Global Human

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24 June 2009

Epidemics in a Changing World Parliamentary
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Epidemics

• Professor Anne Kelso AO
• Director, WHO Collaborating Centre for Reference
  and Research on Influenza
• Member Expert Working Group on Epidemics in a
  Changing World

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24 June 2009

Epidemics in a Changing World Parliamentary
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The first 21st century pandemic
Dr Margaret Chan and Dr Keiji Fukuda at the press
conference to announce the start of the 2009
influenza pandemic, 11 June 2009
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24 June 2009

Epidemics in a Changing World Parliamentary
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A devastating disease eradicated
Frank Fenner announcing the eradication of
smallpox to the World Health Assembly on 8 May
1980
http//epress.anu.edu.au/
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Epidemics in a Changing World Parliamentary
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A changing world

• Disease agents constantly evolve
• New agents emerge
• Our environment is changing more rapidly than
  ever before

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Epidemics in a Changing World Parliamentary
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Members of the Expert Working Group
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Epidemics in a Changing World Parliamentary
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InfluenzaDengueBluetongue
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The spread of influenza
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Epidemics in a Changing World Parliamentary
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Origin of new influenza viruses
Mutation
Drift
Reassortment when two viruses mix in one animal
Shift
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Epidemics in a Changing World Parliamentary
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Seasonal influenza in Australia
Australian Influenza Surveillance Report, Dept
Health Ageing (May 2009)
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Epidemics in a Changing World Parliamentary
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Seasonal influenza in Hong Kong
Yang et al, PlosOne (2008)
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Epidemics in a Changing World Parliamentary
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Origin of new influenza viruses
Seasonal strains Tamiflu resistance 1918
pandemic Equine influenza
Mutation
Reassortment when two viruses mix in one animal
1957 pandemic 1968 pandemic 2009 H1N1 swl
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Origin of new human H1N1 virus
Eurasian swine H1N1
swine
avian
1998 North American swine H1N1
2009 human H1N1
human
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Epidemics in a Changing World Parliamentary
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Equine influenza 2007
NSW DPI (2007)
DAFF (2008)
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Equine influenza 2007

• 80,000 horses infected
• No NSW and QLD racing for 3 months
• Cost to Government gt350 million
• Cost to industry 1 billion

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Epidemics in a Changing World Parliamentary
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Mortality in the 1918 pandemic
Children in a remote Alaskan village survived the
1918-19 pandemic while most of their parents and
grandparents succumbed.
Ahmed et al, Nature Immunol. (2007)
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The way we live
Flinders St Station, Melbourne
World Youth Day, Sydney 2008
MCG
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Epidemics in a Changing World Parliamentary
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Spread of the new H1N1 influenza
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Spread of H5N1 avian influenza
www.pandemicflu.gov/
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Changes for the better

• Knowledge and technology
• Vaccines
• Antiviral drugs
• Global surveillance and cooperation
• Communication systems
• Pandemic planning and response

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Dengue viruses
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Dengue viruses

• Dengue fever 50 million infections p.a.
• Dengue haemorrhagic fever 500,000 p.a.
• No vaccines or drugs
• Transmitted by mosquitoes Aedes aegypti
• Aedes albopictus

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Control of dengue virus water storage
www.who.int
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Areas at risk of dengue transmission
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Bluetongue viruses
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Bluetongue viruses

• Mainly affect sheep
• Spread depends on
• - midge vector
• - susceptible animals
• - warm weather

Saegerman et al. (2008)
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Bluetongue viruses
Saegerman et al. (2008)
Colours represent different virus types
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Influenza, dengue and bluetongue

• Mobility
• Demographic change
• Animal management and trade
• Climate change

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Epidemics

• Professor Stephen Prowse
• CEO of the Australian Biosecurity Cooperative
  Research Centre for Emerging Infectious Disease
• Deputy Chair Expert Working Group on Epidemics
  in a Changing World

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An emerging disease SARS - 2003
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What is an emerging infectious disease?
A disease that Causes more serious illness
bluetongue virus in Europe Changes geographic
region rabies in Bali Changes host
Ebola-Reston in Philippines
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Mortality associated with global influenza
outbreaks
WHO (2005)
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Impacts of recent disease events
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Foot and mouth disease - UK
Burning foot and mouth disease infected animals,
UK 2001
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Emerging infectious diseases are increasing
Jones et al. (2008)
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Climate change Temperature Rainfall Water
use Extreme weather events
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Water storage
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Movement of people
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Movement of livestock and commodities
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Prosperity
Shanghai skyline
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Intensive livestock production
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Poverty
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Nipah outbreak in pigs in Malaysia
105 deaths US 276 million
Culling pigs
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Urban infrastructure
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Livestock at the urban-rural interface
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Vaccination
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Complex inter-related factors
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Risks to Australia

• Entry through northern borders
• Entry through ports and airports
• Disease emerging within Australia

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Our northern neighbours
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Ports and airports
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Home grown diseases
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Summary
Uncertainty and inevitability
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Summary

• We are changing the world
• This is changing the emergence and spread of
  human and animal diseases
• We need preparedness and agility to tackle the
  unknown unknowns

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24 June 2009

Epidemics in a Changing World Parliamentary
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