Infectious diseases, security and ethics: the case of HIV/AIDS

Securitization of infectious diseases may involve suspension of ordinary human rights and liberties. In the event of an epidemic, therefore, it is important to limit the occasions upon which draconian disease control measures are implemented in the name of security. The term 'security', moreover, should not be used too loosely if it is to retain force and meaning in political discourse. It may be argued that the bar for disease securitization should be set high so that it is limited to contexts involving rapidly spreading pathogens. Such an approach, however, would rule out securitization of more slowly spreading, endemic diseases such as HIV/AIDS. An advantage of characterizing HIV/AIDS as a security threat in developing countries, where the burden of the disease is concentrated, is that this is likely to mobilize resources needed to improve the situation there. That is, if HIV/AIDS is convincingly framed as a security threat, then governments may recognize self-interested reasons to ramp up control measures. Following consideration of arguments for narrow (excluding HIV/AIDS) versus broad (including HIV/AIDS) conceptions of security, we conclude that the legitimacy of 'securitizing' HIV/AIDS ultimately turns on empirical and semantic issues, and we emphasize the importance of distinguishing (1) the nature of the threat posed by HIV/AIDS and (2) the measures required to address that threat.     

Emerging infectious diseases associated with bat viruses

Bats play important roles as pollen disseminators and pest predators. However, recent interest has focused on their role as natural reservoirs of pathogens associated with emerging infectious diseases. Prior to the outbreak of severe acute respiratory syndrome (SARS), about 60 bat virus species had been reported. The number of identified bat viruses has dramatically increased since the initial SARS outbreak, and most are putative novel virus species or genotypes. Serious infectious diseases caused by previously identified bat viruses continue to emerge throughout in Asia, Australia, Africa and America. Intriguingly, bats infected by these different viruses seldom display clinical symptoms of illness. The pathogenesis and potential threat of bat-borne viruses to public health remains largely unknown. This review provides a brief overview of bat viruses associated with emerging human infectious diseases.     

From Pasteur to genomics: progress and challenges in infectious diseases

Over the past decade, microbiology and infectious disease research have undergone the most profound revolution since the times of Pasteur. Genomic sequencing has revealed the much-awaited blueprint of most pathogens. Screening blood for the nucleic acids of infectious agents has blunted the spread of pathogens by transfusion, the field of antiviral therapeutics has exploded and technologies for the development of novel and safer vaccines have become available. The quantum jump in our ability to detect, prevent and treat infectious diseases resulting from improved technologies and genomics was moderated during this period by the greatest emergence of new infectious agents ever recorded and a worrisome increase in resistance to existing therapies. Dozens of new infectious diseases are expected to emerge in the coming decades. Controlling these diseases will require a better understanding of the worldwide threat and economic burden of infectious diseases and a global agenda.     

Evolution of virulence,environmental change,and the threat posed by emerging and chronic diseases

Assessments of future threats posed by infection have focused largely on zoonotic, acute disease, under the rubric “emerging diseases.” Evolutionary and epidemiological studies indicate, however, that particular aspects of infrastructure, such as protected water supplies, vector-proof housing, and health care facilities, protect against the emergence of zoonotic, acute infectious diseases. While attention in the global health community has focused on emerging diseases, there has been a concurrent, growing recognition that important chronic diseases, such as cancer, are often caused by infectious agents that are already widespread in human populations. For economically prosperous countries, the immediacy of this threat contrasts with their infrastructural protection from severe acute infectious disease. This reasoning leads to the conclusion that chronic infectious diseases pose a more significant threat to economically prosperous countries than zoonotic, acute infectious diseases. Research efforts directed at threats posed by infection may therefore be more effective overall if increased efforts are directed toward understanding and preventing infectious causes of chronic diseases across the spectrum of economic prosperity, as well as toward specific infrastructural improvements in less prosperous countries to protect against virulent, acute infectious diseases.     

Syndemics and public health: reconceptualizing disease in bio-social context

The world of public health has undergone dramatic changes since the emergence of AIDS in the early 1980s. The appearance and global spread in recent years of wave after wave of new and renewed infectious diseases and their entwinement with each other and with the social conditions and biopsychological consequences of disparity, discrimination, and structural violence has produced a new significant threat to public health internationally. The term syndemic has been introduced recently by medical anthropologists to label the synergistic interaction of two or more coexistent diseases and resultant excess burden of disease. This article provides the fullest examination of this new concept to date, including a review of relevant new literature and recent research finds concerning coinfection and synergistic interaction of diseases and social conditions at the biological and population levels.     

The Economic Case for a Pandemic Fund

The rapid urban spread of Ebola virus in West Africa in 2014 and consequent breakdown of control measures led to a significant economic impact as well as the burden on public health and wellbeing. The US government appropriated $5.4 Billion for FY2015 and WHO proposed a $100 Million emergency fund largely to curtail the threat of future outbreaks. Using epidemiological analyses and economic modeling, we propose that the best use of these and similar funds would be to serve as global insurance against the continued threat of emerging infectious diseases. An effective strategy would involve the initial investment in strengthening mobile and adaptable capacity to deal with the threat and reality of disease emergence, coupled with repeated investment to maintain what is effectively a ‘national guard’ for pandemic prevention and response. This investment would create a capital stock that could also provide access to safe treatment during and between crises in developing countries, lowering risk to developed countries.     

细菌感染与Gasdermin家族介导的宿主细胞程序性死亡的研究进展

侵入宿主后,细菌生长、繁殖并与宿主相互作用,引发机体不同程度的病理变化。为抑制细菌致病过程,宿主免疫系统产生抗感染免疫应答,感染的发生和发展取决于细菌对机体的致病性与机体抗细菌免疫的相互抗争。在细菌所致感染性疾病的发生、发展过程中,细菌与宿主细胞的拮抗往往涉及程序性细胞死亡(programmed cell death, PCD)这一过程。新近发现Gasdermin家族成员Gasdermin D和Gasdermin E参与PCD过程,并在其中发挥重要作用,跟踪其研究进展将有助于应对细菌感染造成的威胁。     

Genetic tracing of HCoV-19 for the re-emerging outbreak of COVID-19 in Beijing,China

The ongoing pandemic of coronavirus disease 2019(COVID-19)caused by a novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2,also named as 2019-nCoV or HCoV-19)poses an unprecedented threat to public health(Zhu et al.,2020;Wang et al.,2020;Jiang et al.,2020).The novel HCoV-19 virus has rapidly spread into multiple countries across the world since it was first reported in December 2019.The World Health Organization(WHO)declared COVID-19 as a pandemic on 11th March 2020.As of 4th July,over 10 million confirmed COVID-19 cases have been reported in over 200 countries/regions with more than 0.5 million deaths,including 85,287 documented cases and 4,648 deaths in China(WHO,2020a).     

Modelling climatic suitability for myrtle rust with a widespread host species

Biological Invasions - Globalisation has resulted in the spread of infectious plant diseases to new regions and host species and the novel disease caused by myrtle rust poses a global threat to...     

Administrative issues related to infectious disease research in the age of bioterrorism

The recent unprecedented growth in infectious disease research funding and infrastructure has resulted in part from an outgrowth of concern about newly emerging and re-emerging diseases and the progressive development of antibiotic-resistant pathogens. However, the most compelling impetus is the suspected and demonstrated capability and will of unknown individuals, groups, or states to use biological agents and/or toxins as weapons. Although the actual number of known victims and fatalities from bioterrorism in the United States has been miniscule compared with many other daily hazards, biological agents have the potential to cause human mass casualties, severely damage segments of our economy or agricultural infrastructure, poison or compromise our food or water supply, and, perhaps most damaging, disrupt our society physically and psychologically. The significant institutional commitment necessary to participate in infectious disease research is described, with a focus on programs that involve research with pathogens thought to have potential for use by bioterrorists. Administrative considerations are described, and include obtaining necessary research funding to offset high operating costs; complying with "select agent" regulations, security screening of employees; building or renovating a biocontainment facility; finding skilled professional and technical manpower; providing adequate physical security in a threat environment; conducting targeted training; overcoming potential internal and external dissent; developing and/or providing sufficient occupational health and safety programs; achieving and maintaining compliance standards in a fluid regulatory environment; mitigating potentially hazardous working conditions; understanding personal and institutional liability; and reassuring and dealing with a concerned, skeptical, or even hostile public.     

综述与专论: 树鼩病毒感染模型的研究新进展

病毒感染引起的疾病接近中国主要传染病发病率的一半,也是传染病致死的主要病因。建立与人类亲缘关系较近、方便有效的感染人类病毒的动物模型,对了解病毒的生物学特性、感染致病机理及制定有效防控措施具有重要意义。树鼩作为灵长类动物的近亲,与人类在生理生化、基因组学等方面的相似性远高于大鼠、小鼠等常用啮齿类实验动物,并具有个体小、便于实验操作、饲养成本低、能感染多种人类病毒等特点,作为动物模型在病毒感染性疾病研究中突显优势和潜能。本文从地区分布、进化、生物学特性等方面,阐述了树鼩作为动物模型应用于病毒感染性疾病研究的优势,包括在乙型肝炎病毒、甲型肝炎病毒,及其他病毒感染疾病研究中的进展。     

Climate changes, environment and infection: facts, scenarios and growing awareness from the public health community within Europe

Climate change is a current global concern and, despite continuing controversy about the extent and importance of causes and of its effects, it seems likely that it will affect the incidence and prevalence of both residual and imported infections in Europe. Climate affects mainly the range of infectious diseases, whereas weather affects the timing and intensity of outbreaks. Climate change scenarios include a change distribution of infectious diseases with warming and changes in outbreaks associated with weather extremes. The largest health impact from climate change for Europe doesn’t come from vector borne infectious diseases. This does not mean that these types of health impacts will not arise in Europe. The ranges of several vector-borne diseases or their vectors are already changing in altitude due to warming. In addition, more intense weather events create conditions conductive to outbreaks of infectious diseases: Heavy rains leave insect breeding sites, drive rodents from burrows, and contaminate clean water systems. The incidence of mosquito-borne parasitic and viral diseases, are among those diseases most sensitive to climate. Climate change affect disease transmission by shifting the vector’s geographic range and by shortening the pathogen incubation period. climate-related increases in temperature in sea surface and level would lead to higher incidence of waterborne infectious and toxin-related illnesses, such as cholera and seafood intoxication. Climate changes all around the world with impact in Europe are demonstrated by the fact that recent cases of cholera have been imported to Europe from Kenya, where spreading epidemic has been linked to the El Niño phenomenon, originated from the Pacific Ocean. Human migration and damage to health infrastructures from aberrant climate changes could indirectly contribute to disease transmission. Human susceptibility to infections might be further compounded by alterations in the human immune system caused by increased exposure to ultraviolet radiation and malnutrition due to alterations in agricultural products. Different kind of incidents in Europe with extreme weather events demonstrated effects on public health. The recent outbreak of the insect-borne Chikungunya virus in Italy in 2007 is an example of the kind of new health threat that the EU must be vigilant to confront. In addition, health effects of flooding, have been related to an excess cases of leptospirosis and campylobacter enteritis. Such examples have been demonstrated reported after flooding in the Czech Republic. Similarly, an increase of cryptosporidiosis in the United Kingdom has been related to flooding. Changing vector distributions associated with tickborne encephalitis and malaria have also been dempostrated in EU. A recently reported case of malaria in Italy in June 2008, suspected to be indigenously acquired, has shown how easily malaria could be reintroduced into several countries in the region. Another case of malaria in Greece in May 2010 affecting a young man living in a forestry region was claimed at KEELPNO-the Greek Center for disease control. Would this latest case be considered closely related to the one from Italy? If yes, then Public Health Services should elaborate plans to affront possible tickborne diseases. Heat waves are important causes of mortality on mortality are important. The deaths seen in France in 2003 from a heat wave are projected to be repeated, as heat waves become more severe. However, heat waves impacts on the transmission and severity of infectious diseases have not been elucidated. Finally scientific challenges include the elucudation of climate changes and extreme weather condition impact on infection transmission and outcome, human immune system changes and infection response, outbreak scenarios, animal and plant health and public health preparedness. European action plans to affront climate changes related health and infection problems are developed by the EU Commission at different levels and jointly by different DGs. In a few words within the EU the following points on human, animal and plant health are considered a priority: * Strengthening cooperation between the services of these three branches of health (human, animals, plants); * Developing action plans in the event of extreme weather conditions, in order to be better prepared and to react in the best way; * Gathering more reliable information on the risks of climate change whilst maintaining international cooperation, in particular with the WHO, as cooperation beyond that between Member States will be required to be more effective; * Providing additional effort to identify the most effective measures; * Improving the surveillance and the control of the animal diseases. The European Commission has decided to consider climate change, and the consequences it has on health, with greater importance whilst being aware that it is at the root of numerous diseases.     

CONTROL OF DIARRHEAL DISEASES IN CALIFORNIA STATE HOSPITALS FOR RETARDED CHILDREN

The three California state hospitals for mentally retarded persons have been having a severe problem with amebic and bacillary dysentery and with other infectious diseases of the gastrointestinal tract. At Sonoma, the oldest of these hospitals, this problem is known to have existed for many years. Improved medical and nursing staffing and the use of antibiotics and other effective drugs developed in recent years have greatly lowered morbidity and mortality rates in these institutions. However, in themselves these measures have not been effective in lowering the incidence of infection.Studies have demonstrated that mass treatment of cottage groups known to have a high incidence of amebic infection has resulted in control of this disease where such mass treatment was followed by adequate laboratory follow-up, with isolation and retreatment of treatment failures. Where mass treatment of such groups has been carried out without such laboratory followup, there was a rapid return to the previous high incidence of infection.Statistics show that these diseases are a serious threat to employees working in these institutions. Increasing attention is being paid to the potential threat to the surrounding communities and the state as a whole from the focus of infection present in these hospitals.     

Development and application of synthetic peptides as vaccines

Vaccination against bacterial and viral diseases has been one of the major achievements in medicine and immunology since the beginning of this century. Extensive vaccination programs have been able to control or, in the case of smallpox, virtually wipe out some of the most dangerous infectious diseases e.g. poliomyelitis, measles, whooping cough, diphtheria and tetanus. However, as this success has been limited mainly to the developed, affluent countries, infectious diseases still remain the worlds largest health problem. Furthermore, vaccines against human parasites are non-existent. Recent advances in immunology and molecular biology including recombinant DNA technology have provided the basis for new approaches to vaccine development.     

拉沙病毒分子流行病学特征和跨境传播风险

拉沙热主要流行于西非,经鼠传播,人群普遍易感,病死率高,暴发疫情频发,跨境传播时有发生。拉沙病毒易于传播,病毒分离、培养需在生物安全四级实验室(BSL-4)。2018年,世界卫生组织将其列为年度重点关注传染病,需加快研制防治关键技术手段。随着中非关系的日益紧密,贸易往来频繁,中国面临拉沙热的威胁显著增加。本文检索20世纪50年代首例拉沙热病例报道以来公开发表的主要文献,归纳拉沙热临床表现、病原学特征、流行病学特征、实验室检测以及跨境传播风险等,并对GenBank发布的全部287条拉沙病毒S基因编码区全长序列进行复核分析,以加强人们对拉沙热的了解,提高防控意识。     

对两用生物技术发展现状与生物安全的思考

生命科技的蓬勃发展与全球化步伐的持续加速,为人类社会带来了诸多福祉。然而,生物技术的两用特征和传染病严峻的流行趋势带来了一系列生物安全隐患,引发了世界性的生物安全问题。随着国际形势的日趋复杂,生物安全这一非传统安全问题已成为国家安全体系的重要组成部分。本文通过分析典型两用生物技术的潜在威胁及新发突发传染病的发展趋势,指出我国生物安全领域面临的挑战性问题。同时结合研究发达国家在战略、政策与技术方面应对生物安全的重要举措,从战略布局、科技创新、团队建设、政策支持等方面为我国在两用生物技术的生物安全领域的发展提出建议。     

The real place of infectious pathology in overall population morbidity

The statistical decrease of the proportion of infections in the structure of morbidity of the population reflects the existing classification of diseases when only acute diseases are classified with the group "infectious and parasitic diseases". The proportion of diseases caused by infective agents remains constantly high. According to WHO data, such diseases make up one-third of all diseases in the world. In Moscow the proportion of infectious diseases in all diseases registered among the inhabitants of this big city fluctuated within 36.1% and 49.7% during the period of 1926-1997.     

近年来出现的几类新概念动物疫苗

动物疫病流行广泛、传播迅速,严重危害养殖业的发展。疫苗接种是预防和控制动物传染病最有效的策略之一。目前,随着生物技术的发展和疫病防控的需要,安全、高效、广谱、用量少、具有标记特征的新型疫苗成为研发重点。文中就近年来出现的黏膜疫苗、长效与速效疫苗、嵌合疫苗、纳米颗粒疫苗等新概念动物疫苗的发展、应用及优缺点进行了评述,并提出了其发展方向,以期为动物疫苗的研发提供借鉴。     

气候变化对传染病爆发流行的影响研究进展

全球气候变化已影响到传染病发生、传播与变化的各个环节,从病原体及其携带者、传播途径和人体自身抵抗力等方面直接或间接影响传染病的发病趋势,从而对人类健康造成了巨大的威胁。所以加强对气候变化与传染病间关系、预测预报研究,对进一步认识、预防和控制传染病的爆发流行具有重要意义。本文首先阐述了全球气候变化对生物物种的地理分布和人类健康的影响,气候变化改变了生物物种的地理分布范围,增加了某些物种的潜在分布区域,并造成生物物侯期的改变;同时,极端气候事件成为导致种群数量波动的一个重要驱动力。气候变化对人类健康有直接和间接影响,它使得传染病发病率增加、传染病分布范围扩大、人群对疾病易感性增强。文章重点评述了气候变化对疟疾、登革热、霍乱、流行性乙型脑炎、流感、SARS、肠道传染病、鼠疫、血吸虫病等常见传染病流行机制和传播过程的影响研究进展。评述了传染病和气象因子关系分析中常用的定性和定量分析方法,传统的研究多以定性分析为主,方法较单一;目前,利用流行病学资料与同期的气象因子进行单因素相关分析、多元回归分析是常用的研究方法;主成分回归分析、逐步判别分析、灰色关联分析法、RS和GIS等方法近年来逐渐得到应用;数学建模、实验室生物学仿真实验方法是今后需强化的方向。提出了该研究领域国内外研究普遍存在和亟待解决的问题,针对目前的研究现状和存在的问题,提出了未来的研究重点和发展方向。