Volume 1, Number 1—January 1995
Perspective
Factors in the Emergence of Infectious Diseases
Stephen S. Morse
Table 2
Factors in infectious disease emergence*
| Factor | Examples of specific factors | Examples of diseases |
|---|---|---|
| Ecological changes(including those due to economic development and land use) | Agriculture; dams,changes in water ecosystems; deforestation/reforestation; flood/drought; famine; climate changes | Schistosomiasis(dams); Rift Valley fever(dams, irrigation); Argentine hemorrhagic fever(agriculture); Hantaan (Korean hemorrhagic fever) (agriculture); hantavirus pulmonary syndrome, southwestern US, 1993 (weather anomalies) |
| Human demographics, behavior | Societal events: Population growth and migration (movement from rural areas to cities); war or civil conflict; urban decay; sexual behavior; intravenous drug use; use of high-density facilities | Introduction of HIV; spread of dengue; spread of HIV and other sexually transmitted diseases |
| International travel commerce | Worldwide movement of goods and people; air travel | "Airport" malaria; dissemination of mosquito vectors; ratborne hantaviruses; introduction of cholera into South America; dissemination of O139 V. cholerae |
| Technology and industry | Globalization of food supplies; changes in food processing and packaging; organ or tissue transplantation; drugs causing immunosuppression; widespread use of antibiotics | Hemolytic uremic syndrome(E.coli contamination of hamburger meat), bovine spongiform encephalopathy;transfusion-associated hepatitis (hepatitis B, C), opportunistic infections in immunosuppressed patients, Creutzfeldt-Jakob disease from contaminated batches of human growth hormone (medical technology) |
| Microbial adaptation and change | Microbial evolution,response to selection in environment | Antibiotic-resistant bacteria, "antigenic drift" in influenza virus |
| Breakdown in public health measures | Curtailment or reduction in prevention programs; inadequate sanitation and vector control measures | Resurgence of tuberculosis in the United States; cholera in refugee camps in Africa; resurgence of diphtheria in the former Soviet Union |
