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      Global trends in emerging infectious diseases

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          The next new disease

          Emerging infectious diseases are a major threat to health: AIDS, SARS, drug-resistant bacteria and Ebola virus are among the more recent examples. By identifying emerging disease 'hotspots', the thinking goes, it should be possible to spot health risks at an early stage and prepare containment strategies. An analysis of over 300 examples of disease emerging between 1940 and 2004 suggests that these hotspots can be accurately mapped based on socio-economic, environmental and ecological factors. The data show that the surveillance effort, and much current research spending, is concentrated in developed economies, yet the risk maps point to developing countries as the more likely source of new diseases.

          Supplementary information

          The online version of this article (doi:10.1038/nature06536) contains supplementary material, which is available to authorized users.

          Abstract

          The origins of emerging infections diseases are significantly correlated with socio-economic, environmental and ecological factors.

          Supplementary information

          The online version of this article (doi:10.1038/nature06536) contains supplementary material, which is available to authorized users.

          Abstract

          Emerging infectious diseases (EIDs) are a significant burden on global economies and public health 1, 2, 3 . Their emergence is thought to be driven largely by socio-economic, environmental and ecological factors 1, 2, 3, 4, 5, 6, 7, 8, 9 , but no comparative study has explicitly analysed these linkages to understand global temporal and spatial patterns of EIDs. Here we analyse a database of 335 EID ‘events’ (origins of EIDs) between 1940 and 2004, and demonstrate non-random global patterns. EID events have risen significantly over time after controlling for reporting bias, with their peak incidence (in the 1980s) concomitant with the HIV pandemic. EID events are dominated by zoonoses (60.3% of EIDs): the majority of these (71.8%) originate in wildlife (for example, severe acute respiratory virus, Ebola virus), and are increasing significantly over time. We find that 54.3% of EID events are caused by bacteria or rickettsia, reflecting a large number of drug-resistant microbes in our database. Our results confirm that EID origins are significantly correlated with socio-economic, environmental and ecological factors, and provide a basis for identifying regions where new EIDs are most likely to originate (emerging disease ‘hotspots’). They also reveal a substantial risk of wildlife zoonotic and vector-borne EIDs originating at lower latitudes where reporting effort is low. We conclude that global resources to counter disease emergence are poorly allocated, with the majority of the scientific and surveillance effort focused on countries from where the next important EID is least likely to originate.

          Supplementary information

          The online version of this article (doi:10.1038/nature06536) contains supplementary material, which is available to authorized users.

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          Most cited references 20

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          Emerging infectious diseases of wildlife--threats to biodiversity and human health.

          Emerging infectious diseases (EIDs) of free-living wild animals can be classified into three major groups on the basis of key epizootiological criteria: (i) EIDs associated with "spill-over" from domestic animals to wildlife populations living in proximity; (ii) EIDs related directly to human intervention, via host or parasite translocations; and (iii) EIDs with no overt human or domestic animal involvement. These phenomena have two major biological implications: first, many wildlife species are reservoirs of pathogens that threaten domestic animal and human health; second, wildlife EIDs pose a substantial threat to the conservation of global biodiversity.
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            Risk factors for human disease emergence.

            A comprehensive literature review identifies 1415 species of infectious organism known to be pathogenic to humans, including 217 viruses and prions, 538 bacteria and rickettsia, 307 fungi, 66 protozoa and 287 helminths. Out of these, 868 (61%) are zoonotic, that is, they can be transmitted between humans and animals, and 175 pathogenic species are associated with diseases considered to be 'emerging'. We test the hypothesis that zoonotic pathogens are more likely to be associated with emerging diseases than non-emerging ones. Out of the emerging pathogens, 132 (75%) are zoonotic, and overall, zoonotic pathogens are twice as likely to be associated with emerging diseases than non-zoonotic pathogens. However, the result varies among taxa, with protozoa and viruses particularly likely to emerge, and helminths particularly unlikely to do so, irrespective of their zoonotic status. No association between transmission route and emergence was found. This study represents the first quantitative analysis identifying risk factors for human disease emergence.
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              Impact of regional climate change on human health.

              The World Health Organisation estimates that the warming and precipitation trends due to anthropogenic climate change of the past 30 years already claim over 150,000 lives annually. Many prevalent human diseases are linked to climate fluctuations, from cardiovascular mortality and respiratory illnesses due to heatwaves, to altered transmission of infectious diseases and malnutrition from crop failures. Uncertainty remains in attributing the expansion or resurgence of diseases to climate change, owing to lack of long-term, high-quality data sets as well as the large influence of socio-economic factors and changes in immunity and drug resistance. Here we review the growing evidence that climate-health relationships pose increasing health risks under future projections of climate change and that the warming trend over recent decades has already contributed to increased morbidity and mortality in many regions of the world. Potentially vulnerable regions include the temperate latitudes, which are projected to warm disproportionately, the regions around the Pacific and Indian oceans that are currently subjected to large rainfall variability due to the El Niño/Southern Oscillation sub-Saharan Africa and sprawling cities where the urban heat island effect could intensify extreme climatic events.
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                Author and article information

                Contributors
                daszak@conservationmedicine.org
                Journal
                Nature
                Nature
                Nature
                Nature Publishing Group UK (London )
                0028-0836
                1476-4687
                2008
                : 451
                : 7181
                : 990-993
                Affiliations
                [1 ]GRID grid.20419.3e, ISNI 0000 0001 2242 7273, Institute of Zoology, Zoological Society of London, Regents Park, London NW1 4RY, UK, ; ,
                [2 ]GRID grid.420826.a, ISNI 0000 0004 0409 4702, Consortium for Conservation Medicine, Wildlife Trust, 460 West 34th Street, 17th Floor, New York, New York 10001, USA, ; ,
                [3 ]GRID grid.21729.3f, ISNI 0000000419368729, Center for International Earth Science Information Network, Earth Institute, Columbia University, 61 Route 9W, Palisades, New York 10964, USA, ; ,
                [4 ]GRID grid.213876.9, ISNI 0000 0004 1936 738X, Odum School of Ecology, University of Georgia, Athens, Georgia 30602, USA, ; ,
                [5 ]GRID grid.40263.33, ISNI 0000 0004 1936 9094, Present Address: Present addresses: Department of Economics, Brown University, Providence, Rhode Island 02912, USA (A.S.); School of Public Affairs, Baruch College, City University of New York, 1 Bernard Baruch Way, Box D-0901, New York, New York 10010, USA (D.B.)., ; ,
                Article
                BFnature06536
                10.1038/nature06536
                5960580
                18288193
                © Nature Publishing Group 2008

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

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