burden of infectious diseases - globe-network.org · burden of infectious diseases m m di d b t d...
TRANSCRIPT
BURDEN of INFECTIOUS DISEASESINFECTIOUS DISEASES
M M di d B t d Liéb ( 730 798)Mapa Mundi de Beatus de Liébana (v. 730 - 798)Beatus_map.jpg (715 × 450 pixels, taille du fichier : 75 Kio, type MIME : image/jpeg
Higher resolution, http://xoomer.virgilio.it/dicuoghi/Piri_Reis/part4/Beatus4.htm)14 from juin 2005 à 09:58 283×178 (18 Kio)CristianChirita(PD}
http://ucatlas.ucsc.edu/cause.php
Developed vs. Developing EconomiesTop causes of death, according to the WHO for the calendar year 2001
Causes of death indevelopED countries
Causes of death indevelopING countriesp p
Ischaemic heart diseases
Cerebrovascular diseases
COPD
LOWER RESPIRATORY INFECTIONSLOWER RESPIRATORY INFECTIONS
Lung cancer
C id tCar accident
Stomach cancer
Hypertensive diseases
TUBERCULOSIS
Suicide
Developed vs. Developing EconomiesTop causes of death, according to the WHO for the calendar year 2001
Causes of death indevelopED countries
Causes of death indevelopING countriesp p
Ischaemic heart diseases HIV-AIDS
Cerebrovascular diseases LOWER RESPIRATORY INFECTIONS
COPD Ischaemic heart diseases
LOWER RESPIRATORY INFECTIONS DiarrhoeaLOWER RESPIRATORY INFECTIONS Diarrhoea
Lung cancer Cerebrovascular diseases
C id t Childh d diCar accident Childhood diseases
Stomach cancer Malaria
Hypertensive diseases TUBERCULOSIS
TUBERCULOSIS COPD
Suicide Measles
AGEING WORLD
M M di d B t d Liéb ( 730 798)Mapa Mundi de Beatus de Liébana (v. 730 - 798)Beatus_map.jpg (715 × 450 pixels, taille du fichier : 75 Kio, type MIME : image/jpeg
Higher resolution, http://xoomer.virgilio.it/dicuoghi/Piri_Reis/part4/Beatus4.htm)14 from juin 2005 à 09:58 283×178 (18 Kio)CristianChirita(PD}
Percentage of total population aged 60 years or older20502050
The boundaries shown on this maps do not imply official endorsement by the United Nationshttp://www.un.org/esa/population/publications/ageing/Graph.pdf
European Union + European Economic Area + European Free Trade Association
EUEEAEEAEFTA
BURDEN f INFECTIOUS DISEASES BURDEN of INFECTIOUS DISEASES in the ELDERLY:
The INDUSTRIALIZED COUNTRIES PERSPECTIVESPERSPECTIVES
European Union + pEuropean Economic Area +
European Free Trade Association
In 2008, the total European populationthe total European population
= 880 4 illi880,4 million(11% of the world population)
170 million of 65+ adults« World Population Prospects »
UN — department of Economic and Social Affairs. http://esa.un.org/unpp. Retrieved on 2008-06-10.
MAJOR PUBLIC HEALTH BURDEN:INFECTIOUS DISEASES
• Lower respiratory infections
INFECTIOUS DISEASES
• Lower respiratory infections• Influenza• Pneumococcal infections
• Tuberculosis• Tuberculosis• Other vaccine preventable diseasesOther vaccine preventable diseases• Antimicrobial resistance• Healthcare-associated infections
Adapted from the European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
INFLUENZAINFLUENZA(Seasonal Flu)(Seasonal Flu)
SEASONAL FLUSEASONAL FLUIt has been estimated that
betweenbetween 40,000 and 220,000 excess deaths per year
i th Ein the Europe can be attributed to influenza,
depending on the virulence of the circulating strainthe virulence of the circulating strain
European Centre for Disease Prevention and Control 2008
Seasonal FLUepidemics in England & Walesepidemics in England & Wales
(winters between 1989 and 2001)
E h it l d i iExcess hospital admissions:> 50% of the excess winter admissions
i i 75 loccurring in 75+ people
Excess mortality Not only linked to the disease itself
BUT to Pulmonary tract surinfections ++
C &SAMSON SI et al Aging Clin Exp Res 2009; 21: 210-5 CISZEWSKI A et al Eur Heart J 2008; 29: 1350-8
Cardio- & neuro-vascular complications ++
MAJOR PUBLIC HEALTH BURDEN:INFECTIOUS DISEASES
• Lower respiratory infections
INFECTIOUS DISEASES
• Lower respiratory infections• Influenza• Pneumococcal infections
• Tuberculosis• Tuberculosis• Other vaccine preventable diseasesOther vaccine preventable diseases• Antimicrobial resistance• Healthcare-associated infections
Adapted from the European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
Streptococcus pneumoniaeStreptococcus pneumoniae
INVASIVEPNEUMOCOCCAL DISEASE European Union + DISEASE (very partial data*)
pEuropean Economic Area +
European Free Trade Association
Countries with notifications:UK (2004-2006): N = 18’204 casesBelgium (1999 2005): N = 9’305 casesBelgium (1999-2005): N = 9’305 casesNorway (1999-2006): N = 7’618 casesFinland (2004-2006): N = 2’226 cases
8 years:8 years:N = 77’778 cases
WHO – CISID – htpp:/data.euro.who.int/cisid/
European Centre for Disease Prevention and Control, 2008
Importance of herd immunity
Seasonal Flu favours the onset of the invasive pneunococcal disease ?
European Centre for Disease Prevention and Control, 2008
Respiratory tract infections Respiratory tract infections (seasonal flu and pneumococcus)(seasonal flu and pneumococcus)
represent th 4th f d ththe 4th cause of deathin developed countriesin developed countries
MAJOR PUBLIC HEALTH BURDEN:INFECTIOUS DISEASES
• Lower respiratory infections
INFECTIOUS DISEASES
• Lower respiratory infections• Influenza• Pneumococcal infections
• Tuberculosis• Tuberculosis• Other vaccine preventable diseasesOther vaccine preventable diseases• Antimicrobial resistance• Healthcare-associated infections
Adapted from the European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
MYCOBACTERIUM TUBERCULOSIS
In 2006, EU and EEA/EFTA countries
reported 87 591 tuberculosis (TB) cases87 591 tuberculosis (TB) cases
with an overall notification rate of 17.6 per 100 00017.6 per 100 000
[range: 3.0 (Cyprus) to 126.4 cases per 100 000 (Romania)]
Atlas of Health in Europe 2008 WHO Regional Office for Europe,
Copenhagen, Denmark
European Centre for Disease Prevention and Control, 2008European Centre for Disease Prevention and Control, 2008
New cases of TuberculosisIn 2006,
19.5 % of cases inin
the EU and EEA/EFTA countries were
in persons of foreign originpe so s o o e g o g
The percentage ranged from p g g0 % to 81 %
across the Member States
European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
Multidrug-resistant TB u t d ug es sta tremains
an issue requiring attention. q g
Multi-drug resistancegwas present in
15 – 19 % of cases in the Baltic States, ,but ranged
from 0 to 2 % in other countries
European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
MAJOR PUBLIC HEALTH BURDEN:INFECTIOUS DISEASES
• Lower respiratory infections
INFECTIOUS DISEASES
• Lower respiratory infections• Influenza• Pneumococcal infections
• Tuberculosis• Tuberculosis• Other vaccine preventable diseasesOther vaccine preventable diseases• Antimicrobial resistance• Healthcare-associated infections
Adapted from the European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
MEASLES
European Union + European Economic Area p p+ European Free Trade Association
WHO Vaccine preventable diseases - Global summary – Geneva - 2007
MEASLESMEASLESEuropean Union +
WHO – CISID – htpp:/data.euro.who.int/cisid/
pEuropean Economic Area +
European Free Trade Association
Within 10 years:Turkey: N = 91’670 casesUk i N 2 484Ukraine: N = 72’484 casesFrance: N = 39’312 casesItaly: N = 36’700 cases
10 year period:1999 N = 56’319 cases2008 N = 6’840 cases
10 year period:N = 301’635 cases
Importance of childhood vaccination!
European Centre for Disease Prevention and Control, 2008
p
European Union + European Economic Area + European Free Trade Association+ European Free Trade Association
WHO Vaccine preventable diseases - Global summary – Geneva - 2007
DIPHTHERIADIPHTHERIAEuropean Union +
WHO – CISID – htpp:/data.euro.who.int/cisid/
pEuropean Economic Area +
European Free Trade Association
Within 10 years:Russian federation: N = 5’148 casesU i d Ki d N 1 90United Kingdom: N = 1’790 casesLatvia: N = 625 cases
10 year period:1999 N = 1’306 cases2008 N = 184 cases
10 year period:N = 8’470 cases
Importance of childhood vaccinationImportance of childhood vaccinationand adulthood booster!
PERTUSSIS
Photomicrograph of Bordetella (Haemophilus) pertussis bacteriawww.vaccineinformation.org/photos/pertcdc001a.jpg
Courtesy of Centers for Disease Control and Prevention
PERTUSSISPERTUSSISEuropean Union + p
European Economic Area + European Free Trade Association
WHO – CISID – htpp:/data.euro.who.int/cisid/
Within 10 years:Netherlands: N = 59’915 casesNorway: N = 36’889 casesNorway: N 36 889 casesSwitzerland: N = 34’400 cases
10 year period:1999 N = 55’166 cases2008 N = 21’061 cases
10 year period:N = 292’806 cases
Importance of childhood vaccinationEuropean Centre for Disease Prevention and Control, 2008
Importance of childhood vaccinationand adulthood booster!
TETANUSTETANUS
TETANUSTETANUSEuropean Union + p
European Economic Area + European Free Trade Association
WHO – CISID – htpp:/data.euro.who.int/cisid/
Within 10 years:Turkey: N = 420 casesFederation of Russia: N = 285 casesFederation of Russia: N = 285 casesFrance: N = 173 casesItaly: N = 139 cases
10 year period:1999 N = 190 cases2008 N = 181 cases
10 year period:N = 2’039 cases
European Centre for Disease Prevention and Control, 2008Importance of a Importance of a
life course vaccination programme
MAJOR PUBLIC HEALTH BURDEN:INFECTIOUS DISEASES
• Lower respiratory infections
INFECTIOUS DISEASES
• Lower respiratory infections• Influenza• Pneumococcal infections
• Tuberculosis• Tuberculosis• Other vaccine preventable diseasesOther vaccine preventable diseases• Antimicrobial resistance• Healthcare-associated infections
Adapted from the European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
European Centre for Disease Prevention and Control, 1st report Stockholm 2007
European Centre for Disease Prevention and Control, 1st report Stockholm 2007
Antimicrobial resistance=
A major public health concernThe extensive use or misuse of antibiotic to treat
infectious diseases
ANTIBIOTIC RESISTANCE (AB-R)
The use of vaccines the probabilty of infection with AB-Rp y the need of prescribing antibiotics
Prevent bacterial complication of a viral infectionp
GUSMANO M et MICHEL JP Aging 2009; 21: 258-63
MAJOR PUBLIC HEALTH BURDEN:INFECTIOUS DISEASES
• Lower respiratory infections
INFECTIOUS DISEASES
• Lower respiratory infections• Influenza• Pneumococcal infections
• Tuberculosis• Tuberculosis• Other vaccine preventable diseasesOther vaccine preventable diseases• Antimicrobial resistance• Healthcare-associated infections
Adapted from the European Centre for Disease Prevention and Control, 2008; ISBN 978-92-9193-137-8; ISSN 1830-6160; DOI 10.2900/22770
European Centre for Disease Prevention and Control, 2008
837’810
Over four million people in the EU acquire aacquire a
healthcare-associated infection every year,of whom approximately
37 000 die as a direct
result of the infection.
BURDEN of INFECTIOUS DISEASESINFECTIOUS DISEASES
CONCLUSION
MAJOR PUBLIC HEALTH BURDEN:INFECTIOUS DISEASES
A GREAT NUMBERINFECTIOUS DISEASES
A GREAT NUMBER OFOF
INFECTIOUS DISEASES CAN BE AVOIDED BY
THE BETTER APPLICATION A LIFE COURSE
VACCINE PROGRAMVACCINE PROGRAM
Vaccine programs
PregnancyScientific
knowledgeVery effective
Precise guidelinesp gfor a better life ChildrenHow to improve their
growth ?
Precise guidelines
Well accepted
Are they healthy ?
Midlif d lt
Scientificknowledge
Continuity of the vaccine program !!
How to improve it ?Midlife adultsthe vaccine program !!
HEALTHY AGEING
Part ofScientific
knowledge
How good is their health ?
Part ofpreventivemedicine !
The target: old adults
H t i it ?
Maintenance of
How to improve it ?
How goodofQoL ++
How good is their health?
MANY THANKS for YOUR ATTENTIONYOUR ATTENTION
M M di d B t d Liéb ( 730 798)Mapa Mundi de Beatus de Liébana (v. 730 - 798)Beatus_map.jpg (715 × 450 pixels, taille du fichier : 75 Kio, type MIME : image/jpeg
Higher resolution, http://xoomer.virgilio.it/dicuoghi/Piri_Reis/part4/Beatus4.htm)14 from juin 2005 à 09:58 283×178 (18 Kio)CristianChirita(PD}
Developed vs. Developing EconomiesTop causes of death, according to the WHO for the calendar year 2001
Causes of death indevelopED countries
Causes of death indevelopING countriesp p
Ischaemic heart diseases
Cerebrovascular diseases
COPD
LOWER RESPIRATORY INFECTIONSLOWER RESPIRATORY INFECTIONS
Lung cancer
C id tCar accident
Stomach cancer
Hypertensive diseases
TUBERCULOSIS
Suicide
Developed vs. Developing EconomiesTop causes of death, according to the WHO for the calendar year 2001
Causes of death indevelopED countries
Causes of death indevelopING countriesp p
Ischaemic heart diseases HIV-AIDS
Cerebrovascular diseases LOWER RESPIRATORY INFECTIONS
COPD Ischaemic heart diseases
LOWER RESPIRATORY INFECTIONS DiarrhoeaLOWER RESPIRATORY INFECTIONS Diarrhoea
Lung cancer Cerebrovascular diseases
C id t Childh d diCar accident Childhood diseases
Stomach cancer Malaria
Hypertensive diseases TUBERCULOSIS
TUBERCULOSIS COPD
Suicide Measles
DEATHS BY BROAD CAUSE GROUPin DEVELOPED COUNTRIES
Communicable Diseases Non Communicable Conditionshttp://ucatlas.ucsc.edu/cause.php
Percent POPULATION aged 65 and over: 2008
An Ageing World 2008, International population Reports, US department of Health and Human Services, June 2009
Percent POPULATION aged 65 and over: 2040
An Ageing World 2008, International population Reports, US department of Health and Human Services, June 2009
Population in DevelopED and developING countries by age and gendery g g
1960
An Ageing World 2008, International population Reports, US department of Health and Human Services, June 2009
Population in DevelopED and developING countries by age and gender
20002000
An Ageing World 2008, International population Reports, US department of Health and Human Services, June 2009
Population in DevelopED and developING countries by age and gendery g g
2040
An Ageing World 2008, International population Reports, US department of Health and Human Services, June 2009
Advanced Age and Ri k f T b l iRisk of Tuberculosis
Natives ofNatives of Belgium
Natives of Belgium
Immigrants to Belgiumg g
VAN DEN BRANDE P Drugs Aging 2005; 22: 663-86
Proposed EUGMS and IAGG-ERvaccine programme for the old adultsvaccine programme for the old adults
By the 7th decade /Retirement (after a clinical assessment of the vaccine status)yage
- TdaP or Td vaccine- Influenza vaccine
- Pneumococcal vaccine- Herpes Zoster vaccineInfluenza vaccine Herpes Zoster vaccine
Each year after the retirement age (after assessment of the vaccine status)
- Influenza vaccine
New medical/injury event Multiple hospital stays(after assessment of the vaccine status) (after assessment of the vaccine status)
- Td or TT vaccine - Pneumococcal vaccine
- TdaP or Td or TT vaccine - Pneumococcal vaccine
By the 9 th decade of age / Nursing Home admission
TdaP or Td or TT vaccine- Influenza vaccine
Pneumococcal vaccine- Herpes Zoster vaccine*
MICHEL JP et al Rejuvenation Research 2009; 19: 127-35
Vaccine programs
PregnancyScientific
knowledgeVery effective
Precise guidelinesp gfor a better life ChildrenHow to improve their
growth ?
Precise guidelines
Well accepted
Are they healthy ?
Midlif d lt
Scientificknowledge
Continuity of the vaccine program !!
How to improve it ?Midlife adultsthe vaccine program !!
HEALTHY AGEING
Part ofScientific
knowledge
How good is their health ?
Part ofpreventivemedicine !
The target: old adults
H t i it ?
Maintenance of
How to improve it ?
How goodofQoL ++
How good is their health?
?
Possible impact of increased vaccine coverage
MANY THANKS MANY THANKS for
YOUR ATTENTION