Epidemics I

“If history is our guide, we can assume that the battle between the intellect and will of the human species and the extraordinary adaptability of microbes will be never-ending.” (1)

Despite all the remarkable technological breakthroughs that we have made over the past few decades, the threat from infectious diseases has significantly accelerated. In this course, we will learn why this is the case by looking at the fundamental scientific principles underlying epidemics and the public health actions behind their prevention and control in the 21st century.

This is the first (origins of novel pathogens) of the four courses, covers these topics:

• Epidemics: Past, Present and Future
• Discussion on Ebola and Zika Outbreak, and Supplementary Module on Next Generation Informatics for Global Health
• Ecology, Evolution and Emergence of Infectious Diseases
• Medical Detective: Bug Hunting in Epidemics

如果历史是我们的向导，我们可以认为人类的智慧和意志与微生物种惊人的适应性之间的斗争将永远持续下去。”(1)

尽管过去的几十年间我们在科技领域取得了令人瞩目的突破，可是传染病对人类的威胁却显著增加。本课程将通过学习流行病学的基础科学原理以及预防与控制流行病的公共卫生措施，对上述现象予以阐释。

这是四個课程中的第一个（新型病原體的起源）：

• 流行病：过去、现在和未来
• 讨论埃博拉和寨卡疫情的爆发，以及全球卫生信息学的补充单元
• 传染病的生态、演变和形成
• 医学侦探：追踪流行病的病原体

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(1) Fauci AS, Touchette NA, Folkers GK. Emerging Infectious Diseases: a 10-Year Perspective from the National Institute of Allergy and Infectious Diseases. Emerg Infect Dis 2005 Apr; 11(4):519-25.

Week 1: Epidemics: Past, Present and Future

• What is epidemic?
• How epidemics of infectious disease arise from historic transitions?
• Why novel emerging infectious diseases continue to arise?
• Emerging infectious disease, re-emerging infectious disease and zoonosis
• Factors leading to infectious disease emergence and re-emergence (microbial factors, climate and weather, changes in ecosystem and land use, human demographics, migrations and behaviour, international travel and commerce, technology, industry and intensive animal husbandry, breakdown in public health due to poverty, wars, natural disasters, and bioterrorism)
• Regions with higher risk of future emerging infectious disease and estimated economic costs of emerging infectious disease

Week 2: Discussion on Ebola and Zika Outbreak, and Supplementary Module on Next Generation Informatics for Global Health

• How to prepare for the next epidemic?
• How to allocate our resources among our fights against different pathogens?
• How should we channel our resources?
• Vaccines
• Antimicrobial resistance
• Supplementary module: towards digital pathogen surveillance: a very bumpy, winding road

Week 3: Ecology, Evolution and Emergence of Infectious Diseases

• Ecology of infectious diseases
• Emerging infectious diseases at the human-animal interface
• What is phylogenetic tree?
• How to use phylogenetic trees to study an epidemic of infectious disease?
• Emergence of highly pathogenic H5N1 Avian Influenza virus in Asia
• Emergence of the H7N9 Influenza A virus in china
• Swine Influenza and the 2009 pandemic H1N1

Week 4: Discussion on Ebola Outbreak, and Supplementary Module on Next Generation Informatics for Global Health

• Ebola in the wider context
• Border controls
• Is stopping bushmeat the answer?
• How should we use experimental treatments and vaccines?
• Should we centralise care and enforce lockdowns?
• Will Ebola become airborne?
• Will Ebola be become a huge human pandemic like HIV?
• Supplementary module: global variation in risk of influenza virus emergence

Week 5: Medical Detective: Bug Hunting in Epidemics

• Discovery of a novel microbe: first suspicion
• Finding the cause of interstitial pneumonia
• The identification of the novel virus associated with this infectious pneumonia
• Proof of association & causation: is SARS coronavirus really the cause of SARS?
• Control of emerging infections depends on: control at the source
• Alert: coronavirus as the cause of emerging infectious diseases!
• Supplementary module: using genetic data at multiple scales to understand constraints on viral evolution