History of Infectious Diseases

The sheer magnitude and mortality of early epidemics is difficult to imagine. Medicine and religion both strove to console the sick and dying. However, before advances in the underlying science of health, medicine lacked effective tools, and religious explanations for disease dominated. As early communi-ties consolidated people more closely, severe epidemics of plague, smallpox, and syphilis occurred.The bubonic plague and its coinfections, measles and smallpox, were the most devastating of the epidemic diseases. In 160 CE plague contributed to the collapse of the Han Empire, (Lee HSJ., 2000)and six years later the Roman Empire was ravaged by the Antonine Plague (165–180 CE), which likely killed both coemperors Lucius Verus (130–169 CE) and Marcus Aurelius (121–180 CE) along with 5 million others.( Fears JR.,2004),( Antonine plague.,2006)Plague and other communicable diseases flourished in the cities of the Roman Empire and surely contributed to its final demise.¹¹Four centuries later (1104–1110 CE) nearly 90% of Europeans were killed by plague. (Lee HSJ., 2000)The plague, or Black Deathas it was then called, struck again in 1345 and swept across Europe. Starting in the lower Volga it spread to Italy and Egypt in 1347 on merchant ships carrying rats and fleas infected with the plague bacillus, Yesinia pestis During the next five years (1347–1351), the Black Death killed 3 Europeans out of 10, leaving 24 million Europeans dead with a total of 40 million deaths worldwide. (Watts S..1997),( Rosen G.,1993),( McNeill WH.,1977),(Hirst LF.,1953) These waves of bubonic plague fundamentally affected the development of civilizations as well as imposed a genetic bottleneck on those populations exposed. Europeans may be able to attribute their lower susceptibility to leprosy and HIV to the selec-tive pressure of bubonic plague.(Duncan SR.,2005)To survive in an ancient city was no small immunologic feat—and populations that had the immunologic fortitude had an advantage over others when exploration and colonization brought them and their pathogens together. (Rosen G.,1993).The first recorded epidemic of smallpox was in 1350 BCE, during the Egyptian–Hittite war.In addition to Ramses V, typical smallpox scars have been seen on the faces of mummies from the time of the 18^th and 20^th Egyptian dynasties (1570–1085 BCE) Smallpox wasdisseminated during the Arabian expansion, the Crusades, the discovery of the West Indies, and the colonization of the Americas. Mortality ranged from 10–50% in many epidemics. The disease apparently was unknown in the New World prior to the appearance of the Spanish and Portuguese conquistadors. Cortez was routed in battle in 1520 butwas ultimately victorious as smallpox killed more than 25% of the Aztecs over the next year.(Lee HSJ.,2000)Mortality rates of 60–90% were described by the Spanish priest Fray Toribio Motolinia. He reported that 1000 persons per day died in Tlaxcala, with ultimately 150,000 total dead.16Smallpox then traveled north across the Americas, devastating the previously unexposed American populations.11At that time, there was a reasonable understanding of the epidemiology of smallpox transmission. At the least, it was appreciated that the skin lesions and scabs could transmit the disease. It was known that survivors of the infection were immune to reinfection after further exposure. The practice of inoculation, or variolation, whereby people were intentionally exposed to smallpox was practiced in China, Africa, and India centuries before the practice would be adopted in Europe and the Americas³.(Watts S.,1997)

The history of the world is intertwined with the impact that infectious diseases have had on populations. Evidence of smallpox has been found in 3000-year-old Egyptian mummies. Egyptian papyrus paintings depict infectious diseases such as poliomyelitis. Hippocrates wrote about the spread of disease by means of airs, water, and places, and made an association between climate, diet, and living conditions. Investigators described miasmas as the source of infections. Fracastoro discussed the germ theory in the 1500s and three routes of contagion were proposed—direct contact, fomites, and contagion from a distance (airborne). Epidemics of leprosy, plague, syphilis, smallpox, cholera, yellow fever, typhoid fever, and other infectious diseases were the norm.

The development of the microscope by Leeuwenhoek in the 1600s allowed scientists to visualize micro-organisms for the first time. The 1800s brought knowledge of the cultivation and identification of micro-organisms. Vaccines were developed and used which introduced specific methods to our storehouse of measures for control and prevention. Pasteurization was another important contribution to disease control. An appreciation of the environment and its relationship to infectious diseases resulted in implementation of broad control measures such as community sanitation, personal hygiene, and public health education. The importance of nutrition was appreciated for its impact on infectious diseases.But we are now aware that emerging and re-emerging infections have become a significant worldwide problem². In 1991, the Institute of Medicine of the National Research Council in the US appointed a 19-member multidisciplinary expert committee to study the emergence of microbial threats to health. Their report published in 1992 was entitled, ‘Emerging Infections —Microbial Threats to Health in the United States’ but the concepts that they discussed certainly have worldwide application (Lederberg J, Shope RE.,1992)

Worldwide deaths due to Infectious Diseases⁴

We are bold in our attempts to control infectious diseases. We have eradicated one disease (smallpox) and two other diseases are in the final stages of eradication (poliomyelitis and dracunculiasis). These eradication programmes demonstrate how international collaboration and co-operation can significantly benefit the world. However, our goals must be realistic, that is, initiation of an eradication programme must be limited to the few diseases for which this is a valid goal. Control and prevention should be our main emphasis as we plan our ongoing commitment in our approach to infectious diseases.

In this issue of the International Journal of Epidemiology, a number of articles are included that exemplify the continuing problems with infectious diseases. Modelling has become an important ally in our attempts to project future occurrence of infectious diseases and can have a significant impact on our distribution of resources for purposes of control and prevention. Murray et al. studied behavioural changes among intravenous drug users in Australia as to the occurrence of HIV and hepatitis C virus (HCV) and, using a mathematical model, have made projections as to what the future prevalence of these two diseases will be (Murray JM, et al.,2003). Law and colleagues modelled HCV incidence in Australia, being concerned about the impact of hepatitis C infection on the development of chronic liver disease and increased mortality (Law MGet al.,2003). These two papers demonstrate the relationships between an infectious agent and chronic disease and the authors discuss their concern about the burden that these infections will have on future populations^5.

Thus the current era of globalization is more properly viewed as an intensification of trends that have occurred throughout history. Never before have so many people moved so quickly throughout the world, whether by choice or force. Never before has the population density been higher, with more people living in urban areas. Never before have food, animals, commodities, and capital been transported so freely and quickly across political boundaries. And never before have pathogens had such ample opportunity to hitch global rides on airplanes, people, and products⁷.

Current Outbreak (2014)

The deadliest Ebola outbreak in recorded history is happening right now. The outbreak is unprecedented both in the number of cases and in its geographic scope. And so far, it doesn't look like it's slowing down.

The outbreak has now hit three countries: Guinea, Sierra Leone, and Liberia. And the virus — which starts off with flu-like symptoms and often ends with horrific hemorrhaging — has infected about 600 people and killed an estimated 367 since this winter, according to the numbers on June 26 from the World Health Organization.

 Countries showing EBOLA outbreak⁸

Members associated with Infectious Diseases

• Centre for Infectious Diseases and Policy includes 218 members
• Global Public Health is having 106913 members
• Members Pediatric Infectious Disease and Immunology has 3291 members
• European Society of Clinical Microbiology and Infectious Diseases has 3438 members
• Infectious Diseases Society has 707 members

Worldwide Data

• Worldwide members of Infectious are 3,683 members
• European Congress in Clinical Microbiology and Infectious Diseases is having 1,369 members
• National Foundation for Infectious Diseases has 365 members
• UNC Institute for Global Health & Infectious Diseases has237 members
• Cirion; bridging the gap in infectious diseases between science and society has55 members
• HIV/AIDS & Infectious Diseases has 85 members
• M.S. in Public Health Microbiology & Emerging Infectious Diseases has 44 members
• Infectious Diseases and Public Health (IDPH) Research Group has 45 members
• EUPHA Section Infectious diseases control has 38 members
• Center for Structural Genomics of Infectious Diseases (CSGID) has30 members
• LSHTM_Control of Infectious Diseases has 19 members

Hospital Associated with Infectious diseases⁹

• North Central London consists of 23 hospitals till now
• North East London has18 hospitals
• North West London has19 hospitals
• South East London has23 hospitals

Societies Associated in London for Infectious Diseases

• British Infection Association
• European Society for pediatric Infectious diseases
• Health care Infection Society
• Worldwide societies for infectious diseases is about 150

Association related to Infectious Diseases

• Healthcare Infection Society
• European Society for Pediatric Infectious Diseases
• European Society of Clinical Microbiology and Infectious Diseases
• Infection Prevention Society
• British Society for Immunology
• British Infection Association

Universities related to Infectious Diseases(UK)

• University of Cambridge
• Kings College of London
• London School of Hygiene and Tropical Medicine
• Imperial College London
• UCL Institute of Epidemiology and Health care
• University of Sheffeild
• Pediatric Infectious Diseases Society

Universities (Developed Countries)

• Columbia University
• University of Maryland
• Swedish Institute for Infectious Disease Control
• Uppsala University
• University of Gothenburg
• University of Otago
• Oslo University
• University of Pittsburgh

Actively Participating Universities

• Emory Health Sciences
• Queensland University of Technology
• University of Liverpool
• University of Colorado Denver
• Infectious Diseases Society of America
•  Medical College of Georgia at Georgia Regents   University

Market Analysis of Companies

Product manufactured and revenue¹⁰

Total sales of Aspirin™ (including Aspirin™ Complex), also including Aspirin™ Cardio, which is reflected in sales of the Pharmaceuticals segment, decreased by 5.6% (Fx adj. -1.0%) in 2013 to €916 million (2012: €970 million).

Funding (Infectious Diseases)¹¹

NIH funding for Infectious diseases¹²

The NIH does not expressly budget by category. The annual estimates reflect amounts that change as a result of science, actual research projects funded, and the NIH budget. The research categories are not mutually exclusive. Individual research projects can be included in multiple categories so amounts depicted within each column of this table do not add up to 100 percent of NIH-funded research. 

References

1. http://www.mayoclinic.org/diseases-conditions/infectious-diseases/basics/definition/con-   20033534
2. http://ije.oxfordjournals.org/content/32/5/684.full
3. http://www.jblearning.com/samples/0763728799/28799_CH01_001_022.pdf
4.  https://www.research.olemiss.edu/UMQuest/2007/Winter/ThePowerOfPartnerships.html
5.  http://ije.oxfordjournals.org/content/32/5/684.full
6.  http://www.ncbi.nlm.nih.gov/books/NBK56579/
7. http://www.nhshistory.net/voluntary_hospitals.html
8.  http://www.vox.com/2014/6/26/5839394/the-deadliest-ebola-outbreak-in-history-is-happening-right-now
9.  http://en.wikipedia.org/wiki/List_of_hospitals_in_England
10. http://www.healthcare.bayer.com/scripts/pages/en/company/products/index.php
11.  http://kff.org/global-health-policy/fact-sheet/the-u-s-government-and-global-tuberculosis/
12.  http://report.nih.gov/categorical_spending.aspx
13. Murray JM, Law MG, Gao Z, Kaldor JM. The impact of behavioural changes on the prevalence of human immunodeficiency virus and hepatitis C among injecting drug users. Int J Epidemiol 2003;32: 708–14.
14. Law MG, Dore GJ, Bath N et al. Modelling hepatitis C virus incidence, prevalence and long-term sequelae in Australia, 2001. Int J Epidemiol 2003;32:717–24.
15. Lederberg J, Shope RE (eds). Emerging Infections: Microbial Threats to Health in the United States. Washington, DC: National Academy Press, 1992.
16. Watts S. Epidemics and History: Disease, Power and Imperialism.New Haven, Conn: Yale University Press; 1997
17. Lee HSJ, ed. Dates in Infectious Diseases. Boca Raton, Fla: The Parthenon Publishing Group; 2000.
18. Fears JR. The plague under Marcus Aurelius and the decline and fall of the Roman Empire. Infect Dis Clin North Am. 2004;18:65–77.
19. Antonine plague. Wikipedia Web page. Available at: http://en.wikipedia.org/wiki/Antonine_Plague. Accessed Feb 22, 2006.
20. Porter R, ed. Cambridge Illustrated History of Medicine. New York, NY: Cambridge University Press; 1996.
21. Rosen G. A History of Public Health. Baltimore, Md: Johns Hopkins University Press; 1993.
22. McNeill WH. Plagues and Peoples.New York, NY: Doubleday; 1977.
23. Hirst LF. The Conquest of Plague. London, England: Oxford University Press; 1953.
24. Duncan SR, Scott S, Duncan CJ. Reappraisal of the historical selective pressures for the CCR5-Delta32 mutation. J Med Genet. 2005;42:205–208.