Emerging Infectious Diseases from the Global to the Local Perspective A Summary of a Workshop of the Forum on Emerging Infections (2001) / Chapter Skim
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Emerging Infections in Europe
Emerging Infections in Europe
Pages 72-84
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From page 72... ...
A challenge for Europe lies in how best to integrate local needs with national, political, and international needs when it comes to disease surveillance and response. The need for a clearer understanding of local requirements and the need for leadership behind the issues, followed by critical assessment and strategic planning for infrastructure development for infectious disease surveillance and response systems, are as evident in Europe as elsewhere.
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From page 73... ...
defined emerging and reemerging infectious diseases as those "diseases of infectious origin whose incidence in humans has increased within the past two decades, or threatens to increase in the near future." This definition is wide, encompassing not only new entities, but also new incidents or outbreaks of established diseases with public health implications, changing trends, and diseases that have increased in importance because of, for example, the actual or potential emergence of antimicrobial resistance. Diseases appear on the national or international political agenda for a variety of reasons: (1)
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From page 74... ...
The speed at which the outbreak became widely publicly reported led to some initial confusion about its nature and the size of the geographical area through which it was spreading, emphasizing the importance of a strong communications strategy. The United Kingdom was fortunate in that the WHO laboratory based in London was able to provide authoritative information during these early stages.
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From page 75... ...
In early-warning and response systems, the local level is required to serve a disease intelligence function and needs the ability to assess possible indicator events (e.g., changes in over-the-counter drug sales at pharmacies, school absenteeism, as well as the data generated from more conventional disease surveillance activities)
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From page 76... ...
This summary focuses on the situation in five Central Asian states that were part of the former Soviet Union (FSU) Kazakhstan, Uzbekistan, Kyrgyzstan, Turkmenistan, and Tajikistan with a particular focus on the 5 million people living in what is considered the world's greatest environmental disaster area, the Aral Sea area.
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From page 77... ...
The incidence of malaria, which had been all but eradicated in the FSU, in the last few years has shown an alarming increase in the most southern statesfrom a few incidental and most likely imported cases of malaria in Tajikistan in the early l990s, to almost 20,000 cases reported in 1998. In a region with a vast amount of stagnant water because of ineffective irrigation schemes and an entire generation of people with no experience with malaria prevention, a public health crisis is in the making as the malaria belt moves north.
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From page 78... ...
At present, however, MDR-TB has increased the transnational public health threat, and the costs associated with combating the disease cannot be met locally. Directly associated with the economic collapse and the lack of political commitment is a long list of forces at play, and these are driving the TB epidemic in the FSU.
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From page 79... ...
Indeed, during the Soviet era, health care workers were numerous and well trained. In the Aral Sea area, not only has there been a significant exodus of trained staff because of the environmental disaster, placing a huge strain on the capacity of the health system, but the majority of health care workers who have remained in the region are nearing retirement and have had little to no upgrading of their skills.
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From page 80... ...
Pilot programs should aim to develop momentum by reducing community stigmatization of TB, gaining patient and health worker confidence, and obtaining political commitment. Implementation of pilot programs is not the same as further extension of program coverage.
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From page 81... ...
Pro-Vice Chancellor (ResearchJ, School of Informatics, City University, London, and Honorary Consultant Epidemiologist, Public Health Laboratory Service, Communicable Disease Surveillance Centre, London It is important when setting priorities for control of emerging and reemerging infectious diseases that one does not lose sight of the importance of controlling diseases that persist, for example, acute respiratory infection in children in the developing world. The European Union (KU)
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From page 82... ...
Critical aspects of international collaborations are establishing trust and harmonizing epidemiological and laboratory practices. One of the great successes of EntreNet, a network established to improve the prevention and control of human salmonellosis and other food-borne infections in European Union countries, has been the development of a Europe-wide typing system for Salmonella enterica serovar Enteritidis, a process that has resulted in the development of trust, collaboration, and exchange of materials.
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From page 83... ...
Influenza was identified as a high priority for international surveillance, as was acute poliomyelitis, antimicrobial resistance, and cholera.
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