MIGRAMIGRAÇÇÕES, DOENÕES, DOENÇÇAS EMERGENTES E DOENAS EMERGENTES E DOENÇÇAS AS TROPICAISTROPICAISLuís Távora Tavira

BASIC CONCEPTS

EMERGING DISEASES & GEOGRAPHICAL DISTRIBUTION

CAN TROPICAL DISEASES EMERGE IN THE NORTH?

STUDY CASE 1: MALARIA

STUDY CASE 2: DENGUE

STUDY CASE 3: LEISHMANIASIS

CONCLUSIONS & QUESTIONS

DISCUSSION

3

3

5

3

3

3

5

60

TIM

EL

INE

EBOLATIMELINE

1973 Rotavirus Enteritis/Diarrhea

1976 Cryptosporidium Enteritis/Diarrhea

1977 Ebola virus VHF

1977 Legionella Legionnaire’s dz

1977 Hantaan virus VHF w/ renal flr

1977 Campylobacter Enteritis/Diarrhea

1980 HTLV-1 Lymphoma

1981 Toxin prod. S.aureus Toxic Shock Synd.

1982 E.coli 0157:H7 HUS

1982 HTLV-II Leukemia

1982 Borrelia burgdorferi Lyme disease

1983 HIV AIDS

1983 Helicobacter pylori Peptic ulcer dz

1988 Hepatitis E Hepatitis

1989 Hepatitis C Hepatitis

1990 Guanarito virus VHF

1991 Encephalitozoon Disseminated dz

1992 Vibrio cholerae O139 Cholera

1992 Bartonella henselae Cat scratch dz

1993 Sin Nombre virus Hanta Pulm. Synd.

1994 Sabia virus VHF

1994 Hendra virus Respiratory dz

1995 Hepatitis G Hepatitis

1995 H Herpesvirus-8 Kaposi sarcoma

1996 vCJD prion Variant CJD

1997 Avian influenza (H5N1) Influenza

1999 Nipah virus Encephalitis

1999 West Nile virus Encephalitis

2001 BT Bacillus anthracis Anthrax

2003 Monkeypox Pox

2003 SARS-CoV SARS

CHOLERA

AIDS

BA

SIC

CO

NC

EP

TS

EMERGING DISEASE REMARKS

Class Diseases

New Disease AIDS ;

Ebola;

Legionnaires; Nipah virus infection

Old Disease, New Place

Smallpox, the New World, 16th

Century,

Black death (plague), Europe, 14th

Century

Hepatitis E, Haiti ;

West Nile fever, NY, 1999 Reintroduced

Plague, India;

Dengue fever, Texas ;

Measles, United States;

Malaria, Korea; Adenovirus, US Military training camps

New Population

Malaria, US soldiers in Somalia ; Marburg virus, lab workers in Germany

;

Cholera, PeruIncreased Virulence

Influenza, 1918 worldwide pandemic;

H5N1 influenza, Hong Kong ;

E. coli O157:H7, United States

Drug Resistance

Campylobacter;

Malaria;

Strep

BA

SIC

CO

NC

EP

TS

TROPICAL DISEASES

TDR

disease

category

Disease burden

DALYs* (thousands)

Deaths

(thousands)

Total Male Female Total Male Female

African trypanosomiasis 1 1,525 996 559 48 31 17

Dengue 1 616 279 337 19 8 10

Leishmaniasis 1 2,090 1,249 840 51 30 21

Malaria 2 46,486 22,243 22,242 1,272 607 665

Schistosomiasis 2 1,702 1,020 681 15 10 5

Tuberculosis 2 34,736 21,905 12,831 1,566 1,030 536

Chagas disease 3 667 343 324 14 8 7

Leprosy 3 199 117 82 6 4 2

Lymphatic filariasis 3 5,777 4,413 1,364 0 0 0

Onchocerciasis 3 484 280 204 0 0 0

GE

OG

RA

PH

ICA

LGLOBAL

GE

OG

RA

PH

ICA

LCHOLERA

MALARIA

EM

ER

GIN

G D

ISE

AS

ES

& G

EO

GR

AP

HIC

AL

DIS

TR

IBU

TIO

NMALARIA

ANOPHELES

LEISHMANIASIS

SLEEPING SICKNESS

CH

AN

GIN

G P

AT

TE

RN

SSOUTH TO NORTH

REMARKS

NORTH TO SOUTH

REMARKS

ST

UD

Y C

AS

E 1

: MA

LA

RIA

STATUS

MYTHS

RISKS

FACTS

ST

UD

Y C

AS

E 2

: DE

NG

UE

STATUS

MYTHS

RISKS

FACTS

ST

UD

Y C

AS

E 3

: LE

ISM

AN

IAS

ISSTATUS

MYTHS

RISKS

FACTS

CO

NC

LU

SIO

NS

CONCERNING TROPICAL DISEASES AS EMERGENT

1973 Rotavirus Enteritis/Diarrhea

1976 Cryptosporidium Enteritis/Diarrhea

1977 Ebola virus VHF

1977 Legionella Legionnaire’s dz

1977 Hantaan virus VHF w/ renal flr

1977 Campylobacter Enteritis/Diarrhea

1980 HTLV-1 Lymphoma

1981 Toxin prod. S.aureus Toxic Shock Synd.

1982 E.coli 0157:H7 HUS

1982 HTLV-II Leukemia

1982 Borrelia burgdorferi Lyme disease

1983 HIV AIDS

1983 Helicobacter pylori Peptic ulcer dz

1988 Hepatitis E Hepatitis

1989 Hepatitis C Hepatitis

1990 Guanarito virus VHF

1991 Encephalitozoon Disseminated dz

1992 Vibrio cholerae O139 Cholera

1992 Bartonella henselae Cat scratch dz

1993 Sin Nombre virus Hanta Pulm. Synd.

1994 Sabia virus VHF

1994 Hendra virus Respiratory dz

1995 Hepatitis G Hepatitis

1995 H Herpesvirus-8 Kaposi sarcoma

1996 vCJD prion Variant CJD

1997 Avian influenza (H5N1) Influenza

1999 Nipah virus Encephalitis

1999 West Nile virus Encephalitis

2001 BT Bacillus anthracis Anthrax

2003 Monkeypox Pox

2003 SARS-CoV SARS

ABOUT CHANGING PATTERNS

QU

ES

TIO

NS

LINGUAGENS E IDIOMAS

PRODUÇÃO E REGULAÇÃO DA EVIDÊNCIA

MEDIAEPIDEMICS

GLOBALIZAÇÃO E TRANSFERÊNCIA DE TECNOLOGIA