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Emerging infectious diseases in an island ecosystem: the New Zealand perspective
J A Crump1, D R Murdoch, M G Baker
1Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. znc0@cdc.gov
Abstract:
Several unique features characterize infectious disease epidemiology in New Zealand. Historically, well-organized, government-run control programs have eliminated several zoonoses. More recently, however, communicable disease control has been mixed. Rates of rheumatic fever, tuberculosis, and enteric infectious are high, and rates of meningococcal disease are increasing. These diseases are over-represented in New Zealanders of Polynesian descent, who generally live in more deprived and overcrowded conditions than do those of European descent. Measles and pertussis epidemics are recurring because of inadequate vaccine coverage, despite a well-developed childhood immunization program. A progressive response to the HIV epidemic has resulted in relatively low rates of infection, particularly among injecting drug users; however, the response to other sexually transmitted infections has been poor. A key challenge for the future is to build on successful strategies and apply them to persisting and emerging infectious disease threats in a small, geographically isolated country with limited economic resources.
Insights
New Zealand faces mixed infectious disease control, with high rates of rheumatic fever, tuberculosis, and meningococcal disease disproportionately affecting Polynesian populations. Challenges include vaccine coverage gaps and addressing sexually transmitted infections.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- New Zealand has a history of successful zoonoses control through government programs.
- Current communicable disease control shows a mixed record, with persistent challenges.
- Certain infectious diseases disproportionately impact Polynesian populations due to socioeconomic factors.
Purpose of the Study:
- To analyze the unique features of infectious disease epidemiology in New Zealand.
- To identify successes and challenges in controlling communicable diseases.
- To highlight future challenges for infectious disease management in the country.
Main Methods:
- Review of historical and current infectious disease data in New Zealand.
- Analysis of disease rates across different ethnic and socioeconomic groups.
- Evaluation of control program effectiveness for various infectious diseases.
Main Results:
- High rates of rheumatic fever, tuberculosis, enteric infections, and increasing meningococcal disease.
- Recurring measles and pertussis epidemics due to inadequate vaccine coverage.
- Successful HIV epidemic control contrasted with poor response to other STIs.
Conclusions:
- Infectious disease control in New Zealand is complex, with significant health inequities.
- Addressing socioeconomic determinants is crucial for controlling endemic diseases.
- Future strategies must adapt successful approaches to emerging threats in a unique national context.