Emerging infectious disease

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When Anthony Fauci became director of the NIAID, he drew a map of the world for presentation at a congressional hearing that showed a single notable emerging infectious disease threat: HIV. Since then, he has continually updated the map, now showing the emergence of numerous infectious disease threats to illustrate the experiences of his years in office as well as highlighting certain infections that had emerged before HIV. Global Examples of Emerging and Re-Emerging Infectious Diseases.jpg
When Anthony Fauci became director of the NIAID, he drew a map of the world for presentation at a congressional hearing that showed a single notable emerging infectious disease threat: HIV. Since then, he has continually updated the map, now showing the emergence of numerous infectious disease threats to illustrate the experiences of his years in office as well as highlighting certain infections that had emerged before HIV.

An emerging infectious disease (EID) is an infectious disease whose incidence has increased recently (in the past 20 years), and could increase in the near future. [2] [3] The minority that are capable of developing efficient transmission between humans can become major public and global concerns as potential causes of epidemics or pandemics. [4] Their many impacts can be economic and societal, as well as clinical. [5] EIDs have been increasing steadily since at least 1940. [6]

Contents

For every decade since 1940, there has been a consistent increase in the number of EID events from wildlife-related zoonosis. Human activity is the primary driver of this increase, with loss of biodiversity a leading mechanism. [7]

Emerging infections account for at least 12% of all human pathogens. [8] EIDs can be caused by newly identified microbes, including novel species or strains of virus [9] (e.g. novel coronaviruses, ebolaviruses, HIV). Some EIDs evolve from a known pathogen, as occurs with new strains of influenza. EIDs may also result from spread of an existing disease to a new population in a different geographic region, as occurs with West Nile fever outbreaks. Some known diseases can also emerge in areas undergoing ecologic transformation (as in the case of Lyme disease [10] ). Others can experience a resurgence as a re-emerging infectious disease, like tuberculosis [11] (following drug resistance) or measles. [12] Nosocomial (hospital-acquired) infections, such as methicillin-resistant Staphylococcus aureus are emerging in hospitals, and are extremely problematic in that they are resistant to many antibiotics. [13] Of growing concern are adverse synergistic interactions between emerging diseases and other infectious and non-infectious conditions leading to the development of novel syndemics.

Many EID are zoonotic, [4] deriving from pathogens present in animals, with only occasional cross-species transmission into human populations. [14] For instance, most emergent viruses are zoonotic [4] (whereas other novel viruses may have been circulating in the species without being recognized, as occurred with hepatitis C [15] ).

History of the concept of emerging infectious diseases

The French doctor Charles Anglada (1809–1878) wrote a book in 1869 on extinct and new diseases. [16] He did not distinguish infectious diseases from others (he uses the terms reactive and affective diseases, to mean diseases with an external or internal cause, more or less meaning diseases with or without an observable external cause). He writes in the introduction:

A widely held opinion among physicians admits the invariability of pathologies. All the illnesses which have existed or which have an outbreak around us are categorized according to arrested and preconceived types, and must enter one way or the other into the frameworks established by the nosologists. History and observation protest wildly against this prejudice, and this is what they teach: Diseases which have disappeared and whose traces are confined to the archives of science, are followed by other diseases, unknown to the contemporary generation, and which come for the first time to assert their rights. In other words, there are extinct and new diseases.

Charles Nicolle, laureate of the Nobel Prize in Physiology or Medicine elaborated the concept of emergence of diseases in his 1930 book Naissance, vie et mort des maladies infectieuses (Birth, Life and Death of Infectious Diseases), and later in Destin des maladies infectieuses (Fate of Infectious Diseases) [17] published in 1933 which served as lecture notes for his teaching of a second year course at the Collège de France. In the introduction of the book he sets out the program of the lectures:

It is this historical existence, this destiny that will be the subject of our talks. I will have to answer, to the extent that our current knowledge allows, questions that you have asked yourself, that every thoughtful or simply curious mind asks: have the infectious diseases that we observe today always existed? Or have some of them appeared in the course of history? Can we assume that new ones will appear? Can we assume that some of these diseases will disappear? Have some of them already disappeared? Finally, what will become of humanity and domestic animals if, as a result of more and more frequent contacts between people, the number of infectious diseases continues to increase?

The term emerging disease has been in use in scientific publications since the beginning of the 1960s at least [18] and is used in the modern sense by David Sencer in his 1971 article "Emerging Diseases of Man and Animals" [19] where in the first sentence of the introduction he implicitly defines emerging diseases as "infectious diseases of man and animals currently emerging as public health problems" and as a consequence also includes re-emerging diseases:

Infectious diseases of man and animals currently emerging as public health problems include some old acquaintances and some that are new in respect to identity or concept.

He also notes that some infectious agents are newly considered as diseases because of changing medical technologies:

But there are also many familiar organisms formerly considered nonpathogenic that are now associated with nosocomial infections, use of artificial kidneys, and the acceptance or rejection of organ transplants, for example.

He concludes the introduction with a word of caution:

And so infectious disease, one of man's oldest enemies, survives as an adversary that calls forth our best efforts.

However, to many people in the 1960s and 1970s the emergence of new diseases appeared as a marginal problem, as illustrated by the introduction to the 1962 edition of Natural History of Infectious Disease by Macfarlane Burnet: [20]

to write about infectious disease is almost to write of something that has passed into history

as well as the epilogue of the 1972 edition: [21]

On the basis of what has happened in the last thirty years, can we forecast any likely developments for the 1970s? If for the present we retain a basic optimism and assume no major catastrophes occur [...] the most likely forecast about the future of infectious disease is that it will be very dull. There may be some wholly unexpected emergence of a new and dangerous infectious disease, but nothing of the sort has marked the past fifty years.

Throughout the 20th century until 1980, with the exception of the 1918 Spanish flu pandemic, the death rate from infectious diseases in the United States was steadily decreasing. However, because of the AIDS epidemic, the death rate from infectious diseases increased by 58% between 1980 and 1992. Trends in Infectious Diseases Mortality, 1900-1996.png
Throughout the 20th century until 1980, with the exception of the 1918 Spanish flu pandemic, the death rate from infectious diseases in the United States was steadily decreasing. However, because of the AIDS epidemic, the death rate from infectious diseases increased by 58% between 1980 and 1992.

The concept gained more interest at the end of the 1980s as a reaction to the AIDS epidemic. On the side of epistemology, Mirko Grmek worked on the concept of emerging diseases while writing his book on the history of AIDS [22] and later in 1993 published an article [23] about the concept of emerging disease as a more precise notion than the term "new disease" that was mostly used in France at that time to qualify AIDS among others.

Also under the shock of the emergence of AIDS, epidemiologists wanted to take a more active approach to anticipate and prevent the emergence of new diseases. Stephen S. Morse from The Rockefeller University in New York was chair and principal organizer of the NIAID/NIH Conference "Emerging Viruses: The Evolution of Viruses and Viral Diseases" held 1–3 May 1989 in Washington, DC. In the article summarizing the conference the authors write: [24]

Challenged by the sudden appearance of AIDS as a major public health crisis [...] jointly sponsored the conference "Emerging Viruses: The Evolution of Viruses and Viral Diseases" [...] It was convened to consider the mechanisms of viral emergence and possible strategies for anticipating, detecting, and preventing the emergence of new viral diseases in the future.

They further note:

Surprisingly, most emergent viruses are zoonotic, with natural animal reservoirs a more frequent source of new viruses than is the sudden evolution of a new entity. The most frequent factor in emergence is human behavior that increases the probability of transfer of viruses from their endogenous animal hosts to man.

In a 1991 paper [25] Morse underlines how the emergence of new infectious diseases (of which the public became aware through the AIDS epidemic) is the opposite of the then generally expected retreat of these diseases:

The striking successes achieved with antibiotics, together with widespread application of vaccines for many previously feared viral diseases, made it appear to many physicians and the public that infectious diseases were retreating and would in time be fully conquered. Although this view was disputed by virologists and many specialists in infectious diseases, it had become a commonplace to suggest that infectious diseases were about to become a thing of the past [...].

As a direct consequence of the 1989 conference on emerging viruses, the Institute Of Medicine convened in February 1991 the 19-member multidisciplinary Committee on Emerging Microbial Threats to Health, co-chaired by Joshua Lederberg and Robert Shope, to conduct an 18-month study. According to the report produced by the committee in 1992, [26] its charge "was to identify significant emerging infectious diseases, determine what might be done to deal with them, and recommend how similar future threats might be confronted to lessen their impact on public health." The report recommended setting up a surveillance program to recognize emerging diseases and proposed methods of intervention in case an emergent disease was discovered.

A well-designed, well-implemented surveillance program can detect unusual clusters of disease, document the geographic and demographic spread of an outbreak, and estimate the magnitude of the problem. It can also help to describe the natural history of a disease, identify factors responsible for emergence, facilitate laboratory and epidemiological research, and assess the success of specific intervention efforts.

The proposed interventions were based on the following: the U.S. public health system, research and training, vaccine and drug development, vector control, public education and behavioral change. A few years after the 1989 Emerging Viruses conference and the 1992 IOM report, the Program for Monitoring Emerging Diseases (ProMED) was formed by a group of scientists as a follow-up in 1994 [27] and the Centres for Disease Control (CDC) launched the Emerging Infectious Diseases journal in 1995. [18]

A decade later the IOM convened the Committee on Emerging Microbial Threats to Health in the 21st Century which published its conclusions in 2003. [28]

In April 2000 the WHO organized a meeting on Global Outbreak Alert and Response, [29] which was the founding act of the Global Outbreak Alert and Response Network.

In 2014, the Western African Ebola virus epidemic demonstrated how ill-prepared the world was to handle such an epidemic. In response, the Coalition for Epidemic Preparedness Innovation was launched at the World Economic Forum in 2017 with the objective of accelerating the development of vaccines against emerging infectious diseases to be able to offer them to affected populations during outbreaks. [30] CEPI promotes the idea that a proactive approach is required to "create a world in which epidemics are no longer a threat to humanity". [31]

Classification

One way to classify emerging infections diseases is by time and how humans were involved in the emergence: [32]

Contributing factors

The 1992 IOM report [26] distinguished 6 factors contributing to emergence of new diseases (Microbial adaptation and change; Economic development and land use; Human demographics and behavior; International travel and commerce; Technology and industry; Breakdown of public health measures) which were extended to 13 factors in the 2003 report [28] (Chapter 3 of the report detailing each of them)

Their classification serves as a basis for many others. The following table gives examples for different factors:

Factor of emergenceExample
Microbial adaption genetic drift and genetic shift in Influenza A
Changing human susceptibilitymass immunocompromisation with HIV/AIDS
Climate change diseases transmitted by animal vectors such as mosquitoes (e.g. West Nile fever) are moving further from the tropics as the climate warms
Changes in human demographics and travel facilitating rapid global spread SARS-related coronaviruses
Economic developmentuse of antibiotics to increase meat yield of farmed cows leads to antibiotic resistance
War and famine Clearing of animal habitats that increase the range of diseases such as ebola
Inadequate public health services
Poverty and social inequality tuberculosis is primarily a problem in low-income areas
Bioterrorism 2001 Anthrax attacks
Land useDam construction and irrigation systems can encourage malaria and other mosquito-borne diseases
Use of indiscriminate pesticides in industrial farming reduces/eliminates biological controls (e.g. dragonflies, amphibians, insectivorous birds, spiders) of known disease vectors (e.g. mosquito, tick, biting midge)
Anti-vaccination or Vaccine hesitancy Re-emergence of measles [33] [34]
Wildlife trade Has been linked to zoonotic emergence and spread of new infectious diseases in humans, including Nipah virus and COVID-19. [35] [36] Crowded and unhygienic wet markets and wildlife farms have been implicated in animal-human transmission of emergent viruses, including novel coronaviruses and influenza viruses [37] Complex issues surrounding the commerce and consumption of bushmeat are also of particular concern. [38] [39] [40]

Emerging Infectious Diseases between Humans and Animals

Emerging infectious diseases between human, animal have become a significant concern in recent years, playing a crucial role in the occurrence and spread of diseases. [41] [42] Human population growth, increased proximity to wildlife, and climate change have created favorable conditions for the transmission of zoonotic diseases, leading to outbreaks such as Zika, Ebola, and COVID-19. The One Health approach, which integrates animal, human, and environmental health, has emerged as a crucial tool for monitoring and mitigating the spread of infectious diseases. [43]

Zoonotic diseases, originating from animal sources, pose a significant threat to human health. Up to 75% of emerging infectious diseases are zoonotic, originating from viruses and other pathogens that are transmitted from animals to humans. Understanding the mechanisms of transmission, the role of wildlife trade, and the importance of surveillance and early detection is crucial for mitigating the impact of zoonotic diseases on human health. Surveillance efforts involving wastewater have been identified as valuable tools for detecting early warning signs of disease emergence and providing timely interventions. [41] [42]

List

NIAID list of Biodefense and Emerging Infectious Diseases

The U.S. National Institute of Allergy and Infectious Diseases (NIAID) maintains a list of Biodefense and Emerging Infectious Diseases. The list is categorized by biodefense risk, which is mostly based on biological warfare and bioterrorism considerations. As of 2004, it recognized the following emerging and re-emerging diseases. [44]

Newly recognized (since the 1980s):

Re-emerging:

Diseases with bioterrorism potential, CDC category A (most dangerous):

Diseases with bioterrorism potential, CDC category B:

Diseases with bioterrorism potential, CDC category C (least dangerous):

Since 2004, NIAID has added to its biodefense emerging pathogen list: [45]

NIAID also monitors antibiotic resistance, which can become an emerging threat for many pathogens.

WHO list of most important emerging infectious diseases

In December 2015, the World Health Organization held a workshop on prioritization of pathogens "for accelerated R&D for severe emerging diseases with potential to generate a public health emergency, and for which no, or insufficient, preventive and curative solutions exist." [46] The result was a list containing the following six diseases:

These were selected based on the following measures:

  1. Human transmissibility (including population immunity, behavioural factors, etc.)
  2. Severity or case fatality rate
  3. Spillover potential
  4. Evolutionary potential
  5. Available countermeasures
  6. Difficulty of detection or control
  7. Public health context of the affected area(s)
  8. Potential scope of outbreak (risk of international spread)
  9. Potential societal impacts

Newly reported infectious diseases

In 2007 Mark Woolhouse and Eleanor Gaunt established a list of 87 human pathogens first reported in the period between 1980 and 2005. [47] These were classified according to their types.

Numbers of pathogen species by taxonomic category
Number of species

known in 2005

Number of species

reported from 1980 to 2005

TOTAL139987
Bacteria54111
Fungi32513
Helminths2851
Prions21
Protozoa573
Viruses18958
DNA viruses369
RNA viruses15349

Major outbreaks

The following table summarizes the major outbreaks since 1998 caused by emerging or re-emerging infectious diseases. [48]

DiseaseCountry or regionYear of start of outbreak
Ngari virus [49] Kenya, Tanzania, Somalia1998
Nipah virus Malaysia1998
West Nile virus US1999
Itaya virus [50] Peru1999
Rift Valley fever Saudi Arabia and Yemen2000
EBLV-2 Scotland2002
SARS-CoV 2002
Influenza A virus subtype H7N2 2002
Monkeypox US2003
Chapare virus Bolivia2003
Plague Algeria2003
HTLV-3, HTLV-4 Cameroon2005
Melaka virus Malaysia2006
LuJo virus southern Africa2008
Multi-drug resistant P. falciparum South-East Asia2008
Candida auris 2009
Heartland virus US2009
Bas-Congo virus DRC2009
Lassa fever Mali2009
Pandemic H1N1/09 virus Global pandemic2009
Huaiyangshan banyangvirus 2009
Plague Libya2009
Cholera Haiti2010
Lassa fever Ghana2011
Plasmodium cynomolgi [51] Malaysia2011
H3N2v 2011
MERS -CoV 2012
Mojiang paramyxovirus [52] 2012
H7N9 2013
Sosuga pararubulavirus 2013
H10N8 [53] 2013
Chikungunya Caribbean2013
Variegated Squirrel Bornavirus 1  [ de ]2013
Colpodella sp. Heilongjiang [54] China2013
Ebola virus disease [55] West Africa2014
H5N6 2014
Lassa fever Benin2014
Bourbon virus US2014
Zika virus [56] Americas2015
Crimean–Congo hemorrhagic fever Spain2016
Chikungunya Pakistan2016
Lassa fever Togo2016
Ntwetwe virus [57] Uganda2016
Monkeypox Nigeria2017
Yellow fever Brazil2017
Rat hepatitis E virus [58] 2017
Guinea worm Chad2018
Lyme disease 2018
H7N4 2018
Monkeypox Liberia, UK2018
Nipah virus India2018
COVID-19 [14] Global pandemic2019

Methicillin-resistant Staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) evolved from methicillin-susceptible Staphylococcus aureus (MSSA), otherwise known as common S. aureus. Many people are natural carriers of S. aureus, without being affected in any way. MSSA was treatable with the antibiotic methicillin until it acquired the gene for antibiotic resistance. [59] Through genetic mapping of various strains of MRSA, scientists have found that MSSA acquired the mecA gene in the 1960s, which accounts for its pathogenicity, before this it had a predominantly commensal relationship with humans. It is theorized that when this S. aureus strain that had acquired the mecA gene was introduced into hospitals, it came into contact with other hospital bacteria that had already been exposed to high levels of antibiotics. When exposed to such high levels of antibiotics, the hospital bacteria suddenly found themselves in an environment that had a high level of selection for antibiotic resistance, and thus resistance to multiple antibiotics formed within these hospital populations. When S. aureus came into contact with these populations, the multiple genes that code for antibiotic resistance to different drugs were then acquired by MRSA, making it nearly impossible to control. [60] It is thought that MSSA acquired the resistance gene through the horizontal gene transfer, a method in which genetic information can be passed within a generation, and spread rapidly through its own population as was illustrated in multiple studies. [61] Horizontal gene transfer speeds the process of genetic transfer since there is no need to wait an entire generation time for gene to be passed on. [61] Since most antibiotics do not work on MRSA, physicians have to turn to alternative methods based in Darwinian medicine. However, prevention is the most preferred method of avoiding antibiotic resistance. By reducing unnecessary antibiotic use in human and animal populations, antibiotics resistance can be slowed.

Scientific Advisory Group for Origins of Novel Pathogens

On 16 July 2021, the Director-General of WHO announced the formation of the Scientific Advisory Group for Origins of Novel Pathogens (SAGO), [62] [63] [64] which is to be a permanent advisory body of the organisation. The Group was formed with a broad objective to examine emerging infectious diseases, including COVID-19. [62] [65] According to the WHO Director-General, "SAGO will play a vital role in the next phase of studies into the origins of SARS-CoV-2, as well as the origins of future new pathogens." [62]

See also

Related Research Articles

<span class="mw-page-title-main">Zoonosis</span> Disease that can be transmitted from other species to humans

A zoonosis or zoonotic disease is an infectious disease of humans caused by a pathogen that can jump from a non-human to a human and vice versa.

<i>Staphylococcus aureus</i> Species of Gram-positive bacterium

Staphylococcus aureus is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive for catalase and nitrate reduction and is a facultative anaerobe that can grow without the need for oxygen. Although S. aureus usually acts as a commensal of the human microbiota, it can also become an opportunistic pathogen, being a common cause of skin infections including abscesses, respiratory infections such as sinusitis, and food poisoning. Pathogenic strains often promote infections by producing virulence factors such as potent protein toxins, and the expression of a cell-surface protein that binds and inactivates antibodies. S. aureus is one of the leading pathogens for deaths associated with antimicrobial resistance and the emergence of antibiotic-resistant strains, such as methicillin-resistant S. aureus (MRSA), is a worldwide problem in clinical medicine. Despite much research and development, no vaccine for S. aureus has been approved.

Methicillin-resistant <i>Staphylococcus aureus</i> Bacterium responsible for difficult-to-treat infections in humans

Methicillin-resistant Staphylococcus aureus (MRSA) is a group of gram-positive bacteria that are genetically distinct from other strains of Staphylococcus aureus. MRSA is responsible for several difficult-to-treat infections in humans. It caused more than 100,000 deaths worldwide attributable to antimicrobial resistance in 2019.

Vancomycin-resistant <i>Staphylococcus aureus</i> Antibiotica resistant bacteria

Vancomycin-resistant Staphylococcus aureus (VRSA) are strains of Staphylococcus aureus that have acquired resistance to the glycopeptide antibiotic vancomycin. Bacteria can acquire resistant genes either by random mutation or through the transfer of DNA from one bacterium to another. Resistance genes interfere with the normal antibiotic function and allow a bacteria to grow in the presence of the antibiotic. Resistance in VRSA is conferred by the plasmid-mediated vanA gene and operon. Although VRSA infections are uncommon, VRSA is often resistant to other types of antibiotics and a potential threat to public health because treatment options are limited. VRSA is resistant to many of the standard drugs used to treat S. aureus infections. Furthermore, resistance can be transferred from one bacterium to another.

Tick-borne diseases, which afflict humans and other animals, are caused by infectious agents transmitted by tick bites. They are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa. The economic impact of tick-borne diseases is considered to be substantial in humans, and tick-borne diseases are estimated to affect ~80 % of cattle worldwide. Most of these pathogens require passage through vertebrate hosts as part of their life cycle. Tick-borne infections in humans, farm animals, and companion animals are primarily associated with wildlife animal reservoirs. many tick-borne infections in humans involve a complex cycle between wildlife animal reservoirs and tick vectors. The survival and transmission of these tick-borne viruses are closely linked to their interactions with tick vectors and host cells. These viruses are classified into different families, including Asfarviridae, Reoviridae, Rhabdoviridae, Orthomyxoviridae, Bunyaviridae, and Flaviviridae.

<span class="mw-page-title-main">Natural reservoir</span> Type of population in infectious disease ecology

In infectious disease ecology and epidemiology, a natural reservoir, also known as a disease reservoir or a reservoir of infection, is the population of organisms or the specific environment in which an infectious pathogen naturally lives and reproduces, or upon which the pathogen primarily depends for its survival. A reservoir is usually a living host of a certain species, such as an animal or a plant, inside of which a pathogen survives, often without causing disease for the reservoir itself. By some definitions a reservoir may also be an environment external to an organism, such as a volume of contaminated air or water.

Multiple drug resistance (MDR), multidrug resistance or multiresistance is antimicrobial resistance shown by a species of microorganism to at least one antimicrobial drug in three or more antimicrobial categories. Antimicrobial categories are classifications of antimicrobial agents based on their mode of action and specific to target organisms. The MDR types most threatening to public health are MDR bacteria that resist multiple antibiotics; other types include MDR viruses, parasites.

An emergent virus is a virus that is either newly appeared, notably increasing in incidence/geographic range or has the potential to increase in the near future. Emergent viruses are a leading cause of emerging infectious diseases and raise public health challenges globally, given their potential to cause outbreaks of disease which can lead to epidemics and pandemics. As well as causing disease, emergent viruses can also have severe economic implications. Recent examples include the SARS-related coronaviruses, which have caused the 2002-2004 outbreak of SARS (SARS-CoV-1) and the 2019–21 pandemic of COVID-19 (SARS-CoV-2). Other examples include the human immunodeficiency virus which causes HIV/AIDS; the viruses responsible for Ebola; the H5N1 influenza virus responsible for avian flu; and H1N1/09, which caused the 2009 swine flu pandemic. Viral emergence in humans is often a consequence of zoonosis, which involves a cross-species jump of a viral disease into humans from other animals. As zoonotic viruses exist in animal reservoirs, they are much more difficult to eradicate and can therefore establish persistent infections in human populations.

<span class="mw-page-title-main">Subclinical infection</span> Nearly or completely asymptomatic infection

A subclinical infection—sometimes called a preinfection or inapparent infection—is an infection by a pathogen that causes few or no signs or symptoms of infection in the host. Subclinical infections can occur in both humans and animals. Depending on the pathogen, which can be a virus or intestinal parasite, the host may be infectious and able to transmit the pathogen without ever developing symptoms; such a host is called an asymptomatic carrier. Many pathogens, including HIV, typhoid fever, and coronaviruses such as COVID-19 spread in their host populations through subclinical infection.

A reverse zoonosis, also known as a zooanthroponosis or anthroponosis, is a pathogen reservoired in humans that is capable of being transmitted to non-human animals.

<span class="mw-page-title-main">Staphylococcal infection</span> Medical condition

A staphylococcal infection or staph infection is an infection caused by members of the Staphylococcus genus of bacteria.

In biology, a pathogen, in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ.

Staphylococcus schleiferi is a Gram-positive, cocci-shaped bacterium of the family Staphylococcaceae. It is facultatively anaerobic, coagulase-variable, and can be readily cultured on blood agar where the bacterium tends to form opaque, non-pigmented colonies and beta (β) hemolysis. There exists two subspecies under the species S. schleiferi: Staphylococcus schleiferi subsp. schleiferi and Staphylococcus schleiferi subsp. coagulans.

Staphylococcus pseudintermedius is a gram positive coccus bacteria of the genus Staphylococcus found worldwide. It is primarily a pathogen for domestic animals, but has been known to affect humans as well. S. pseudintermedius is an opportunistic pathogen that secretes immune modulating virulence factors, has many adhesion factors, and the potential to create biofilms, all of which help to determine the pathogenicity of the bacterium. Diagnoses of Staphylococcus pseudintermedius have traditionally been made using cytology, plating, and biochemical tests. More recently, molecular technologies like MALDI-TOF, DNA hybridization and PCR have become preferred over biochemical tests for their more rapid and accurate identifications. This includes the identification and diagnosis of antibiotic resistant strains.

<span class="mw-page-title-main">Feline zoonosis</span> Medical condition

A feline zoonosis is a viral, bacterial, fungal, protozoan, nematode or arthropod infection that can be transmitted to humans from the domesticated cat, Felis catus. Some of these diseases are reemerging and newly emerging infections or infestations caused by zoonotic pathogens transmitted by cats. In some instances, the cat can display symptoms of infection and sometimes the cat remains asymptomatic. There can be serious illnesses and clinical manifestations in people who become infected. This is dependent on the immune status and age of the person. Those who live in close association with cats are more prone to these infections, but those that do not keep cats as pets can also acquire these infections as the transmission can be from cat feces and the parasites that leave their bodies.

ESKAPE is an acronym comprising the scientific names of six highly virulent and antibiotic resistant bacterial pathogens including: Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter spp. The acronym is sometimes extended to ESKAPEE to include Escherichia coli. This group of Gram-positive and Gram-negative bacteria can evade or 'escape' commonly used antibiotics due to their increasing multi-drug resistance (MDR). As a result, throughout the world, they are the major cause of life-threatening nosocomial or hospital-acquired infections in immunocompromised and critically ill patients who are most at risk. P. aeruginosa and S. aureus are some of the most ubiquitous pathogens in biofilms found in healthcare. P. aeruginosa is a Gram-negative, rod-shaped bacterium, commonly found in the gut flora, soil, and water that can be spread directly or indirectly to patients in healthcare settings. The pathogen can also be spread in other locations through contamination, including surfaces, equipment, and hands. The opportunistic pathogen can cause hospitalized patients to have infections in the lungs, blood, urinary tract, and in other body regions after surgery. S. aureus is a Gram-positive, cocci-shaped bacterium, residing in the environment and on the skin and nose of many healthy individuals. The bacterium can cause skin and bone infections, pneumonia, and other types of potentially serious infections if it enters the body. S. aureus has also gained resistance to many antibiotic treatments, making healing difficult. Because of natural and unnatural selective pressures and factors, antibiotic resistance in bacteria usually emerges through genetic mutation or acquires antibiotic-resistant genes (ARGs) through horizontal gene transfer - a genetic exchange process by which antibiotic resistance can spread.

Decolonization, also bacterial decolonization, is a medical intervention that attempts to rid a patient of an antimicrobial resistant pathogen, such as methicillin-resistant Staphylococcus aureus (MRSA) or antifungal-resistant Candida.

Necrotizing pneumonia (NP), also known as cavitary pneumonia or cavitatory necrosis, is a rare but severe complication of lung parenchymal infection. In necrotizing pneumonia, there is a substantial liquefaction following death of the lung tissue, which may lead to gangrene formation in the lung. In most cases patients with NP have fever, cough and bad breath, and those with more indolent infections have weight loss. Often patients clinically present with acute respiratory failure. The most common pathogens responsible for NP are Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae. Diagnosis is usually done by chest imaging, e.g. chest X-ray, CT scan. Among these CT scan is the most sensitive test which shows loss of lung architecture and multiple small thin walled cavities. Often cultures from bronchoalveolar lavage and blood may be done for identification of the causative organism(s). It is primarily managed by supportive care along with appropriate antibiotics. However, if patient develops severe complications like sepsis or fails to medical therapy, surgical resection is a reasonable option for saving life.

An occupational infectious disease is an infectious disease that is contracted at the workplace. Biological hazards (biohazards) include infectious microorganisms such as viruses, bacteria and toxins produced by those organisms such as anthrax.

MRSA ST398 is a specific strain of Methicillin-resistant Staphylococcus aureus (MRSA). Staphylococcus aureus is a gram-positive, spherical bacterium that can cause a range of infections in humans and animals. And Methicillin-resistant Staphylococcus aureus (MRSA) is a bacterium that is resistant to many antibiotics. The abbreviation "ST" in MRSA ST398 refers to the sequence type of the bacterium. MRSA ST398 is a clonal complex 398 (CC398). This means that the strain had emerged in a human clinic, without any obvious or understandable causes. MRSA ST398, a specific strain of MRSA, is commonly found in livestock, and can cause infections in humans who come into contact with infected animals.

References

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  2. ↑ "Emerging Infectious Diseases - NIOSH Workplace Safety and Health Topic". www.cdc.gov. Centers for Disease Control and Prevention. 17 October 2018. Archived from the original on 18 April 2020.
  3. ↑ A brief guide to emerging infectious diseases and zoonoses. WHO Regional Office for South-East Asia. 2014. hdl:10665/204722. ISBN   9789290224587.
  4. 1 2 3 Woolhouse ME, Gowtage-Sequeria S (2005). "Host Range and Emerging and Reemerging Pathogens". Emerging Infectious Diseases. 11 (12): 1842–7. doi:10.3201/eid1112.050997. PMC   3367654 . PMID   16485468.
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Further reading

  • Nathan Wolfe (2012). The Viral Storm: The Dawn of a New Pandemic Age. St. Martin's Griffin. ISBN   978-1250012210.
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