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4 - The Nature of Plagues 2013–14: A Year of Living Dangerously

Published online by Cambridge University Press:  24 March 2017

Angela McLean
All Souls College in Oxford
Jonathan L. Heeney
University of Cambridge
Sven Friedemann
University of Bristol
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The 12 months from June 2013 to May 2014 were, in many ways, typical in the emerging infectious disease events that occurred. There were no huge shocks, no massive outbreaks nor new pandemics, but every month there were important events and together the year's events form a good illustration of what is a ‘normal’ rhythm of events for emerging infectious diseases. However, after May 2014 the Ebola epidemic in West Africa (described, in its infancy, under ‘March’ in this chapter) rapidly expanded to become a very large epidemic, illustrating how quickly small outbreaks can become very large problems given circumstances that favour human to human transmission and rapid spread.

Whilst many people think of ‘emerging infections’ as only the brand new infections like SARS and HIV, the definition of emerging infections is broader and includes five types of infections that are in some sense ‘new’. Table 4.1 describes those five types and gives examples of each from the past.

In England, Public Health England (an agency of the Department of Health) routinely gathers up evidence about new infectious disease both nationally and internationally. This ‘horizon scanning’ activity is an important part of identifying new infectious hazards that may pose a risk to public health. Each month Public Health England, along with other government bodies, publishes a two-page summary of notable events of public health significance. These summaries are widely circulated in government and academia and are publically available. They form both an excellent warning of current events and a record of how events unfold over months and years.

In this article I have picked one event from each of the past twelve months to illustrate the ‘normal’ rhythm of incidents. Those events have been chosen to illustrate the five types of emerging infectious disease events. They include the three events of 2013–14 that are most likely to trigger substantial, global problems in the future: the ongoing MERS-coronavirus outbreak in the Middle East (July 2013), the ongoing zoonotic cases of Avian Influenza in China (February 2014) and the re-emergence of Polio in early 2014 (May 2014). Despite the ongoing fears about a devastating influenza pandemic, the biggest realised threat from emerging infections continues to be the evolution of antimicrobial resistance. This is a slow, chronic problem that is happening everywhere all the time and therefore never triggers a single ‘event’.

Plagues , pp. 92 - 113
Publisher: Cambridge University Press
Print publication year: 2017


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