy
Hepatopathy in Wisconsin
Stunting, Humpback
Chub
Sea Turtle Retrovirus
Rainbow Trout
Enteritis
Splenitis, Hepatitis in Brant
Coral Coccidiosis,
Tumors
1990s
2000s
LT Duck Adenovirus
Poisoning in Asian Vultures
Newcastle Disease
L. polyoon Enteritis
Chytrid Fungus/
Ranavirus
Emerging Diseases Identified by NWHC
???
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1.9% (1.4-2.5%)n = 2602
0.2% (0.04-4.0%)n = 2393
0% (0-0.5%)n = 624
6.7% (5.7-7.9%)n = 1994
Model
Disease Distribution in Wisconsin’s Eradication Zone
Deer Processing Station
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Specialized Biocontainment Facilities
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Infectious Disease Investigations
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Rabies
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Wildlife
DomesticAnimal
Human
Translocation
Human encroachmentEx situ contactEcological manipulationHuman behaviors
Global travelUrbanizationBiomedicalmanipulation
Food processing/distributionTechnology andIndustry
AgriculturalIntensification
EncroachmentIntroduction“Spill over” &“Spill back”
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SARS has cost an estimated $50 – $100 billion
Economic and Social ImpactsEconomic and Social Impacts
Tourism$
$ $$
$ Recreation
Commerce
Agriculture
Human Health
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Component Primary Focus
Monitoring Disease patterns, trends, and geographic distribution
Surveillance Pathogen presence and disease activity
Reporting Real-time awareness and summaries
Field Response Disease control activities
Disease EcologyDisease maintenance, eruption and spread – finding the weak links
Technology Development New capabilities for disease detection, diagnosis and control
Interagency Collaboration Efforts crossing areas of jurisdiction/agency responsibilities
Training and Education Enhancing societal awareness, addressing disease issues
Components Required to Adequately Address Wildlife Disease
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Characteristic HumansDomestic Animals
WIldlife
Species One Several Many
Species Biology & Ecology
Well Known Well Known Highly Variable
Disease Ecology* Well Known Well Known Poorly Known
Disease Control High Probability High ProbabilityLimited Success
Profession Long Standing Long Standing Recent Origin
Status of Knowledge for Disease Prevention and Control
* for established diseases
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Non-Governmental Organizations
Department of Interior
State Wildlife
Agencies
Tribal Governments
General Public
Other Federal Agencies
Stewardship Network
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Foundation for an Effective Wildlife Disease Capability
Operational Resources
Timely Response
Scientific Knowledge Early Detection
Rapid, accurate diagnosis
$$$
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“...emerging zoonotic diseases are among the most important public health threats facing humanity.”
(Mahy and Brown, 2000)
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“Pathogens that infect wildlife are twice as likely to become emerging diseases of humans as pathogens without wildlife hosts.”
(Cleaveland et al., 2001)
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• Diseases in wildlife are often transmitted to humans
• USGS is well positioned to develop the type of wildlife disease program needed to best serve wildlife and human health
• Wildlife disease surveillance and monitoring are weak links in the protection of human health
• Wildlife are important to the national economy and natural heritage and can be impacted by disease
• USGS has increasingly been called upon to respond with its wildlife disease expertise to help combat emerging infectious diseases of humans, such as WNV and monkeypox.