African swine fever (ASF) is one of the most important swine diseases, mainly because of its significant sanitary and socioeconomic consequences. This review gives an update on the epidemiology of the disease and reviews key issues and strategies to improve control of the disease and promote its eradication. Several characteristics of ASF virus (ASFV) make its control and eradication difficult, including the absence of available vaccines, marked virus resistance in infected material and contaminated animal products, and a complex epidemiology and transmission involving tick reservoir virus interactions. The incidence of ASF has not only increased on the African continent over the last 15 years, so that it now affects West African countries, Mauritius and Madagascar, but it has also reached new areas, such as the Caucasus region in 2007. In fact, the rapid spread of the disease on the European continent and the uncontrolled situation in the Russian Federation places all countries at great risk as a result of intense global trade. The proximity of some affected areas to the European Union (EU) borders (
Diseases and biological toxins have been used as weapons of war throughout recorded history, from Biblical times through to the present day. Bioweapon uses have historically been directed primarily, although not exclusively, against human populations. Specialised technicians and state-of-the-art research facilities are no longer necessary for the production or deployment of many known bioweapon agents and commercially available technologies now permit the large-scale production of bioweapon agents in small-scale facilities at relatively low cost. Failures in the detection and containment of bioweapon and emerging disease outbreaks among populations of wildlife and indigenous peoples in developing countries could result in severe erosion of genetic diversity in local and regional populations of both wild and domestic animals, the extinction of endangered species and the extirpation of indigenous peoples and their cultures. Our ability to understand and control the spread of diseases within and among human and animal populations is increasing but is still insufficient to counter the threats presented by existing bioweapon diseases and the growing number of highly pathogenic emergent infections. Interdisciplinary and international efforts to increase the monitoring, surveillance, identification and reporting of disease agents and to better understand the potential dynamics of disease transmission within human and animal populations in both industrialised and developing country settings will greatly enhance our ability to combat the effects of bioweapons and emerging diseases on biological communities and biodiversity.
In this paper, the authors review the impacts of diseases facing salmon aquaculture, drawing lessons from terrestrial animal diseases. They discuss the implementation of current control strategies, taking into account transmission patterns (vertical versus horizontal), disease reservoirs, and interactions with wild fish. In addition, the decision-making context of aquatic disease control and the institutional organisation of control strategies are considered, with particular emphasis on the roles and responsibilities of regulatory authorities and the private sector. Case studies on the emergence and control of infectious salmon anaemia worldwide and pancreas disease in Norway are used to examine some of the controversies that may influence decision making and provide lessons for the future.
McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, One Stewart Street, Ottawa, ON K1N 6N5. drain067@uottawa.ca
The emergence of West Nile Virus, as well as other emerging diseases, is linked to complex ecosystem processes such as climate change and constitutes an important threat to population health. Traditional public health intervention activities related to vector surveillance and control tend to be reactive and limited in their ability to deal with multiple epidemics and in their consideration of population health determinants. This paper reviews the current status of West Nile Virus in Canada and describes how complex systems and geographical perspectives help to acknowledge the influence of ecosystem processes on population health. It also provides examples of how these perspectives can be integrated into population-based intervention strategies.
[Experience of information sharing between local healthcare management and regional Administration of Federal Service for Surveillance for Protection of Consumers Rights and Human Welfare in Sverdlovsk region during outbreak of Legionnaires' disease in town Verkhnyaya Pyshma in July-August 2007].
Issues of reliability, uniformity, and timeliness of reporting and sharing of information during outbreaks of infectious diseases are basic for establishment of tactics and strategy of organizational, antiepidemic, and clinical measures. Analysis of experience in sharing of information between medical care organization service and services ensuring sanitary-epidemiological welfare of population during outbreak of Legionnaires' disease in town Verkhnyaya Pyshma in July-August 2007 was performed in the article.
The recent SARS epidemic has renewed widespread concerns about the global transmission of infectious diseases. In this commentary, we explore novel approaches to global infectious disease surveillance through a focus on an important Canadian contribution to the area--the Global Public Health Intelligence Network (GPHIN). GPHIN is a cutting-edge initiative that draws on the capacity of the Internet and newly available 24/7 global news coverage of health events to create a unique form of early warning outbreak detection. This commentary outlines the operation and development of GPHIN and compares it to ProMED-mail, another Internet-based approach to global health surveillance. We argue that GPHIN has created an important shift in the relationship of public health and news information. By exiting the pyramid of official reporting, GPHIN has created a new monitoring technique that has disrupted national boundaries of outbreak notification, while creating new possibilities for global outbreak response. By incorporating news within the emerging apparatus of global infectious disease surveillance, GPHIN has effectively responded to the global media's challenge to official country reporting of outbreak and enhanced the effectiveness and credibility of international public health.
Centre for Research on Inner City Health, The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario, M5B 1W8, Canada.
During the 2003 severe acute respiratory syndrome (SARS) outbreak in Toronto, the potential introduction of SARS into the homeless population was a serious concern. Although no homeless individual in Toronto contracted SARS, the outbreak highlighted the need to develop an outbreak preparedness plan that accounts for unique issues related to homeless people. We conducted key informant interviews with homeless service providers and public health officials (n = 17) and identified challenges specific to the homeless population in the areas of communication, infection control, isolation and quarantine, and resource allocation. Planning for future outbreaks should take into account the need to (1) develop systems that enable rapid two-way communication between public health officials and homeless service providers, (2) ensure that homeless service providers have access to infection control supplies and staff training, (3) prepare for possible homeless shelter closures due to staff shortages or high attack rates among clients, and (4) plan for where and how clinically ill homeless individuals will be isolated and treated. The Toronto SARS experience provided insights that are relevant to response planning for future outbreaks in cities with substantial numbers of homeless individuals.
Department of Community and Family Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong SAR, China PRC. cwwong@cuhk.edu.hk
This study was designed to compare the response and management of severe acute respiratory syndrome (SARS) by the family physicians of the Hong Kong and the Toronto health systems, and to provide evidence to improve health policy and practices in a newly emerging infectious disease.
A questionnaire was sent to family medicine tutors affiliated with either the Chinese University of Hong Kong or the University of Toronto in 2003. The survey questions covered training for SARS, the use of screening tools, an anxiety scale, clinical practices, and demographic data.
137 (74.8%) and 51 (34%) doctors from Hong Kong and Toronto replied to the questionnaire, respectively. Most (80-84.6%) had no training in infectious disease control and were not confident in dealing with SARS (68.1-73.5%). In Hong Kong, the screening tools provided by international agencies did not meet the local needs. In Toronto, lack of a centralized hospital admission policy and fully public laboratory probably resulted in appointment cancellation and dissatisfaction. There may be a need for deployment of personnel between institutions but loss of income was not a major concern.
Sharing the "lessons learned" in different regions during a SARS outbreak will help prepare for the next epidemic.
In September 2004, Kingston, Frontenac, Lennox and Addington (KFL and A) Public Health, in collaboration with the Public Health Division of the Ontario Ministry of Health and Long-Term Care, Queen's University, the Public Health Agency of Canada, Kingston General Hospital and Hotel Dieu Hospital, began a 2-year pilot project to implement and evaluate an emergency department (ED) chief complaint syndromic surveillance system. Our objective was to evaluate a comprehensive and readily deployable real-time regional syndromic surveillance program and to determine its ability to detect gastrointestinal or respiratory outbreaks well in advance of traditional reporting systems. In order to implement the system, modifications were made to the University of Pittsburgh's Real-time Outbreak and Disease Surveillance (RODS) system, which has been successfully integrated into public health systems, and has enhanced communication and collaboration between them and EDs. This paper provides an overview of a RODS-based syndromic surveillance system as adapted for use at a public health unit in Kingston, Ontario. We summarize the technical specifications, privacy and security considerations, data capture, classification and management of the data streams, alerting and public health response. We hope that the modifications described here, including the addition of unique data streams, will provide a benchmark for future Canadian syndromic surveillance systems.
