potential pandemic in south africa

POTENTIAL PANDEMIC IN SOUTH AFRICA

Obumneke Amadi

Outline Of Presentation

• South Africa and pandemics• Pandemic• Infectious diseases- trends• Definition of emerging & re-emerging diseases• Factors contributing to emergence• Examples• Public health response

(CHATURVEDI,2011)

South Africa And Potential Pandemics

Why Potential Pandemics?

Dr. KANUPRIYA CHATURVEDI

What is a pandemic?

• Pandemic – spread of infectious diseases through large regions of populations; generally from continent to continent

• Has to meet three conditions:• Emergence of a disease new to a population• Agents infect humans, causing serious illness• Agents spread easily and be sustainable among

humans

(Supra and FranK,2009)

Historical Pandemics• Bubonic Plague• Cholera• Yellow Fever• Influenza• Smallpox• Malaria


Infectious Disease- Trends• Urban sanitation, improved housing, personal hygiene, antisepsis & vaccination• Antibiotics further suppressed morbidity & mortality• New & Resurgent infectious diseases

Infectious Diseases: A World in Transition

• AIDS • Avian Influenza• Ebola• Cholera• Typhoid • Tuberculosis• Malaria • Antimicrobial resistance

(CHATURVEDI,2011)

Definition

Emerging infectious diseaseNewly identified & previously unknown infectious agents that cause public health problems either locally or internationally

Re-emerging infectious diseaseInfectious agents that have been known for some time, had fallen to such low levels that they were no longer considered public health problems & are now showing upward trends in incidence or prevalence worldwide

(CHATURVEDI,2011)

Definition

• Re-emerging infectious disease

Infectious agents that have been known for some time, had fallen to such low levels that they were no longer considered public health problems & are now showing upward trends in incidence or prevalence worldwide

(CHATURVEDI,2011)

Factors Contributing To Emergence

AGENT

• Evolution of pathogenic infectious agents (microbial adaptation & change)

• Development of resistance to drugs • Resistance of vectors to pesticides

(CHATURVEDI,2011)


HOST• Human demographic change• Human behaviour (sexual & drug use)• Human susceptibility to infection

(Immunosuppression)• Poverty & social inequality

(CHATURVEDI,2011)


ENVIRONMENT

• Climate & changing ecosystems• Economic development & Land use (urbanization, deforestation)• Technology & industry (food processing & handling)• International travel & commerce • Breakdown of public health measure (war, unrest, overcrowding)• Deterioration in surveillance systems (lack of political will)

(CHATURVEDI,2011)

Transmission of Infectious Agent from Animals to Humans

• >2/3rd emerging infections originate from animals- wild & domestic

• Emerging Influenza infections in Humans associated with Geese, Chickens & Pigs

• Animal displacement in search of food after deforestation/ climate change (Lassa fever)

• Humans themselves penetrate/ modify unpopulated regions- come closer to animal reservoirs/ vectors (Yellow fever, Malaria)

(CHATURVEDI,2011)

Climate & Environmental Changes

• Deforestation forces animals into closer human contact- increased possibility for agents to breach species barrier between animals & humans

• Global warming- spread of Malaria, Dengue, Leishmaniasis, Filariasis

Poverty, Neglect & Weakening of Health Infrastructure• Poor populations- major reservoir & source of continued transmission• Poverty- Malnutrition- Severe infectious disease cycle• Lack of funding, Poor prioritization of health funds, Misplaced in curative

rather than preventive infrastructure, Failure to develop adequate health delivery systems

(CHATURVEDI,2011)

Uncontrolled Urbanization & Population Displacement

Uncontrolled Urbanization & Population Displacement•Growth of densely populated cities- substandard housing, unsafe water, poor sanitation, overcrowding, indoor air pollution (>10% preventable ill health)

Human Behavior•Unsafe sexual practices (HIV, Gonorrhea, Syphilis)•Changes in agricultural & food production patterns- food-borne infectious agents (E. coli)•Increased international travel (Influenza)•Outdoor activity

(CHATURVEDI,2011)

HUMAN

ANIMALS

ENVIRONMENT

VECTORSZoonosis

PopulationGrowth

Mega-cities

Migration

Exploitation

Pollution

Climate changeVectorproliferation

Vectorresistance

Transmission

Antibiotics

Intensive farming

Foodproduction

What Is Influenza • Influenza is a viral infection that affects mainly the nose, throat,

bronchi, and lungs• Generally lasts for a week, but in the very young, elderly, and

those with serious medical conditions, it can lead to severe complications and death


Influenza potential Pandemics(H5N1)• Since Nov 2003, avian influenza H5N1 in birds affected 60

countries across Asia, Europe, Middle-East & Africa• >220 million birds killed by AI virus or culled to prevent further

spread• Majority of human H5N1 infection due to direct contact with

birds infected with virus(CHATURVEDI,2011)

Important Points to Remember:There is no danger of getting bird flu from eating chicken. You

cannot get bird flu from properly cooked chicken. Cooking would kill any virus.

Keep all poultry products properly refrigerated and cook thoroughly before eating


H5N1 Avian Influenza(Bird Flu)Important Points to Remember:•There is no danger of getting bird flu from eating chicken. You cannot get bird flu from properly cooked chicken. Cooking would kill any virus.•Keep all poultry products properly refrigerated and cook thoroughly before eating.


Ways to prevent influenza• Get a yearly flu vaccination• Basic flu prevention can include: staying away from people who seem to be sick with the

flu, washing hands constantly, etc.• Masks also can be worn to prevent inhaling germs, but may not prevent all germs from

entering the body.


• Key Tasks in Dealing with Emerging Diseases :Public health surveillance & response systems at national, regional, global level:

• epidemiological, • Laboratory• Ecological

(CHATURVEDI,2011)

Key tasks - carried out by whom?

National

RegionalGlobal

Synergy

References

Emerging & Re-emerging Infectious Diseases. Dr. KANUPRIYACHATURVEDI

Amanda Supra and Dr. Frank(2009). Flanders.Pandemic.Georgia CTAE Resource NetworkInstructional Resources Office

potential pandemic in south africa

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