Week 3 Topic discussion 1

[Saranath]

Could you list the disease outbreaks that have been declared as the Public Health Emergency of International Concern (PHEIC)?

Why do these outbreaks raise such concerns?

In your opinion, is there a disease or condition that may potentially lead to PHEIC in the future? Why?

[Sri Budi Fajariyan]

Six events were declared PHEIC between 2007 and 2020: the 2009 H1N1 influenza pandemic, Ebola (West African outbreak 2013-2015, outbreak in Democratic Republic of Congo 2018-2020), poliomyelitis (2014 to present), Zika (2016) and COVID- 19 (2020 to present)

A PHEIC is defined in the IHR (2005) as, “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”. This definition implies a situation that is:
serious, sudden, unusual or unexpected;
carries implications for public health beyond the affected State’s national border; and
may require immediate international action.

future events that can become a PHEIC according to Says are catastrophic due to climate change

[TARO KITA]

Regarding a disease or condition that could lead to PHEIC, although it’s very difficult to predict, a quick search on the web shows increased communication with wildlife may increase the likelihood of cross-species disease transmission that could lead to pandemic.

[Navin Prasai]

PHEIC stands for Public Health Emergency of International Concern which includes the reporting of not only infectious diseases but also the chemical agents, radioactive substances to WHO within 24 hours from which there is public harm and spread of diseases internationally. Most PHEIC diseases are notifiable diseases like Ebola, Zika virus, polio, swine flu, and the recent ongoing COVID-19. All these diseases impacted people’s lives internationally and for the mitigation, control and prevention needed teamwork and effort from different countries.

[Auswin Rojanasumapong]

List of the diseases outbreak that has occurred that the International Health Regulations Emergency Committees were convened, but only the events with “*” have been declared as the Public Health Emergency of International Concern (PHEIC)
– Influenza A (H1N1) pandemic (2009–2010)*
– The Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak (2013–2015)
– The international spread of poliovirus (2014-ongoing in 2020)*
– The West Africa Ebola Virus Disease (EVD) outbreak (2014–2016)*
– The Zika virus outbreak (2016)*
– Yellow fever (2016)
– The 9th EVD outbreak in the Equateur province of DRC (2018)
– The 10th EVD outbreak in DRC which began in the North Kivu and Ituri provinces (2018-ongoing in 2020)*
– On-going epidemic of COVID-19*

The reasons of these outbreaks raise such concerns, refers to PHEIC declaration criteria, are
– Constitutes of an extraordinary event
– Public health risk to other states via international spreading
– Requires a coordinated international response

Other important criteria that some events did not have are
– Sustained community transmission
– Gaps in knowledge due to a novel agent or limited response experience

In my opinion, a condition that may potentially lead to PHEIC in the future might be a known infectious disease caused by climate change that helps vectors to reproduce or transmit the diseases easier, for example, climate change can lead to change in weather that bugs or mosquitoes prefer in reproducing and the infection might occur in an area that has no history of this disease before.

[chanapong]

List of the disease outbreaks that have been declared as PHEIC
-2009: The Influenza A (H1N1) pandemic
-2014: poliomyelitis
-2014: outbreak of Ebola in Western Africa
-2018–2020: Ebola epidemic in the Democratic Republic of Congo
-2015–2016: Zika virus epidemic
-2020: COVID-19 pandemic

These outbreaks raise concerns because they are extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response. The situation is serious, sudden, unusual, or unexpected which carries implications for public health beyond the affected state’s national border and may require immediate international action.

Conditions that can lead to PHEIC in the future are global warming, biological terrorism, and advanced genetic engineering.

[Arwin Jerome Manalo Onda]

I remember how I was confused during the A(H1N1) outbreak in 2009. I was in high school that time and I didn’t know how grave the situation was. All I can remember is that, it is a flu but more contagious and severe. Now that I’ve taken some epidemiology subjects, it must have been worrisome for people before who had full awareness of the disease.

[Auswin Rojanasumapong]

Thank you for sharing. I agree with you that biological terrorism can lead to future PHEIC in the future. COVID-19 pandemic situation shows us that how bad it can be if there is an outbreak of serious diseases, and terrorists can threaten the people with these biological attacks, too.

[Napisa Freya Sawamiphak]

Thank you for sharing. I agree for global warming and climate change that could lead to new unknown pathogen and advanced genetic engineering is also interesting.

[Arwin Jerome Manalo Onda]

My classmates have already given the famous examples of Public Health Emergencies of International Concern. The most notable ones I can remember are SARS (2004), MERS-CoV (2012), Ebola (2014), and the ongoing COVID-19 pandemic (2019-present).

These outbreaks raise concern since they disrupt normal day-to-day living, adversely affects health, overwhelm the healthcare system (eventually increased utilization rates of resources), and are easily transmitted from person-to-person. The cooperation and action of every country is required to implement preventive measures to contain and limit the spread of the disease.

I believe that there will be next incidence of PHEICs. There are many organisms in Earth that are yet to be discovered and characterized. Based on the recent outbreaks of communicable diseases, a disease or condition that can cause another PHEIC can be characterized by the following:
– Ability to transmit and infect humans, especially those that can evade the immune system and can cause severe sickness
– High transmission rate (eg, spread through respiratory droplets or aerosolization)
– Found in reservoirs not yet discovered/studied/characterized by scientists
– Short incubation period
– Fastly mutating

[Karina Dian Lestari]

There are six disease outbreaks that have been declared as PHEIC:
– H1N1 (2009-2010)
– Poliovirus (2014-present)
– Ebola (2014-2016) in West Africa
– Zika (2016)
– Ebola (2019-2020) in the Democratic Republic of Congo
– COVID-19 (2020-present)
These disease outbreaks were declared PHEIC because they checked all the WHO decision algorithms: the public health impact is serious, the event is unusual/unexpected, there was a significant risk of international spread, and significant risk for international travel or trade restriction.

There are also several disease outbreaks that were not declared PHEIC such as MERS (2013) in Saudi Arabia, the resurgence of measles in the Americas, and yellow fever in Angola (2016). These diseases were not declared because while they were unusual serious public health problems, the spread of infection is limited and can be prevented by vaccination.
Any emerging virus (for example new type of human influenza) potentially lead to PHEIC because it could rapidly spread and could harm human mobilization.

[Napisa Freya Sawamiphak]

There are six PHEIC declarations: 2009 H1N1, 2014 polio declaration, 2014 outbreak of Ebola, 2015–16 Zika virus epidemic, 2018–20 Ebola epidemic in Congo and 2020 COVID-19 pandemic. The outbreaks raise concern because they are unusual event that could affect the people lives, public health and healthcare system. It also requires the rapid response and active plan in order to control the disease spreading.

In my opinion, any condition that have affect people in the large circle may potentially lead to PHEIC in the future. For example, the newly infectious disease. I also agree with several comments above that climate change can lead to new disease or unknown pathogen.

[Theekhathat Huapai]

Some diseases have been declared as PHEIC
– 2009 H1N1 influenza
– Ebola outbreak
– Zika virus outbreak
– Polio outbreak
These diseases have been raised concern because they have four characteristics of PHEIC
– Is the public health impact of the event serious?
– Is the event unusual or unexpected?
– Is there a significant risk for international spread?
– Is there a significant risk for international travel or trade restrictions?
In my opinion, Future PHEIC may be a disease facilitated by global warmings, such as newly emerging tropical diseases or neglected tropical diseases.

[Ashaya.i]

There are six events were declared PHEIC;
– 2009 H1N1 influenza pandemic
– Ebola (West African outbreak 2013-2015)
– Ebola (Democratic Republic of Congo 2018-2020)
– Poliomyelitis (2014 to present)
– Zika (2016)
– COVID-19 (2020 to present)

All these outbreaks raise the concerns because this public health event causes serious impact, the event are unusual or unexpected, it has a significant risk, it can internationally spread and effects the international travel and trade restriction.

In my opinion, any emerging and re-emerging infectious disease may lead to PHEIC in the future because nowadays, there are many factor that make the pathogens can mutate and reproduction easily. Moreover, it tends to have more rapid transmission than before because of the technological and transportation development.

[Tossapol Prapassaro]

There are six events of PHEIC that are a formal declaration by WHO, which everybody already mentions ( H1N1 swine flu, polio, Ebola, Zika, Kivu Ebola, COVID-19 ).

These outbreaks had raised concerns because of their impact not only on public health locally but also the public health worldwide, so that it may need immediate international action.

I believe that the disease that might be potentially lead to PHEIC in the future would be the condition that very contagious, especially air-borne transmitted disease like a new strain of influenza virus or coronavirus.

[Saranath]

Almost all PHEIC events are due to virus. As the nature of virus, the mutation can occur very frequently. I also agree that other events due to environmental change would be possible to cause PHEIC.

Thanks everyone for sharing.

[Anawat ratchatorn]

These are six disease declared as PHEIC Since 2009
2009 H1N1 (or swine flu)
2014 polio declaration
2014 outbreak of Ebola in Western Africa
2015–16 Zika virus epidemic
2018–20 Kivu Ebola epidemic
2019-now COVID-19 pandemic

These disease were concerned as PHEIC because it might cause event that needed collaboration in international level to manage and control the disease.

In my opinion, climate change and terrorism are major concerns to cause PHEIC.
– Climate change may lead to an outbreak that caused by unknown biological agent, So it might be very difficult to deal with it. Climate change can also lead to changes in animal behavior that might cause other problems.
– Global politics are quite stressful now. It might be some terrorism that use biological weapon to hurt people.

[Pisit Saiwangjit]

The International Health Regulations (IHR) had declared Public Health Emergency of International Concern (PHEIC) of six events since 2007, including H1N1 influenza, Ebola, poliomyelitis, Zika, and COVID-19.[1]

The sudden outbreak of these diseases raises concerns in such an extent because they potentially pose a serious threat in international level and require a international collaboration to response.

In my point of view, bioterrorism can be the cause of the PHEIC, such as smallpox. Smallpox virus DNA is available in the DNA library so it potentially has a chance to be used in in a biological attack.

Reference
[1] Wilder-Smith A, Osman S. Public health emergencies of international concern: a historic overview. J Travel Med. 2020;27(8).

[Author]

Posts