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Prospects for emerging infections in East and southeast Asia 10 years after severe acute respiratory syndrome.

Horby PW, Pfeiffer D, Oshitani H - Emerging Infect. Dis. (2013)

Bottom Line: It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases.The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products.Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades.

View Article: PubMed Central - PubMed

Affiliation: Oxford University Clinical Research Unit, National Hospital of Tropical Diseases, 78 Giai Phong St, Dong Da District, Hanoi, Vietnam. peter.horby@gmail.com

ABSTRACT
It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases. The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products. The region is now better able to detect and respond to emerging infectious diseases than it was a decade ago, but the tools and methods to produce sufficiently refined assessments of the risks of disease emergence are still lacking. Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades.

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Self-reported global and regional average attribute scores for international health regulations core capacities, 2011. Source: World Health Organization, Summary of 2011 States Parties Report on International Health Regulations Core Capacity Implementation. (www.who.int/ihr/publications/WHO_HSE_GCR_2012.10eng/en/index.html). The attribute score is the percentage of attributes (a set of elements or functions that reflect the level of performance or achievement of an indicator) in which moderate or strong technical capacity has been attained in each core capacity area. SEAR results are the average for 11/11 eligible countries. WPR results are the average for 19/27 eligible countries (8 countries did not complete the questionnaire in 2011). SEAR, World Health Organization’s (WHO) South-East Asia Region; WPR, WHO Western Pacific Region.
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Figure 3: Self-reported global and regional average attribute scores for international health regulations core capacities, 2011. Source: World Health Organization, Summary of 2011 States Parties Report on International Health Regulations Core Capacity Implementation. (www.who.int/ihr/publications/WHO_HSE_GCR_2012.10eng/en/index.html). The attribute score is the percentage of attributes (a set of elements or functions that reflect the level of performance or achievement of an indicator) in which moderate or strong technical capacity has been attained in each core capacity area. SEAR results are the average for 11/11 eligible countries. WPR results are the average for 19/27 eligible countries (8 countries did not complete the questionnaire in 2011). SEAR, World Health Organization’s (WHO) South-East Asia Region; WPR, WHO Western Pacific Region.

Mentions: The SARS pandemic highlighted what had been apparent to some since the 1990s: few countries possessed the necessary surveillance and response capacities to rapidly detect and control emerging infectious diseases (32). The deficiencies of the 1969 International Health Regulations at the global level had long been recognized, and attempts to revise them were ongoing before 2003, but the SARS outbreak added new urgency and momentum for change. The International Health Regulations were successfully revised in 2005, and for the first time they defined a series of core capacities that each country is required to establish to detect, report, and control public health emergencies of international concern. The target for attaining these core capacities was set as June 2012, and an assessment undertaken in 2011 found that although these core capacities had not yet been fully achieved in several countries of East and Southeast Asia, considerable progress had been made (Figure 3) (33). For example, the influenza surveillance network in China expanded from 63 laboratories and 197 sentinel hospitals in 2005 to 441 laboratories and 556 sentinel hospitals in 2009 (34). Field epidemiology training programs have played a central role in strengthening epidemiology capacity in human and animal health, and new field epidemiology training programs were implemented in Laos, Mongolia, and Vietnam in 2009 and in Cambodia in 2011 (35). An analysis of the global capacity for detecting outbreaks showed improvements in the median time from outbreak start to outbreak discovery between 1996 (29.5 days) and 2009 (13.5 days) and from start to public communication (40 days in 1996 to 19 days in 2009); the WHO Western Pacific Region was the only WHO region that showed a statistically significant improvement in both areas (36).


Prospects for emerging infections in East and southeast Asia 10 years after severe acute respiratory syndrome.

Horby PW, Pfeiffer D, Oshitani H - Emerging Infect. Dis. (2013)

Self-reported global and regional average attribute scores for international health regulations core capacities, 2011. Source: World Health Organization, Summary of 2011 States Parties Report on International Health Regulations Core Capacity Implementation. (www.who.int/ihr/publications/WHO_HSE_GCR_2012.10eng/en/index.html). The attribute score is the percentage of attributes (a set of elements or functions that reflect the level of performance or achievement of an indicator) in which moderate or strong technical capacity has been attained in each core capacity area. SEAR results are the average for 11/11 eligible countries. WPR results are the average for 19/27 eligible countries (8 countries did not complete the questionnaire in 2011). SEAR, World Health Organization’s (WHO) South-East Asia Region; WPR, WHO Western Pacific Region.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713834&req=5

Figure 3: Self-reported global and regional average attribute scores for international health regulations core capacities, 2011. Source: World Health Organization, Summary of 2011 States Parties Report on International Health Regulations Core Capacity Implementation. (www.who.int/ihr/publications/WHO_HSE_GCR_2012.10eng/en/index.html). The attribute score is the percentage of attributes (a set of elements or functions that reflect the level of performance or achievement of an indicator) in which moderate or strong technical capacity has been attained in each core capacity area. SEAR results are the average for 11/11 eligible countries. WPR results are the average for 19/27 eligible countries (8 countries did not complete the questionnaire in 2011). SEAR, World Health Organization’s (WHO) South-East Asia Region; WPR, WHO Western Pacific Region.
Mentions: The SARS pandemic highlighted what had been apparent to some since the 1990s: few countries possessed the necessary surveillance and response capacities to rapidly detect and control emerging infectious diseases (32). The deficiencies of the 1969 International Health Regulations at the global level had long been recognized, and attempts to revise them were ongoing before 2003, but the SARS outbreak added new urgency and momentum for change. The International Health Regulations were successfully revised in 2005, and for the first time they defined a series of core capacities that each country is required to establish to detect, report, and control public health emergencies of international concern. The target for attaining these core capacities was set as June 2012, and an assessment undertaken in 2011 found that although these core capacities had not yet been fully achieved in several countries of East and Southeast Asia, considerable progress had been made (Figure 3) (33). For example, the influenza surveillance network in China expanded from 63 laboratories and 197 sentinel hospitals in 2005 to 441 laboratories and 556 sentinel hospitals in 2009 (34). Field epidemiology training programs have played a central role in strengthening epidemiology capacity in human and animal health, and new field epidemiology training programs were implemented in Laos, Mongolia, and Vietnam in 2009 and in Cambodia in 2011 (35). An analysis of the global capacity for detecting outbreaks showed improvements in the median time from outbreak start to outbreak discovery between 1996 (29.5 days) and 2009 (13.5 days) and from start to public communication (40 days in 1996 to 19 days in 2009); the WHO Western Pacific Region was the only WHO region that showed a statistically significant improvement in both areas (36).

Bottom Line: It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases.The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products.Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades.

View Article: PubMed Central - PubMed

Affiliation: Oxford University Clinical Research Unit, National Hospital of Tropical Diseases, 78 Giai Phong St, Dong Da District, Hanoi, Vietnam. peter.horby@gmail.com

ABSTRACT
It is 10 years since severe acute respiratory syndrome (SARS) emerged, and East and Southeast Asia retain a reputation as a hot spot of emerging infectious diseases. The region is certainly a hot spot of socioeconomic and environmental change, and although some changes (e.g., urbanization and agricultural intensification) may reduce the probability of emerging infectious diseases, the effect of any individual emergence event may be increased by the greater concentration and connectivity of livestock, persons, and products. The region is now better able to detect and respond to emerging infectious diseases than it was a decade ago, but the tools and methods to produce sufficiently refined assessments of the risks of disease emergence are still lacking. Given the continued scale and pace of change in East and Southeast Asia, it is vital that capabilities for predicting, identifying, and controlling biologic threats do not stagnate as the memory of SARS fades.

Show MeSH
Related in: MedlinePlus