6.Global Health & Infectious Disease Outbreak

VetPubHealth Journal ISSUE 17 IVSA Standing Committe on One Health April 2020 Global health & Infectious Disease Outbreak Anish Balchhaudi Introduction Global health is the health of the population in the global context. Koplan et al. define global health as: ‘an area for study, research, and practice that places a priority on improving health and achieving health equity for all people worldwide’. And there are many other definitions of global health and all together it is the health of all the populations not only human being but also health of the animals and environment too. All three health viz. human health, animal health and community or environmental health must be studied together so as to create a healthy relation between those essential components of the ecosystem. Infectious diseases are disorders caused by organisms such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They’re normally harmless or even helpful. But under certain conditions, some organisms may cause disease. Some infectious diseases can be passed from person to person. Some are transmitted by insects or other animals to humans . And human get others by consuming contaminated food or water or being exposed to organisms in the environment. Those diseases which transmit one individual to other individuals are more dangerous and they affect global health; HIV, MERS, SARS, Hepatitis etc are examples of those infectious disease. What is an outbreak, epidemic and pandemic? Outbreak is a sudden increase in occurrence of a disease in a particular time and place. It may affect a small or a large group of population. In another language an outbreak is a spike in the no. of cases of a disease. For example outbreak of COVID-19 was in Wuhan, China. When disease transmitted continuously from one individual to others it become epidemic after its outbreak in 2 or more cities or neighbouring nations. Epidemic is ongoing transmission of a disease, with no clear endpoint. This is why we might hear ‘obesity epidemic’ or ‘opioid epidemics’. As an example let’s take the same example of COVID-19, it was epidemic in china when it was spread in other some cities of China. When the disease spread exponentially and crosses the intercontinental barrier then it becomes pandemic or global pandemic and as example COVID-19 is the global pandemic as it has been spread all over the world. Some infectious disease that became epidemic and pandemic (source:WHO 2020) : • Chikungunya • Cholera • Crimean-Congo haemorrhagic fever • Ebola virus disease • Hendra virus infection • Influenza • Lassa fever • Marburg virus disease • Meningitis • MERS-CoV • Monkeypox • Nipah virus infection • Novel coronavirus (2019-nCoV) • Plague • Rift Valley fever • SARS • Smallpox • Tularaemia • Yellow fever • Zika virus disease 19

VetPubHealth Journal ISSUE 17 IVSA Standing Committe on One Health April 2020 Threat of infectious diseases on global health There are so many microorganism causing infectious diseases having resistant strain due to our uncontrolled and over use of antibiotics over the century. In normal population of microorganisms or bacteria they have 99% non resistant and 1% of resistant strain. But over use of antibiotic leads to the increment of resistant strain in the population as a result of selection pressure. Because of selection pressure there is more resistant strain of the microorganisms which is main threat to the global health. Tuberculosis, cholera, chicken pox etc have developd resistance strain which will may become the threat to global health soon. As in present scenario of COVID-19, a virus from corona virus family; corona virus is not new type of virus as more than 9 strains of corona virus are present in the world, but due to antigenic shift this corona virus became more stronger and new to the population as novel corona virus or COVID-19. Antigenic shift can be the result of a direct jump from an unknown animal strain to humans or a reassorment of two or more influenza virus within the same cell. For example genetic analysis of the COVID-19 virus shows that it is very similar to a coronavirus in bats but the receptor binding looks like the receptor for SARS, so antigenic shift in this novel corona virus is result of both jump of unknown strain from bat and reassortment with SARS within the human cell. Recently in China outbreak of a virus named hantavirus has been found and it is considered to be drifted from mouse or rat. Not only these viruses but also other infectious microorganisms are in the process of becoming more resistant to antibiotics and new to the human population which is main threat to the global health. This suggests that overuse of antibiotics, incomplete treatment or direct or indirect contact with animals are the main reasons to increase the threat of infectious disease to global health. How to decrease the threat of infectious disease? Threat of infectious dis- ease can be minimized or decreased by controlling the spread of infectious dis- eases and by proper and limited use of antibiotics so as to protect global health. The spread of infectious discan be con- trolled by : a. Building ethical principles into infec- tious disease legislation. b. Preventing the transmission of infec- tious disease. c. Compulsory treatment order. d. Limiting contact with infectious indi- viduals. References: 1. Centers for Disease Control and Prevention Fre- quently Asked Questions About SARS. (2012) URL:https://www.cdc.gov/sars/about/faq.html 2. World Health Organization SARS (Severe Acute Respiratory Syndrome). (2019) URL:https://www.who.int/ith/diseases/sars/en/ 3. URL:http://www.who.int/csr/don/en 4. URL:http://www.who.int/csr/en 5. URL:http://www.cdc.gov/outbreaks/index.html 6. Wolfe ND, Dunavan CP, Diamond J. Origins of major human infectious diseases 7. Murphy FA. New, emerging, and reemerging in- fectious diseases 8. Perlman S, Netland J. Coronaviruses post-SARS: update on replication and pathogenesis. Nat. Rev. Microbiol. 2009 Jun;7(6):439-50. 9. International health regulation 2005, 2nd edition Geneva: world health organization; 2008: article 6, annex 2. 10. World health organization/health systems. 11. National centre for biotechnology information/ PubMed. 20