Infectieziekten anno 2015 Prof. Eric C.M. van Gorp

Internist-Infectioloog ErasmusMC

Multidrug-resistant tuberculose

Cryptosporidiosis

Vancomycin-resistant Staphylococcus aureus

Cyclosporiasis

H5N1 avian influenza

E coli 0557:H7 E coli 0557:H7

Hantavirus puimonary syndrome

Dengue hemorrhagic

fever

Lyme disease

West Nile virus

Hepatitis C

v-CJD

Lassa fever

Cholera Drug-resistant malaria Marburg virus

Plague

HIV

Rift Valey fever

Human monkeypox

Nipah virus

Vancomycin-resistant Staphylococcus aureus

Ebola hemorrhagic

fever

Diphtheria

Typhoid fever

Netherlands

3

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South-Africa

Caribbean

Indonesia

Brasil

China

Suriname

St. Elisabeth Hospital Curacao

Klein Venijn!

Voorkomen = preventie Vaccineren Behandelen

Kennis als antivirus

Ontbreken van kennis = angst

Epidemie = toename van het aantal [infectie]ziektegevallen in een gebied/land

Pandemie = verspreiding van een infectieziekte over landsgrenzen

Emerging infectie = infectieziekte met de potentie zich snel te verspreiden

Transmission risks

•  Foodborne infections Norovirus

•  Waterborne infection Cholera

•  Mosquito borne infections Dengue/ YF/ JEV/ WNV/ Malaria

•  Rodent borne infections Hanta virus, Leptospirosis

•  Blood borne infections Hepatitis (B & C)/ HIV/Ebola

•  Airborne infections Influenza /Mers-Co

•  SOA HIV, hepatitis, …

Living circumstances

Public Health Threats Awareness

Action Preparedness

Prevention/Treatment

Emergency

Management

Public Health Threats

Transmission risks

•  Treatment

• Vaccination

Changing Epidemiology

Multidrug-resistant tuberculose

Cryptosporidiosis

Vancomycin-resistant Staphylococcus aureus

Cyclosporiasis

H5N1 avian influenza

E coli 0557:H7 E coli 0557:H7

Hantavirus puimonary syndrome

Dengue hemorrhagic

fever

Lyme disease

West Nile virus

Hepatitis C

v-CJD

Lassa fever

Cholera Drug-resistant malaria Marburg virus

Plague

HIV

Rift Valey fever

Human monkeypox

Nipah virus

Vancomycin-resistant Staphylococcus aureus

Ebola hemorrhagic

fever

Diphtheria

Typhoid fever

Demography: rapidly Increasing Human Population

1 billion people until 1800 6.1 Billion people in 2000

~9.4 to 11.2 Billion in 2050

Source: United Nations, World Population Prospects, The 1998 Revision; and estimates by the Population Reference Bureau.

Mobility

Climate changes!

Recent outbreaks •  Chikungunya in the Caribbean

•  Ebola Central/West Africa

•  MERS CoV Middle East

•  Dengue and Chikungunya in Europe

•  Rabies

•  West Nile in Europe

•  Yellow fever in SE Asia

•  Hanta virus in Surinam and in the Netherlands

•  Hepatitis E

2013 Uitbraak Dengue virus

2013 Uitbraak West Nile virus

2007 Italië

Uitbraak Chikungunya

2007 Uitbraak Chikungunya

Zoonotic infections

60% of all known infections and

75% of all emerging pathogens

Developing  disease  is  the  result  of  a  complex    

interac6on  between:  

 

•  Immune enhancement

•  plasma leakage/ hemorrhagic tendency/ disease severity

•  host factors

•  virus/ virulence

•  vector

•  environment/ climate

•  infection pressure/ immunity of the population

Dengue

Countries/Areas at risk of Dengue transmission

Hawaii

Easter Isands

Galapagos Islands Sudan

Madagascar-La Reunion

Nepal Bhutan

Hongkong SAR Macao SAR

Geographic extension of dengue Risk of dengue transmission

Jan. isoth. 10. C

Jul. isoth. 10. C

Rabies

The annual number of deaths worldwide

is estimated to be between 50,000 and 60,000

Chikungunya virus

CHIKV distribution 2010 2014

MERS-CoV

MERS-Cov pandemic threat?

‘Mers coronavirus doesn’t have pandemic potential yet, but like Hajj, other factors could change the disease distribution’

Hanta virus

Ebola virus

The spread of EVD

Ebola outbreak figures

Multidrug-resistant tuberculose

Cryptosporidiosis

Vancomycin-resistant Staphylococcus aureus

Cyclosporiasis

H5N1 avian influenza

E coli 0557:H7 E coli 0557:H7

Hantavirus puimonary syndrome

Dengue hemorrhagic

fever

Lyme disease

West Nile virus

Hepatitis C

v-CJD

Lassa fever

Cholera Drug-resistant malaria Marburg virus

Plague

HIV

Rift Valey fever

Human monkeypox

Nipah virus

Vancomycin-resistant Staphylococcus aureus

Ebola hemorrhagic

fever

Diphtheria

Typhoid fever

Infectieziekten anno 2015