Infectious disease emergence and global change: thinking systemically in a shrinking world

Characterising Biosecurity Initiatives Globally to Support the Development of a Progressive Management Pathway for Terrestrial Animals: A Scoping Review

While biosecurity is of increasing importance globally, there is still limited evidence of the factors or elements that support the progressive and sustainable scaling up of biosecurity along the value chains from the local to the global level. To gain insight into the current body of literature on biosecurity, a mixed-methods approach was used based on a scoping literature review and an online survey with subject matter experts. Six databases were searched for published literature, and textual information from titles and abstracts of all included records (n = 266) were analysed through inductive content analysis to build biosecurity-relevant categories and identify strengths, weaknesses, opportunities, and threats (SWOT) of existing biosecurity systems or initiatives (such as projects or programs). Most records focused on initiatives in high-income countries, traditional livestock species (pigs, poultry, and large ruminants), and the production stage and had a disease-specific focus. No records described a comprehensive or global framework to progressively scale up biosecurity. Overall, the findings highlight the need for initiatives such as the FAO Progressive Management Pathway for Terrestrial Animal Biosecurity (FAO-PMP-TAB), which is a stepwise approach for strengthening biosecurity management along value chains to enhance the health, resilience, and sustainability of animal sectors. The findings highlight important elements and provide recommendations useful for developing approaches or a global framework to progressively improve biosecurity management.

Biting the hand that feeds: Anthropogenic drivers interactively make mosquitoes thrive

Anthropogenic stressors on the environment are increasing at unprecedented rates and include urbanization, nutrient pollution, water management, altered land use and climate change. Their effects on disease vectors are poorly understood. A series of full factorial experiments investigated how key human induced abiotic pressures, and interactions between these, affect population parameters of the cosmopolitan disease vector, Culex pipiens s.l. Selected pressures include eutrophication, salinity, mean temperature, and temperature fluctuation. Data were collected for each individual pressure and for potential interactions between eutrophication, salinization and temperature. All experiments assessed survival, time to pupation, time to emergence, sex-ratio and ovipositioning behavior. The results show that stressors affect vector survival, may speed up development and alter female to male ratio, although large differences between stressors exist to quite different extents. While positive effects of increasing levels of eutrophication on survival were consistent, negative effects of salinity on survival were only apparent at higher temperatures, thus indicating a strong interaction effect between salinization and temperature. Temperature had no independent effect on larval survival. Overall, increasing eutrophication and temperatures, and the fluctuations thereof, lowered development rate, time to pupation and time to emergence while increasing levels of salinity increased development time. Higher levels of eutrophication positively impacted egg-laying behavior; the reverse was found for salinity while no effects of temperature on egg-laying behavior were observed. Results suggest large and positive impacts of anthropogenically induced habitat alterations on mosquito population dynamics. Many of these effects are exacerbated by increasing temperatures and fluctuations therein. In a world where eutrophication and salinization are increasingly abundant, mosquitoes are likely important benefactors. Ultimately, this study illustrates the importance of including multiple and combined stressors in predictive models as well as in prevention and mitigation strategies, particularly because they resonate with possible, but yet underdeveloped action plans.

The impact of cold weather on respiratory morbidity at Emory Healthcare in Atlanta

BACKGROUND

Research on temperature and respiratory hospitalizations is lacking in the southeastern U.S. where cold weather is relatively rare. This retrospective study examined the association between cold waves and pneumonia and influenza (P&I) emergency department (ED) visits and hospitalizations in three metro-Atlanta hospitals.

METHODS

We used a case-crossover design, restricting data to the cooler seasons of 2009-2019, to determine whether cold waves influenced ED visits and hospitalizations. This analysis considered effects by race/ethnicity, age, sex, and severity of comorbidities. We used generalized additive models and distributed lag non-linear models to examine these relationships over a 21-day lag period.

RESULTS

The odds of a P&I ED visit approximately one week after a cold wave were increased by as much as 11%, and odds of an ED visit resulting in hospitalization increased by 8%. For ED visits on days with minimum temperatures >20 °C, there was an increase of 10-15% in relative risk (RR) for short lags (0-2 days), and a slight decrease in RR (0-5%) one week later. For minimum temperatures <0 °C, RR decreased at short lags (5-10%) before increasing (1-5%) one week later. Hospital admissions exhibited a similar, but muted, pattern.

CONCLUSION

Unusually cold weather influenced P&I ED visits and admissions in this population.

Emergence of epidemic diseases: zoonoses and other origins

Infectious diseases emerge via many routes and may need to overcome stepwise bottlenecks to burgeon into epidemics and pandemics. About 60% of human infections have animal origins, whereas 40% either co-evolved with humans or emerged from non-zoonotic environmental sources. Although the dynamic interaction between wildlife, domestic animals, and humans is important for the surveillance of zoonotic potential, exotic origins tend to be overemphasized since many zoonoses come from anthropophilic wild species (for example, rats and bats). We examine the equivocal evidence of whether the appearance of novel infections is accelerating and relate technological developments to the risk of novel disease outbreaks. Then we briefly compare selected epidemics, ancient and modern, from the Plague of Athens to COVID-19.

Soft X-ray Microscopy Techniques for Medical and Biological Imaging at TwinMic—Elettra

Progress in nanotechnology calls for material probing techniques of high sensitivity and resolution. Such techniques are also used for high-impact studies of nanoscale materials in medicine and biology. Soft X-ray microscopy has been successfully used for investigating complex biological processes occurring at micrometric and sub-micrometric length scales and is one of the most powerful tools in medicine and the life sciences. Here, we present the capabilities of the TwinMic soft X-ray microscopy end-station at the Elettra synchrotron in the context of medical and biological imaging, while we also describe novel uses and developments.

Lassa Fever: An Evolving Emergency in West Africa

Lassa fever remains endemic in parts of West Africa and continues to pose as a quiescent threat globally. We described the background on Lassa fever, factors contributing to its emergence and spread, preventive measures, and potential solutions. This review provides a holistic and comprehensive source for academicians, clinicians, researchers, policymakers, infectious disease epidemiologists, virologists, and other stakeholders.

Towards integrated surveillance-response systems for the prevention of future pandemics

Most human pathogens originate from non-human hosts and certain pathogens persist in animal reservoirs. The transmission of such pathogens to humans may lead to self-sustaining chains of transmission. These pathogens represent the highest risk for future pandemics. For their prevention, the transmission over the species barrier - although rare - should, by all means, be avoided. In the current COVID-19 pandemic, surprisingly though, most of the current research concentrates on the control by drugs and vaccines, while comparatively little scientific inquiry focuses on future prevention. Already in 2012, the World Bank recommended to engage in a systemic One Health approach for zoonoses control, considering integrated surveillance-response and control of human and animal diseases for primarily economic reasons. First examples, like integrated West Nile virus surveillance in mosquitos, wild birds, horses and humans in Italy show evidence of financial savings from a closer cooperation of human and animal health sectors. Provided a zoonotic origin can be ascertained for the COVID-19 pandemic, integrated wildlife, domestic animal and humans disease surveillance-response may contribute to prevent future outbreaks. In conclusion, the earlier a zoonotic pathogen can be detected in the environment, in wildlife or in domestic animals; and the better human, animal and environmental surveillance communicate with each other to prevent an outbreak, the lower are the cumulative costs.

Inference and prediction of malaria transmission dynamics using time series data

BACKGROUND

Disease surveillance systems are essential for effective disease intervention and control by monitoring disease prevalence as time series. To evaluate the severity of an epidemic, statistical methods are widely used to forecast the trend, seasonality, and the possible number of infections of a disease. However, most statistical methods are limited in revealing the underlying dynamics of disease transmission, which may be affected by various impact factors, such as environmental, meteorological, and physiological factors. In this study, we focus on investigating malaria transmission dynamics based on time series data.

METHODS

A data-driven nonlinear stochastic model is proposed to infer and predict the dynamics of malaria transmission based on the time series of prevalence data. Specifically, the dynamics of malaria transmission is modeled based on the notion of vectorial capacity (VCAP) and entomological inoculation rate (EIR). A particle Markov chain Monte Carlo (PMCMC) method is employed to estimate the model parameters. Accordingly, a one-step-ahead prediction method is proposed to project the number of future malaria infections. Finally, two case studies are carried out on the inference and prediction of Plasmodium vivax transmission in Tengchong and Longling, Yunnan province, China.

RESULTS

The results show that the trained data-driven stochastic model can well fit the historical time series of P. vivax prevalence data in both counties from 2007 to 2010. Moreover, with well-trained model parameters, the proposed one-step-ahead prediction method can achieve better performances than that of the seasonal autoregressive integrated moving average model with respect to predicting the number of future malaria infections.

CONCLUSIONS

By involving dynamically changing impact factors, the proposed data-driven model together with the PMCMC method can successfully (i) depict the dynamics of malaria transmission, and (ii) achieve accurate one-step-ahead prediction about malaria infections. Such a data-driven method has the potential to investigate malaria transmission dynamics in other malaria-endemic countries/regions.

Emerging coronavirus diseases and future perspectives

Coronavirus related infectious diseases seems to be biggest challenge of 21 century that have been constantly emerging and threating public health around the globe. Coronavirus disease-19 (COVID-19) that was detected as cause of respiratory tract infection in China by end the December 2019 impelled World Health Organization to declare in January 2020 public health emergency of international concern and consequently pandemic in March 2020. Over a past six months COVID-19 pandemic has wrapped up all continents except Antarctica. Scientists around the globe are finding way to tackle and reduce the ultimate risk and size of pandemic with lower morbidity and mortality rates. In this context, technologies such as sequencing, Crispr and artificial intelligence are playing vital role in diagnosis and management of infectious disease in contrast to conventional methods. Despite of this, there is a need to have rapid and early diagnostic tools and systems that recognize infectious disease in asymptotic condition. Here we provide an overview on the recent CoV outbreak and contribution of technologies with the emphasis on the future management for detection of such infectious diseases.

Planetary Epidemiology: Towards First Principles

PURPOSE OF REVIEW

To combine evolutionary principles of competition and co-operation with limits to growth models, generating six principles for a new sub-discipline, called "planetary epidemiology." Suggestions are made for how to quantify four principles.

RECENT FINDINGS

Climate change is one of a suite of threats increasingly being re-discovered by health workers as a major threat to civilization. Although "planetary health" is now in vogue, neither it nor its allied sub-disciplines have, as yet, had significant impact on epidemiology. Few if any theorists have sought to develop principles for Earth system human epidemiology, in its ecological, social, and technological milieu. The principles of planetary epidemiology described here can be used to stimulate applied, quantitative work to explore past, contemporary, and future population health, at scales from local to planetary, in order to promote enduring health. It is also proposed that global well-being will decline this century, without radical reform.

Climate Change, Health and Existential Risks to Civilization: A Comprehensive Review (1989⁻2013)

Background: Anthropogenic global warming, interacting with social and other environmental determinants, constitutes a profound health risk. This paper reports a comprehensive literature review for 1989⁻2013 (inclusive), the first 25 years in which this topic appeared in scientific journals. It explores the extent to which articles have identified potentially catastrophic, civilization-endangering health risks associated with climate change. Methods: PubMed and Google Scholar were primarily used to identify articles which were then ranked on a three-point scale. Each score reflected the extent to which papers discussed global systemic risk. Citations were also analyzed. Results: Of 2143 analyzed papers 1546 (72%) were scored as one. Their citations (165,133) were 82% of the total. The proportion of annual papers scored as three was initially high, as were their citations but declined to almost zero by 1996, before rising slightly from 2006. Conclusions: The enormous expansion of the literature appropriately reflects increased understanding of the importance of climate change to global health. However, recognition of the most severe, existential, health risks from climate change was generally low. Most papers instead focused on infectious diseases, direct heat effects and other disciplinary-bounded phenomena and consequences, even though scientific advances have long called for more inter-disciplinary collaboration.

Planetary Overload, Limits to Growth and Health

Since the use of atomic weapons in 1945 visionaries have warned that without major changes the survival of global civilization is in question. These concerns deepened in following decades, during the Cold War, with The Limits to Growth, the best-selling environmental book of the 1970s. Yet, since then, most concern has faded, fuelled by technological developments and a shift in dominant global ideology. Public health, with a few exceptions (one of which is the book Planetary Overload), has been slow to recognize this debate, even as evidence emerges that civilization may indeed be at risk, driven by an increasingly ominous complex of events. This article outlines the key relevant literature and concepts, attempting to bring emerging and future health consequences to the attention of health workers, including the idea of a "social vaccine," conveying sufficient anxiety to provoke action for environmental protection, but insufficient to induce paralysis.

Traditional uses of medicinal plants used by Indigenous communities for veterinary practices at Bajaur Agency, Pakistan

BACKGROUND

The pastoral lifestyle of Indigenous communities of Bajaur Agency is bringing them close to natural remedies for treating their domestic animals. Several studies have been conducted across the globe describing the importance of traditional knowledge in veterinary care. Therefore, this study was planned with the aim to record knowledge on ethnoveterinary practices from the remote areas and share sit with other communities through published literature.

METHODS

Data was gathered from community members through semi-structured interviews and analyzed through informant consensus factor (Fic) to evaluate the consent of current ethnoveterinary practices among the local people.

RESULTS

In total, 73 medicinal plants were recorded under the ethnoveterinary practices. Most widely used medicinal plants with maximum use reports (URs) were Visnaga daucoides Gaertn., Foeniculum vulgare Mill., Solanum virginianum L., Withania somnifera (L.) Dunal, Glycyrrhiza glabra L., and Curcuma longa L. New medicinal values were found with confidential level of citations for species including Heracleum candicans and Glycerhiza glabra. Family Apiaceae was the utmost family with high number (7 species) of medicinal plants. Maximum number of medicinal plants (32) was used for gastric problems. High Fic was recorded for dermatological (0.97) followed by reproductive (0.93) and gastrointestinal disorders (0.92). The main route of remedies administration was oral.

CONCLUSIONS

Current study revealed that the study area has sufficient knowledge on ethnoveterinary medicinal plants. This knowledge is in the custody of nomadic grazers, herders, and aged community members. Plants with new medicinal uses need to be validated phytochemically and pharmacologically for the development of new alternative drugs for veterinary purposes.

Traditional uses of medicinal plants used by Indigenous communities for veterinary practices at Bajaur Agency, Pakistan

BACKGROUND

The pastoral lifestyle of Indigenous communities of Bajaur Agency is bringing them close to natural remedies for treating their domestic animals. Several studies have been conducted across the globe describing the importance of traditional knowledge in veterinary care. Therefore, this study was planned with the aim to record knowledge on ethnoveterinary practices from the remote areas and share sit with other communities through published literature.

METHODS

Data was gathered from community members through semi-structured interviews and analyzed through informant consensus factor (Fic) to evaluate the consent of current ethnoveterinary practices among the local people.

RESULTS

In total, 73 medicinal plants were recorded under the ethnoveterinary practices. Most widely used medicinal plants with maximum use reports (URs) were Visnaga daucoides Gaertn., Foeniculum vulgare Mill., Solanum virginianum L., Withania somnifera (L.) Dunal, Glycyrrhiza glabra L., and Curcuma longa L. New medicinal values were found with confidential level of citations for species including Heracleum candicans and Glycerhiza glabra. Family Apiaceae was the utmost family with high number (7 species) of medicinal plants. Maximum number of medicinal plants (32) was used for gastric problems. High Fic was recorded for dermatological (0.97) followed by reproductive (0.93) and gastrointestinal disorders (0.92). The main route of remedies administration was oral.

CONCLUSIONS

Current study revealed that the study area has sufficient knowledge on ethnoveterinary medicinal plants. This knowledge is in the custody of nomadic grazers, herders, and aged community members. Plants with new medicinal uses need to be validated phytochemically and pharmacologically for the development of new alternative drugs for veterinary purposes.

Infectious Diseases of Poverty, the first five years

Although the focus in the area of health research may be shifting from infectious to non-communicable diseases, the infectious diseases of poverty remain a major burden of disease of global health concern. A global platform to communicate and share the research on these diseases is needed to facilitate the translation of knowledge into effective approaches and tools for their elimination. Based on the “One health, One world” mission, a new, open-access journal, Infectious Diseases of Poverty (IDP), was launched by BioMed Central in partnership with the National Institute of Parasitic Diseases (NIPD), Chinese Center for Disease Control and Prevention (China CDC) on October 25, 2012. Its aim is to identify and assess research and information gaps that hinder progress towards new interventions for a particular public health problem in the developing world. From the inaugural IDP issue of October 25, 2012, a total of 256 manuscripts have been published over the following five years. Apart from a small number of editorials, opinions, commentaries and letters to the editor, the predominant types of publications are research articles (69.5%) and scoping reviews (21.5%). A total of 1 081 contributing authors divided between 323 affiliations across 68 countries, territories and regions produced these 256 publications. The journal is indexed in major international biomedical databases, including Web of Science, PubMed, Scopus and Embase. In 2015, it was assigned its first impact factor (4.11), which is now 2.13. During the past five years, IDP has received manuscripts from 90 countries, territories and regions across six continents with an annual acceptance rate of all contributions maintained at less than 40%. Content analysis shows that neglected tropical diseases (NTDs), followed by the “Big Three” (HIV/AIDS, malaria and tuberculosis) and infectious diseases in general comprise 88% of all publications. In addition, a series of 10 thematic issues, covering 118 publications in all, was published as separate parts of the first five volumes. These publications were cited 975 times, which equals an average of 8.3 times per publication. The current challenge is to identify cutting-edge research topics and attract and to publish first-rate publications leading to increasing importance and impact of the journal in its field.

Naïve Human Antibody Libraries for Infectious Diseases

Many countries are facing an uphill battle in combating the spread of infectious diseases. The constant evolution of microorganisms magnifies the problem as it facilitates the re-emergence of old infectious diseases as well as promote the introduction of new and more deadly variants. Evidently, infectious diseases have contributed to an alarming rate of mortality worldwide making it a growing concern. Historically, antibodies have been used successfully to prevent and treat infectious diseases since the nineteenth century using antisera collected from immunized animals. The inherent ability of antibodies to trigger effector mechanisms aids the immune system to fight off pathogens that invades the host. Immune libraries have always been an important source of antibodies for infectious diseases due to the skewed repertoire generated post infection. Even so, the role and ability of naïve antibody libraries should not be underestimated. The naïve repertoire has its own unique advantages in generating antibodies against target antigens. This chapter will highlight the concept, advantages and application of human naïve libraries as a source to isolate antibodies against infectious disease target antigens.

Molecular detection of flaviviruses and alphaviruses in mosquitoes (Diptera: Culicidae) from coastal ecosystems in the Colombian Caribbean

Arboviruses belonging to the genera Flavivirus and Alphavirus were detected in mosquitoes in a rural area of San Bernardo del Viento (Córdoba, Colombia). A total of 22,180 mosquitoes were collected, sorted into 2,102 pools, and tested by generic/nested reverse transcription-polymerase chain reaction. Venezuelan equine encephalitis virus, dengue virus, West Nile virus, St. Louis encephalitis virus, yellow fever virus, and Culex flavivirus were detected and identified by sequencing. The detection of arboviral pathogens in this zone represents possible circulation and indicates a human health risk, demonstrating the importance of virological surveillance activities.

Sounding the Alarm: Health in the Anthropocene

There is growing scientific and public recognition that human actions, directly and indirectly, have profoundly changed the Earth system, in a still accelerating process, increasingly called the "Anthropocene". Planetary transformation, including of the atmosphere, climate, ecosystems and biodiversity, has enormous implications for human health, many of which are deeply disturbing, especially in low-income settings. A few health consequences of the Anthropocene have been partially recognized, including within environmental epidemiology, but their long-term consequences remain poorly understood and greatly under-rated. For example Syria could be a "sentinel" population, giving a glimpse to a much wider dystopian future. Health-Earth is a research network, co-founded in 2014, which seeks, with other groups, to catalyse a powerful curative response by the wider health community. This paper builds on a symposium presented by Health-Earth members at the 2015 conference of the International Society for Environmental Epidemiology. It reviews and synthesizes parts of the large literature relevant to the interaction between the changing Earth system and human health. It concludes that this topic should be prominent within future environmental epidemiology and public health. Created by our species, these challenges may be soluble, but solutions require far more understanding and resources than are currently being made available.

Epidemiological Features and Control Progress of Schistosomiasis in Waterway-Network Region in The People's Republic of China

Schistosomiasis was one of the most serious parasitic diseases in The People's Republic of China, and the endemic region was classified into three types according to the epidemiological characteristics and living conditions of the intermediate host. After more than 60years of efforts, schistosomiasis control programme has made great strides in waterway-network regions. We analyse the epidemic changes of schistosomiasis and its control progress through the schistosomiasis regions' documents and investigation data to evaluate the efficacy of the schistosomiasis control strategies in the waterway-network-type endemic region, which provides the basis for refinement of efforts, as well as summary of the Chinese schistosomiasis control experience in the waterway-network areas.

Mining geographic variations of Plasmodium vivax for active surveillance: a case study in China

BACKGROUND

Geographic variations of an infectious disease characterize the spatial differentiation of disease incidences caused by various impact factors, such as environmental, demographic, and socioeconomic factors. Some factors may directly determine the force of infection of the disease (namely, explicit factors), while many other factors may indirectly affect the number of disease incidences via certain unmeasurable processes (namely, implicit factors). In this study, the impact of heterogeneous factors on geographic variations of Plasmodium vivax incidences is systematically investigate in Tengchong, Yunnan province, China.

METHODS

A space-time model that resembles a P. vivax transmission model and a hidden time-dependent process, is presented by taking into consideration both explicit and implicit factors. Specifically, the transmission model is built upon relevant demographic, environmental, and biophysical factors to describe the local infections of P. vivax. While the hidden time-dependent process is assessed by several socioeconomic factors to account for the imported cases of P. vivax. To quantitatively assess the impact of heterogeneous factors on geographic variations of P. vivax infections, a Markov chain Monte Carlo (MCMC) simulation method is developed to estimate the model parameters by fitting the space-time model to the reported spatial-temporal disease incidences.

RESULTS

Since there is no ground-truth information available, the performance of the MCMC method is first evaluated against a synthetic dataset. The results show that the model parameters can be well estimated using the proposed MCMC method. Then, the proposed model is applied to investigate the geographic variations of P. vivax incidences among all 18 towns in Tengchong, Yunnan province, China. Based on the geographic variations, the 18 towns can be further classify into five groups with similar socioeconomic causality for P. vivax incidences.

CONCLUSIONS

Although this study focuses mainly on the transmission of P. vivax, the proposed space-time model is general and can readily be extended to investigate geographic variations of other diseases. Practically, such a computational model will offer new insights into active surveillance and strategic planning for disease surveillance and control.

China-Africa cooperation initiatives in malaria control and elimination

Malaria has affected human health globally with a significant burden of disease, and also has impeded social and economic development in the areas where it is present. In Africa, many countries have faced serious challenges in controlling malaria, in part due to major limitations in public health systems and primary health care infrastructure. Although China is a developing country, a set of control strategies and measures in different local settings have been implemented successfully by the National Malaria Control Programme over the last 60 years, with a low cost of investment. It is expected that Chinese experience may benefit malaria control in Africa. This review will address the importance and possibility of China–Africa collaboration in control of malaria in targeted African countries, as well as how to proceed toward the goal of elimination where this is technically feasible.

Interplay between environment, agriculture and infectious diseases of poverty: case studies in China

Changes in the natural environment and agricultural systems induced by economic and industrial development, including population dynamics (growth, urbanization, migration), are major causes resulting in the persistence, emergence and re-emergence of infectious diseases in developing countries. In the face of rapid demographic, economic and social transformations, the People's Republic of China (P.R. China) is undergoing unprecedented environmental and agricultural change. We review emerging and re-emerging diseases such as schistosomiasis, dengue, avian influenza, angiostrongyliasis and soil-transmitted helminthiasis that have occurred in P.R. China due to environmental and agricultural change. This commentary highlights the research priorities and the response strategies, namely mitigation and adaptation, undertaken to eliminate the resurgence of those infectious diseases.

Integrated control programmes for schistosomiasis and other helminth infections in P.R. China

The prevalence of human schistosomiasis and soil-transmitted helminthiasis (STH) has decreased significantly in the People's Republic of China (P.R. China), particularly after 2005 when the national control programmes were reinforced by forming of integrated control strategies. Furthermore, social-economic development also contributed to the decrease of schistosome and soil-transmitted helminth infections. The prevalence of the zoonotic helminthiasis, including clonorchiasis and echinococcosis, on the other hand, is either underestimated or has in fact increased due to changes in social and environmental factors. In comparison with the control strategies in force and their effects on those four kinds of helminthiasis, the challenges and control priorities for the potential transfer from control to elimination of each disease is reviewed, to provide evidence for policy-makers to act upon.

Preparedness for emerging infectious diseases: pathways from anticipation to action

Emerging and re-emerging infectious disease (EID) events can have devastating human, animal and environmental health impacts. The emergence of EIDs has been associated with interconnected economic, social and environmental changes. Understanding these changes is crucial for EID preparedness and subsequent prevention and control of EID events. The aim of this review is to describe tools currently available for identification, prioritization and investigation of EIDs impacting human and animal health, and how these might be integrated into a systematic approach for directing EID preparedness. Environmental scanning, foresight programmes, horizon scanning and surveillance are used to collect and assess information for rapidly responding to EIDs and to anticipate drivers of emergence for mitigating future EID impacts. Prioritization of EIDs - using transparent and repeatable methods - based on disease impacts and the importance of those impacts to decision-makers can then be used for more efficient resource allocation for prevention and control. Risk assessment and simulation modelling methods assess the likelihood of EIDs occurring, define impact and identify mitigation strategies. Each of these tools has a role to play individually; however, we propose integration of these tools into a framework that enhances the development of tactical and strategic plans for emerging risk preparedness.

Multinational corporations and infectious disease: Embracing human rights management techniques

Background

Global health institutions have called for governments, international organisations and health practitioners to employ a human rights-based approach to infectious diseases. The motivation for a human rights approach is clear: poverty and inequality create conditions for infectious diseases to thrive, and the diseases, in turn, interact with social-ecological systems to promulgate poverty, inequity and indignity. Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases, as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights. These social determinants and economic outcomes associated with infectious diseases should interest multinational companies, partly because they have bearing on corporate productivity and, increasingly, because new global norms impose on companies a responsibility to respect human rights, including the right to health.

Methods

We reviewed historical and recent developments at the interface of infectious diseases, human rights and multinational corporations. Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases, which embraced rights-based disease control strategies.

Results

Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations. Indeed, in an increasingly globalised and interconnected world, multinational corporations have an interest, and an important role to play, in advancing rights-based control strategies for infectious diseases.

Conclusions

There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies. Guidance offered by the United Nations in 2011 that is widely embraced by companies, governments and civil society provides a roadmap for engaging business enterprises in rights-based disease management strategies to mitigate disease transmission rates and improve human welfare outcomes.

Electronic supplementary material

The online version of this article (doi:10.1186/2049-9957-3-39) contains supplementary material, which is available to authorized users.

Human population reduction is not a quick fix for environmental problems

The inexorable demographic momentum of the global human population is rapidly eroding Earth's life-support system. There are consequently more frequent calls to address environmental problems by advocating further reductions in human fertility. To examine how quickly this could lead to a smaller human population, we used scenario-based matrix modeling to project the global population to the year 2100. Assuming a continuation of current trends in mortality reduction, even a rapid transition to a worldwide one-child policy leads to a population similar to today's by 2100. Even a catastrophic mass mortality event of 2 billion deaths over a hypothetical 5-y window in the mid-21(st) century would still yield around 8.5 billion people by 2100. In the absence of catastrophe or large fertility reductions (to fewer than two children per female worldwide), the greatest threats to ecosystems--as measured by regional projections within the 35 global Biodiversity Hotspots--indicate that Africa and South Asia will experience the greatest human pressures on future ecosystems. Humanity's large demographic momentum means that there are no easy policy levers to change the size of the human population substantially over coming decades, short of extreme and rapid reductions in female fertility; it will take centuries, and the long-term target remains unclear. However, some reduction could be achieved by midcentury and lead to hundreds of millions fewer people to feed. More immediate results for sustainability would emerge from policies and technologies that reverse rising consumption of natural resources.

The interconnected and cross-border nature of risks posed by infectious diseases

Infectious diseases can constitute public health emergencies of international concern when a pathogen arises, acquires new characteristics, or is deliberately released, leading to the potential for loss of human lives as well as societal disruption. A wide range of risk drivers are now known to lead to and/or exacerbate the emergence and spread of infectious disease, including global trade and travel, the overuse of antibiotics, intensive agriculture, climate change, high population densities, and inadequate infrastructures, such as water treatment facilities. Where multiple risk drivers interact, the potential impact of a disease outbreak is amplified. The varying temporal and geographic frequency with which infectious disease events occur adds yet another layer of complexity to the issue. Mitigating the emergence and spread of infectious disease necessitates mapping and prioritising the interdependencies between public health and other sectors. Conversely, during an international public health emergency, significant disruption occurs not only to healthcare systems but also to a potentially wide range of sectors, including trade, tourism, energy, civil protection, transport, agriculture, and so on. At the same time, dealing with a disease outbreak may require a range of critical sectors for support. There is a need to move beyond narrow models of risk to better account for the interdependencies between health and other sectors so as to be able to better mitigate and respond to the risks posed by emerging infectious disease.

Emerging and reemerging neglected tropical diseases: a review of key characteristics, risk factors, and the policy and innovation environment

In global health, critical challenges have arisen from infectious diseases, including the emergence and reemergence of old and new infectious diseases. Emergence and reemergence are accelerated by rapid human development, including numerous changes in demographics, populations, and the environment. This has also led to zoonoses in the changing human-animal ecosystem, which are impacted by a growing globalized society where pathogens do not recognize geopolitical borders. Within this context, neglected tropical infectious diseases have historically lacked adequate attention in international public health efforts, leading to insufficient prevention and treatment options. This subset of 17 infectious tropical diseases disproportionately impacts the world's poorest, represents a significant and underappreciated global disease burden, and is a major barrier to development efforts to alleviate poverty and improve human health. Neglected tropical diseases that are also categorized as emerging or reemerging infectious diseases are an even more serious threat and have not been adequately examined or discussed in terms of their unique risk characteristics. This review sets out to identify emerging and reemerging neglected tropical diseases and explore the policy and innovation environment that could hamper or enable control efforts. Through this examination, we hope to raise awareness and guide potential approaches to addressing this global health concern.

A non-stationary relationship between global climate phenomena and human plague incidence in Madagascar

BACKGROUND

Plague, a zoonosis caused by Yersinia pestis, is found in Asia and the Americas, but predominantly in Africa, with the island of Madagascar reporting almost one third of human cases worldwide. Plague's occurrence is affected by local climate factors which in turn are influenced by large-scale climate phenomena such as the El Niño Southern Oscillation (ENSO). The effects of ENSO on regional climate are often enhanced or reduced by a second large-scale climate phenomenon, the Indian Ocean Dipole (IOD). It is known that ENSO and the IOD interact as drivers of disease. Yet the impacts of these phenomena in driving plague dynamics via their effect on regional climate, and specifically contributing to the foci of transmission on Madagascar, are unknown. Here we present the first analysis of the effects of ENSO and IOD on plague in Madagascar.

METHODOLOGY/PRINCIPAL FINDINGS

We use a forty-eight year monthly time-series of reported human plague cases from 1960 to 2008. Using wavelet analysis, we show that over the last fifty years there have been complex non-stationary associations between ENSO/IOD and the dynamics of plague in Madagascar. We demonstrate that ENSO and IOD influence temperature in Madagascar and that temperature and plague cycles are associated. The effects on plague appear to be mediated more by temperature, but precipitation also undoubtedly influences plague in Madagascar. Our results confirm a relationship between plague anomalies and an increase in the intensity of ENSO events and precipitation.

CONCLUSIONS/SIGNIFICANCE

This work widens the understanding of how climate factors acting over different temporal scales can combine to drive local disease dynamics. Given the association of increasing ENSO strength and plague anomalies in Madagascar it may in future be possible to forecast plague outbreaks in Madagascar. The study gives insight into the complex and changing relationship between climate factors and plague in Madagascar.

Ribosomal RNA depletion or exclusion has negligible effect on the detection of viruses in a pan viral microarray

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Ribosomal RNA depletion protocols were assessed to improve microarray performance.

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The outcome was compared with random amplification protocol.

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Ribosomal RNA depletion had little effect on the microarray performance.

Pan viral DNA microarrays, which can detect known, novel and multiple viral infections, are major laboratory assets contributing to the control of infectious diseases. The large quantity of ribosomal RNA (rRNA) found in tissue samples is thought to be a major factor contributing to the comparatively lower sensitivity of detecting RNA viruses, as a sequence-independent PCR is used to amplify unknown samples for microarray analysis. This study aimed to determine whether depletion or exclusion of rRNA can improve microarray detection and simplify its analysis. Therefore, two different rRNA depletion and exclusion protocols, RiboMinus™ technology and non-rRNA binding hexanucleotides, were applied to the microarray sample processing and the outcome was compared with those of the sequence-independent amplification protocol. This study concludes that the two procedures, described to deplete or exclude rRNA, have negligible effect on the microarrays detection and analysis and might only in combination with further techniques result in a significant enhancement of sensitivity. Currently, existing protocols of random amplification and background adjustment are pertinent for the purpose of sample processing for microarray analysis.

Combating infectious diseases of poverty: a year on

The Infectious Diseases of Poverty journal, launched a year ago, is a platform to engage outside the traditional disciplinary boundaries, and disseminate high quality science towards the improvement of health. This paper reviews the milestone achievements during its first year of operation. The journal has filled an important niche, addressing some of the main priorities in the Global Report for Research on Infectious Diseases of Poverty. Highlights include the publication of three thematic issues on health systems, surveillance and response systems, as well as co-infection and syndemics. The thematic issues have foregrounded the importance and innovation that can be achieved through transdisciplinary research. The journal has been indexed by PubMed since April 2013, with the publication of a total of 38 articles. Finally, the journal is delivering to wider range readers both in developing and developed countries with sustained efforts with a focus on relevant and strategic information towards elimination of infectious diseases of poverty.

Field transmission intensity of Schistosoma japonicum measured by basic reproduction ratio from modified Barbour's model

BACKGROUND

Schistosomiasis japonica, caused by infection with Schistosoma japonicum, is still recognized as a major public health problem in the Peoples' Republic of China. Mathematical modelling of schistosomiasis transmission has been undertaken in order to assess and project the effects of various control strategies for elimination of the disease. Seasonal fluctuations in transmission may have the potential to impact on the population dynamics of schistosomiasis, yet no model of S. japonicum has considered such effects. In this paper, we characterize the transmission dynamics of S. japonicum using a modified version of Barbour's model to account for seasonal variation (SV), and investigate the effectiveness of the control strategy adopted in Liaonan village of Xingzi county, Jiangxi Province.

METHODS

We use mathematical tools for stability analysis of periodic systems and derive expressions for the basic reproduction ratio of S. japonicum in humans; we parameterise such expressions with surveillance data to investigate the conditions for persistence or elimination of the disease in the study village. We perform numerical simulations and parametric sensitivity analysis to understand local transmission conditions and compare values of the basic reproductive ratio with and without seasonal fluctuations.

RESULTS

The explicit formula of the basic reproduction ratio for the SV-modified Barbour's model is derived. Results show that the value of the basic reproduction ratio, R0, of Liaonan village, Xingzi county is located between 1.064 and 1.066 (very close to 1), for schistosomiasis transmission during 2006 to 2010, after intensification of control efforts.

CONCLUSIONS

Our modified version of the Barbour model to account for seasonal fluctuations in transmission has the potential to provide better estimations of infection risk than previous models. Ignoring seasonality tends to underestimate R0 values albeit only marginally. In the absence of simultaneous R0 estimations for villages not under control interventions (such villages do not currently exist in China), it is difficult to assess whether control strategies have had a substantial impact on levels of transmission, as the parasite population would still be able to maintain itself at an endemic level, highlighting the difficulties faced by elimination efforts.

Inferring the potential risks of H7N9 infection by spatiotemporally characterizing bird migration and poultry distribution in eastern China

Background

In view of the rapid geographic spread and the increasing number of confirmed cases of novel influenza A(H7N9) virus infections in eastern China, we developed a diffusion model to spatiotemporally characterize the impacts of bird migration and poultry distribution on the geographic spread of H7N9 infection.

Methods

Three types of infection risks were estimated for 12 weeks, from February 4 to April 28, 2013, including (i) the risk caused by bird migration, (ii) the risk caused by poultry distribution, and (iii) the integrated risk caused by both bird migration and poultry distribution. To achieve this, we first developed a method for estimating the likelihood of bird migration based on available environmental and meteorological data. Then, we adopted a computational mobility model to estimate poultry distribution based on annual poultry production and consumption of each province/municipality. Finally, the spatiotemporal risk maps were created based on the integrated impacts of both bird migration and poultry distribution.

Results

In the study of risk estimation caused by bird migration, the likelihood matrix was estimated based on the 7-day temperature, from February 4 to April 28, 2013. It was found the estimated migrant birds mainly appear in the southeastern provinces of Zhejiang, Shanghai and Jiangsu during Weeks 1 to 4, and Week 6, followed by appearing in central eastern provinces of Shandong, Hebei, Beijing, and Tianjin during Weeks 7 to 9, and finally in northeastern provinces of Liaoning, Jilin, and Heilongjiang during Weeks 10 to 12.

In the study of risk caused by poultry distribution, poultry distribution matrix was created to show the probability of poultry distribution. In spite of the fact that the majority of the initial infections were reported in Shanghai and Jiangsu, the relative risk of H7N9 infection estimated based on the poultry distribution model predicted that Jiangsu may have a slightly higher likelihood of H7N9 infection than those in Zhejiang and Shanghai, if we only take the probability of poultry distribution into consideration.

In the study of integrated risk caused by both bird migration and poultry distribution, the higher risk in southeastern provinces occurred during the first 8 weeks, and that in central eastern provinces appeared during Weeks 8 to 12, and that in northeastern provinces since Week 12. Therefore, it is necessary to regulate the poultry markets as long as the poultry-to-poultry transmission is not so well understood.

Conclusion

With reference to the reported infection cases, the demonstrated risk mapping results will provide guidance in active surveillance and control of human H7N9 infections by taking intensive intervention in poultry markets.

Health systems perspectives - infectious diseases of poverty

The right to health as a fundamental human right is enshrined in the World Health Organization's charter and has been reaffirmed in international agreements spanning decades. This new journal reminds us of the essential characteristic of poverty as a violent abuse of human rights. The context of poverty - its social, political and economic dimensions - remain in the reader's mind as evidence is provided on technical solutions to managing the infectious diseases that afflict poor populations world-wide. Applying a health systems framework to a discussion on infectious diseases of poverty emerges from the papers in this journal's first edition. Many of the articles discuss treatments, indicating the importance of pharmaceuticals for neglected diseases. Delivery strategies to reach impoverished populations also figure within this first round of papers. Innovative programs that provide diagnostics and treatment for infectious diseases to hard-to-reach rural and urban communities are needed clearly needed, and some good examples are discussed here. Future editions will explore other health system components, broadening the evidence base to increase understanding of effective and sustainable interventions to reduce the burden of infectious disease among the poor. The editors are to be congratulated on the release of this inaugural issue of the journal Infectious Diseases of Poverty. We look forward to reading subsequent editions.