Overview: Pandemics

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Author: Dr. Ronald St. John

Throughout history there have been outbreaks of infectious diseases. The well-known plague epidemic (Black Death) was a devastating global epidemic of bubonic plague that struck Europe and Asia in the mid-1300s, wiping out an estimated one-third of the population. Disease outbreaks, when large in scope, have been referred to as epidemics. More recently, epidemics that have involved or might involve the global population have been labelled as pandemics.

When does an epidemic become a pandemic? There is no single accepted definition of the term pandemic (ref: Journal of Infectious Diseases, Vol. 200:7, 1 October 2009). Some considerations for labelling an outbreak as a pandemic include outbreaks of diseases:

  • that extend over large geographic areas, e.g., influenza, HIV/AIDS
  • that have high attack rates and explosiveness, e.g., common-source acquisition and highly contagious diseases with short incubation periods
  • that affect populations with minimal population immunity
  • that involve a new or novel version of an infectious agent – the term pandemic has been used most commonly to describe diseases that are new, or at least associated with novel variants of existing organisms, e.g., influenza.
  • that are highly contagious. Many, if not most, infectious diseases considered to be pandemic by public health officials are contagious from person to person
  • that have severe health consequences. The term pandemic has been applied to severe or fatal diseases

For purposes of this paper, a pandemic is an epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.(1)

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16. UN shall adopt a ‘one health approach’ integrating veterinary medicine and environmental science to mitigate disease emergence and antimicrobial resistance and to ensure the continuation of agriculture and civilization

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Rapporteur: Laura H. Kahn, MD, MPH, MPP; Research Scholar, Princeton University

One Health is the concept that human, animal, environmental/ecosystem, and atmospheric health are linked. It is a relatively new term but an ancient concept intuitively understood by indigenous peoples around the world. The One Health concept provides a useful framework for analyzing and addressing complex, interdisciplinary problems such as foodborne and waterborne illnesses, antimicrobial resistance, food security, and even climate change.

We live in a microbial world. We need to learn how to live better in it. We need to learn how to sustainably co-exist with the microbes living in us, on us, and around us.

For example, over 7 billion humans and almost 30 billion domesticated animals produce trillions of kilograms of fecal matter that contain billions of microbes. Each year, the massive amounts of fecal matter produced could fill an estimated 1.6 million Olympic-sized swimming pools. According to the World Bank(1), over 2 billion people don’t have access to basic sanitation systems, and almost 9 million of them practice open defecation. Open defecation, as the name suggests, means squatting and defecating out in the open. Many developing countries lack basic sanitation systems for human fecal matter, much less for animal fecal matter which makes up 80 percent of the total fecal matter produced.

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15. WHO shall promote nations’ use of Incident Management System for early detection and response to pandemics

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Rapporteur: Ronald St. John

Basic Premise:

There will be pandemics at some time in the future.

Small outbreaks of infectious diseases occur daily throughout the world. Depending on the transmission potential for specific or unknown pathogens, a small cluster of infected people can rapidly become an epidemic at a local, district/provincial or national level. In the absence of a comprehensive and internationally accepted definition of what constitutes a pandemic, for purposes of this paper, a pandemic is an epidemic that is occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people with a high degree of morbidity and mortality. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3127276/

Why are pandemics inevitable?

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