Responding to global infectious disease outbreaks: lessons from SARS on the role of risk perception, communication and management.

Human monkeypox is a rare viral zoonosis endemic to central and western Africa that has recently emerged in the USA. Laboratory diagnosis is important because the virus can cause disease that is clinically indistinguishable from other pox-like illnesses, particularly smallpox and chickenpox. Although the natural animal reservoir of the monkeypox virus is unknown, rodents are the probable source of its introduction into the USA. A clear understanding of the virulence and transmissibility of human monkeypox has been limited by inconsistencies in epidemiological investigations. Monkeypox is the most important orthopoxvirus infection in human beings since the eradication of smallpox in the 1970s. There is currently no proven treatment for human monkeypox, and questions about its potential as an agent of bioterrorism persist.

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473309903008569.pdf

Human monkeypox: an emerging zoonosis.

Poor-quality antimalarial drugs lead to drug resistance and inadequate treatment, which pose an urgent threat to vulnerable populations and jeopardise progress and investments in combating malaria. Emergence of artemisinin resistance or tolerance in Plasmodium falciparum on the Thailand-Cambodia border makes protection of the effectiveness of the drug supply imperative. We reviewed published and unpublished studies reporting chemical analyses and assessments of packaging of antimalarial drugs. Of 1437 samples of drugs in five classes from seven countries in southeast Asia, 497 (35%) failed chemical analysis, 423 (46%) of 919 failed packaging analysis, and 450 (36%) of 1260 were classified as falsified. In 21 surveys of drugs from six classes from 21 countries in sub-Saharan Africa, 796 (35%) of 2297 failed chemical analysis, 28 (36%) of 77 failed packaging analysis, and 79 (20%) of 389 were classified as falsified. Data were insufficient to identify the frequency of substandard (products resulting from poor manufacturing) antimalarial drugs, and packaging analysis data were scarce. Concurrent interventions and a multifaceted approach are needed to define and eliminate criminal production, distribution, and poor manufacturing of antimalarial drugs. Empowering of national medicine regulatory authorities to protect the global drug supply is more important than ever.

https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(12)70064-6.pdf

Poor-quality antimalarial drugs in southeast Asia and sub-Saharan Africa

Acknowledgements Foreword Introduction I BACKGROUND Long-term astrophysical processes Evolution theory and the future of humanity Millenial tendencies in responses to apocalyptic threats Cognitive biases potentially affecting judgement of global risks Observation selection effects and global catastrophic risks Systems-based risk analysis Catastrophes and insurance Public policy towards catastrophe II RISKS FROM NATURE Super-volcanism and other geophysical processes of catastrophic import Hazards from comets and asteroids Influence of Supernovae, gamma-ray bursts, solar flares, and cosmic rays on the terrestrial environment III RISKS FROM UNINTENDED CONSEQUENCES Climate change and global risk Plagues and pandemics: past, present, and future Artificial Intelligence as a positive and negative factor in global risk Big troubles, imagined and real IV RISKS FROM HOSTILE ACTS Catastrophe, social collapse, and and human extinction The continuing threat of nuclear war Catastrophic nuclear terrorism: a preventable peril Biotechnology and biosecurity Nanotechnology as global catastrophic risk The totalitarian threat Author's biographies Index

Global Catastrophic Risks

Extraintestinal pathogenic Escherichia coli (ExPEC) possesses virulence traits that allow it to invade, colonize, and induce disease in bodily sites outside of the gastrointestinal tract. Human diseases caused by ExPEC include urinary tract infections, neonatal meningitis, sepsis, pneumonia, surgical site infections, as well as infections in other extraintestinal locations. ExPEC-induced diseases represent a large burden in terms of medical costs and productivity losses. In addition to human illnesses, ExPEC strains also cause extraintestinal infections in domestic animals and pets. A commonality of virulence factors has been demonstrated between human and animal ExPEC, suggesting that the organisms are zoonotic pathogens. ExPEC strains have been isolated from food products, in particular from raw meats and poultry, indicating that these organisms potentially represent a new class of foodborne pathogens. This review discusses various aspects of ExPEC, including its presence in food products, in animals used for food or as companion pets; the diseases ExPEC can cause; and the virulence factors and virulence mechanisms that cause disease.

Marilynn Larkin

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