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The emergence of "emerging diseases": a lesson in holistic epidemiology

E D Kilbourne1

  • 1Department of Microbiology and Immunology, New York Medical College, Valhalla 10595, USA.

The Mount Sinai Journal of Medicine, New York
|May 1, 1996
PubMed

Insights

Emerging diseases encompass old diseases, new zoonotic diseases, and syndromes identified through biotechnology. Holistic epidemiology is crucial for understanding and controlling these diverse health threats.

Area of Science:

  • Epidemiology
  • Infectious Diseases
  • Public Health

Background:

  • Emerging diseases are a complex category including resurgent old diseases, novel diseases from zoonotic agents, and syndromes identified via biotechnology.
  • Factors contributing to resurgent diseases include microbial mutation (e.g., antibiotic-resistant tuberculosis) and immunosuppression (e.g., AIDS).
  • Ecosystem changes and increased human-wildlife contact facilitate the emergence of zoonotic diseases like Lyme disease and Ebola virus infection.

Purpose of the Study:

  • To define and categorize the diverse entities encompassed by the term "emerging diseases."
  • To highlight the importance of recognizing differences between types of emerging diseases for effective control.
  • To introduce the concept of "holistic epidemiology" for addressing these multifaceted health challenges.

Main Methods:

  • Review and synthesis of existing literature on emerging infectious diseases.
  • Analysis of etiological factors, including microbial evolution, host factors, and environmental changes.
  • Conceptual framework development for "holistic epidemiology."

Main Results:

  • Emerging diseases are classified into three main groups: resurgent old diseases, novel zoonotic diseases, and newly defined syndromes.
  • Specific examples illustrate the diverse origins and manifestations of emerging diseases, such as influenza, tuberculosis, parvovirus B19, herpesvirus 6, Lyme disease, and Ebola.
  • The study emphasizes that effective control requires tailored strategies based on the specific nature of each disease.

Conclusions:

  • A clear understanding of the distinct categories of emerging diseases is essential for developing targeted control strategies.
  • "Holistic epidemiology," integrating molecular to macroenvironmental levels, provides a framework for managing these complex health issues.
  • The dynamic relationship between humans, pathogens, and the environment ensures the continued emergence of new diseases.

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