Factors in Emergence of New Infections

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Factors: Introduction - Defining the Danger

  • Emerging infections: Newly appeared or rapidly increasing incidence/geographic range (e.g., COVID-19, Zika).
  • Re-emerging infections: Previously controlled, now increasing (e.g., Tuberculosis, Measles).
  • Deliberately emerging: Bioterrorism agents (e.g., Anthrax).
  • Global impact: Significant morbidity & mortality (e.g., HIV, Influenza, Ebola).

⭐ The majority of emerging infectious diseases are zoonotic in origin (animal to human).

Factors: Microbial Adaptation - Pathogen's Playbook

  • Genetic Roulette: Key to pathogen evolution.

    • Mutation: Point changes; antigenic drift (e.g., Influenza).
    • Recombination: Exchange of genetic segments.
    • Reassortment: Mixing of segmented genomes; antigenic shift (e.g., Influenza). 📌 Shift = Sudden, Severe.
  • Antimicrobial Resistance (AMR) Development:

    • Mechanisms: Enzyme inactivation (e.g., β-lactamases), target modification, ↓ uptake, ↑ efflux.
    • Spread: Horizontal Gene Transfer (plasmids, transposons).
  • Pathogen Power-ups:

    • ↑ Virulence factors: Toxins, adhesins, capsules, immune evasion mechanisms.
    • ↑ Transmissibility: Enhanced host-to-host spread, environmental stability.
  • Zoonotic Spillover & Animal Reservoirs:

    • Reservoirs: Bats (Coronaviruses, Nipah), Rodents (Hantaviruses), Birds (Avian Influenza).
    • Spillover events: Pathogen jumps from animal to human, often via an intermediate host or direct contact.

Antigenic Shift vs Drift in Influenza Virus

⭐ Influenza A: antigenic drift (seasonal epidemics), antigenic shift (pandemics via reassortment).

Zoonotic Spillover Process:

Factors: Human Behavior - Our Influence Amplified

  • Demographics & Mobility:
    • ↑ Population growth, density, and unplanned urbanization intensify pathogen transmission.
    • Human migration (refugees, economic migrants) and displacement introduce pathogens to naive populations.
  • Lifestyle Choices:
    • High-risk sexual practices (e.g., HIV).
    • Intravenous drug use (e.g., HCV).
    • Food habits: consumption of bushmeat or raw/undercooked food (zoonotic risks).
  • Altered Ecosystems:
    • Encroachment into wildlife habitats ↑ human-animal contact.
    • Exotic pet trade and intensive livestock farming create spillover opportunities.
  • Globalization:
    • Rapid international travel and trade act as vectors for swift global pathogen spread.

    ⭐ Air travel can disseminate pathogens worldwide within 24-48 hours, as demonstrated by SARS and COVID-19. One Health approach to prevent pandemics

Factors: Eco-Changes - Environment's Eruption

  • Climate Change:
    • Alters vector (mosquito, tick) distribution, density & breeding seasons.
    • Enhances pathogen survival, replication & virulence.
    • Modifies host immunity & susceptibility.
  • Land Use Changes:
    • Deforestation: ↑ vector-human contact (e.g., Malaria, Leishmaniasis, Nipah).
    • Intensive agriculture (irrigation, livestock): creates new vector habitats.
    • Urbanization, dam building, mining: disrupt ecosystems, alter water flow.
  • Natural Disasters: (Floods, earthquakes, hurricanes)
    • Damage infrastructure: poor sanitation, contaminated water sources.
    • Population displacement & overcrowding: ↑ disease transmission risk.
  • Water & Food Ecology:
    • Changes in aquatic environments: e.g., harmful algal blooms (HABs).
    • Contamination of food & water sources by pathogens or their toxins.

⭐ Deforestation is linked to increased emergence of diseases like Malaria and Leishmaniasis by altering vector and reservoir host ecology.

Environmental changes and vector-borne disease risk

Factors: System Failures - Societal Setbacks

  • Public Health Infrastructure Breakdown:
    • Reduced surveillance & inadequate response.
    • Poor sanitation & hygiene standards.
    • Failed vector control programs (e.g., for mosquitoes).
  • Weak Healthcare Systems:
    • Deficient infection control practices.
    • Limited diagnostic capacity & resources.
    • Restricted access to essential treatments.
  • Antimicrobial Resistance (AMR): Accelerated by widespread, inappropriate antimicrobial use in humans & agriculture.
  • Socio-political & Economic Factors: Poverty, social inequality, conflict, war, political instability.
  • Globalization: Increased international travel & interconnected global food supply chains.
  • Bioterrorism: Potential for deliberate release of pathogens. Factors in Emergence of New Infections: One Health Model

⭐ The decline in childhood vaccination coverage is a major factor in the re-emergence of diseases like measles.

High‑Yield Points - ⚡ Biggest Takeaways

  • Genetic changes in pathogens (e.g., antigenic shift/drift) drive emergence.
  • Human demographics (urbanization, ↑population) and behavior (travel, IV drug use) are crucial.
  • Ecological disturbances like deforestation and climate change promote zoonotic transmission.
  • Globalization (international travel, food trade) enables rapid pandemic spread.
  • Weak public health infrastructure (poor surveillance, ↓vaccination) increases susceptibility.
  • Intensive agriculture and food production systems can be sources of new pathogens.
  • Antimicrobial resistance contributes to re-emergence and difficult-to-treat infections.

Practice Questions: Factors in Emergence of New Infections

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Flashcards: Factors in Emergence of New Infections

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The bugs that are associated with Guillain-Barre Syndrome are ICE MyCZ:I_____CMVEBVMycoplasma PneumoniaeCampylobacterZika

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The bugs that are associated with Guillain-Barre Syndrome are ICE MyCZ:I_____CMVEBVMycoplasma PneumoniaeCampylobacterZika

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