SYMPOSIUM FIGURE 1. THE FOUR SIDES OF EMERGING/REEMERGING INFECTIOUS DISEASES Human Host


• Increasing aging and number of infirm


• Genetic susceptibility to disease and chronic complications of infection


• Increased international travel and migration


• Medical care exposures: hospitalization, antibiotic therapy, drugs, and surgery


• Drug abuse Environment


• Urbanization • Global warming and El Niño with warming of seawater, increase in arthropod vectors, drought, and famine


• Infectious hot spots in tropical and semitropical areas


• Deforestation and reforestation


Infectious Diseases Endemic and Epidemic


Pathogens


• Mutation of RNA viruses and bacteria pathogens avoiding host defenses


• Antibiotic resistance including Clostridium dificile infection and health care-associated infections


• Widespread presence in food products and anthropods


Animals


• Proximity of wild animals and humans, especially in tropical and semitropical areas


• Carriage of viruses by migratory water fowl (e.g., influenza virus)


• Animal organism threatening our food supply (e.g., Shiga toxin-producing Escherichia coli, Salmonella, Campylobacter)


• Animal reservoir of highly infectious RNA viruses (e.g., West Nile, SARS, Zika) and rabies


• Infectious agents transmitted to humans, then becoming a human-to-human transmitted pathogen without future animal participation (e.g., avian influenza, HIV, SARS)


Source: Created by Herbert L. DuPont, MD February 2017 TEXAS MEDICINE 33


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