Emerging Infectious Diseases

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1 Emerging Infectious Diseases René Gottschalk Competence Center Highly Infectious Diseases State of Hesse Quelle: AP

2 4.500 years Emerging Infectious Diseases Pathogens that had never before infected humans Ebola-Virus HIV Influenza A Virus Subtypes SARS-CoV Pathogens spreading into new geographical areas West Nile-Virus Newly discovered pathogens causing previously known diseases Kaposi Sarcoma associated Herpes-Virus Pathogens with increasing significance due to increasing numbers of immunocompromised patients Cytomegaly-Virus Pathogens causing increasing numbers of infections Dengue-Virus Re-emerging pathogens Yersinia pestis (Plague) Smallpox-Virus???

3 Worldwide Distribution of Viral-Hemorrhagic Fever Emerging Infectious Diseases Hanta Hanta Crimean-CongoCrimean Congo-Fever Crimean-Congo-Fever Dengue Hanta Crimean-CongoCrimean Congo-Fever Crimean-Congo-Fever Yellow-Fever Yellow Yellow-Fever Junin-Fever Junin Junin-Fever Machupo-Fever Machupo Machupo-Fever Sabia-Fever Sabia Sabia-Fever Hanta Dengue Rift -Fever Valley Rift ValleyValley-Fever Lassa-Fever Lassa Lassa-Fever Ebola-Fever Ebola Ebola-Fever Yellow-Fever Yellow Yellow-Fever Crimean-CongoCrimean Congo-Fever Crimean-Congo-Fever Dengue Quelle: The Journal of Clinical Investigation Volume 113 Number 6 March 2004 Imported Cases of VHF in Europe Emerging Agent Year Emerging Agent 1969 LassaLassa-Virus 1991 GuanaritoGuanarito-Virus Cryptosporidium parvum 1992 Vibrio cholera O139 Legionella pneumonia 1993 Sin NombreNombre-Virus EbolaEbola-Virus Campylobacter jejuni Human T-LymphotropicLymphotropic-Virus Escherichia coli O157:H Borrelia burgdorferi SabiaSabia-Virus HendraHendra-Virus Kaposi Sarcoma Virus (HHV8) CreutzfeldCreutzfeld-JakobJakob-Disease Australien Bat LyssaLyssa-Virus HTLV2HTLV2-Virus 1997 Avian Flu (H5N1)(H5N1)-Virus Human ImmundeficiencyImmundeficiency-Virus 1999 NipahNipah-Virus Hepatitis EE-Virus 2002 GarissaGarissa-Virus Human HerpesHerpes-Virus SARSSARS-CoV Hepatitis CC-Virus 2XXX /94 CH Côte d'ivoire Ebola (EBO-CI) (EBO(EBO-CI) 04/96 CH Brazil Yellowfever m, 53 f, 34 09/97 D Ghana Lassafever m, 37 12/97 GB Zimbabwe CrimeanCrimean-Congo HF Crimean-Congo 08/99 D Côte d'ivoire Yellowfever m, 40 01/00 D Ghana, Burkina Faso, Côte d'ivoire Lassafever f, 23 03/00 GB Sierra Leone Lassafever m, 50 03/00 D Nigeria Lassafever m, 57 06/00 NL Sierra Leone Lassafever m, 48 12/00 D Kenya HSVHSV-1 HSV-1 m, 47 07/01 - Kosovo CrimeanCrimean-Congo HF Crimean-Congo 69, 6 07/03 RUS Russia CrimeanCrimean-Congo HF Crimean-Congo 14, 2 04/05 I Angola Marburg Fever (susp.) f, 78 f, Year

4 Lassa

5

6 Marburg-/Ebolavirus Marburg-Virus 1967 Ebola Ebola

7 Case Fatality Rates Ebola-/Marburg-Epidemics CFR (%) Zaire 1976 Sudan 1976 Sudan 1979 Zaire 1995 Gabun 1996 Uganda 2001 DRC 2002 DRC 2003 Angola 2005 Source: : WHO West Nile Virus (WNV)

8 West Nile Virus in the United States, 2004 West Nile Virus in the United States, 2002 West Nile Virus in the United States, WNV: Transmission Quelle: The Journal of Clinical Investigation Volume 113 Number 8 April 2004

9 1999 Aedes vexans Culex pipiens Culex restuans Aedes vexans Culex pipiens Cx restuans 1999 Ae vexans Anopheles punctipennis Cx pipiens Culiseta melanura Ochlerotatus cantator Oc japonicus Oc triseriatus Psorophora ferox 2000 Ae albopictus Ae cinereus Ae vexans An punctipennis An quadrimaculatus Coquillettidia perturbans Cx nigripalpus Cx pipiens Cx quinquefasciatus Cx restuans Cx salinarius Cs melanura Oc canadensis Oc cantator Oc japonicus Oc sollicitans Oc trivattatus Orthopodomyia signifera Ps columbiae Ps ferox Uranotaenia sapphirina 2001 Ae aegypti Ae albopictus Ae vexans An atropos An barberi An crucians/bradleyi An punctipennis An quadrimaculatus An walkeri Cq perturbans Cx erraticus Cx nigripalpus Cx pipiens Cx quinquefasciatus Cx restuans Cx salinarius Cx tarsalis Cx territans Cs inornata Cs melanura Deinocerites cancer Oc atropalpus Oc atlanticus/tormentor tormentor Oc canadensis Oc cantator Oc japonicus Oc sollicitans Oc taeniorhynchus Oc triseriatus Oc trivattatus Or signifera Ps ciliata Ps columbiae Ps ferox Ur sapphirina 2002 Ae aegypti Ae albopictus Ae cinereus Ae vexans An atropos An barberi An crucians/bradleyi An punctipennis An quadrimaculatus An walkeri Cq perturbans Cx erraticus Cx nigripalpus Cx pipiens Cx quinquefasciatus Cx restuans Cx salinarius Cx tarsalis Cx territans Cs inornata Cs melanura De cancer Oc atropalpus Oc atlanticus/tormentor tormentor Oc canadensis Oc cantator Oc dorsalis Oc infirmatus Oc fitchii Oc japonicus Oc provocans Oc sollicitans Oc sticticus Oc stimulans Oc taeniorhynchus Oc triseriatus Oc trivattatus Or signifera Ps ciliata Ps columbiae Ps ferox Ps howardii Ur sapphirina 2003 Monkeypox

10 Monkeypox Ultimately, whenever novel infectious agents appear suddenly, it is probably inevitable that there will be speculations and rumors: that they were designed in biowarfare laboratories or emerged from biomedical research (as was argued for HIV), that they came from space (as suggested for SARS), or that they represent a bioterrorist attack. However, reality is more banal but nevertheless painful: Nature itself is the best bioreactor for apocalyptic biological agents and, through evolution, has at the same time developed the best defense strategies against them Gottschalk & Preiser 2005

11 Contact:

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