Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
An emerging infectious disease (EID) is an infectious disease whose incidence has increased in the past 20 years and could increase in the near future. Emerging infections account for at least 12% of all human pathogens. EIDs are caused by newly identified species or strains (e.g. Severe acute respiratory syndrome, HIV/AIDS) that may have evolved from a known infection (e.g. influenza) or spread to a new population (e.g. West Nile fever) or to an area undergoing ecologic transformation (e.g. Lyme disease), or be "reemerging" infections, like drug resistant tuberculosis. Nosocomial (hospital-acquired) infections, such as methicillin-resistant Staphylococcus aureus are emerging in hospitals, and extremely problematic in that they are resistant to many antibiotics. Of growing concern are adverse synergistic interactions between emerging diseases and other infectious and non-infectious conditions leading to the development of novel syndemics. Many emerging diseases are zoonotic - an animal reservoir incubates the organism, with only occasional transmission into human populations.
The symptoms of an infection depend on the type of disease. Some signs of infection affect the whole body generally, such as fatigue, loss of appetite, weight loss, fevers, night sweats, chills, aches and pains. Others are specific to individual body parts, such as skin rashes, coughing, or a runny nose.
In certain cases, infectious diseases may be asymptomatic for much or even all of their course in a given host. In the latter case, the disease may only be defined as a "disease" (which by definition means an illness) in hosts who secondarily become ill after contact with an asymptomatic carrier. An infection is not synonymous with an infectious disease, as some infections do not cause illness in a host.
Infections can be classified by the anatomic location or organ system infected, including:
- Urinary tract infection
- Skin infection
- Respiratory tract infection
- Odontogenic infection (an infection that originates within a tooth or in the closely surrounding tissues)
- Vaginal infections
- Intra-amniotic infection
In addition, locations of inflammation where infection is the most common cause include pneumonia, meningitis and salpingitis.
Zoonoses are infectious diseases of animals (usually vertebrates) that can naturally be transmitted to humans.
Major modern diseases such as Ebola virus disease and salmonellosis are zoonoses. HIV was a zoonotic disease transmitted to humans in the early part of the 20th century, though it has now evolved to a separate human-only disease. Most strains of influenza that infect humans are human diseases, although many strains of swine and bird flu are zoonoses; these viruses occasionally recombine with human strains of the flu and can cause pandemics such as the 1918 Spanish flu or the 2009 swine flu. "Taenia solium" infection is one of the neglected tropical diseases with public health and veterinary concern in endemic regions. Zoonoses can be caused by a range of disease pathogens such as viruses, bacteria, fungi and parasites; of 1,415 pathogens known to infect humans, 61% were zoonotic. Most human diseases originated in animals; however, only diseases that routinely involve animal to human transmission, like rabies, are considered direct zoonosis.
Zoonoses have different modes of transmission. In direct zoonosis the disease is directly transmitted from animals to humans through media such as air (influenza) or through bites and saliva (rabies). In contrast, transmission can also occur via an intermediate species (referred to as a vector), which carry the disease pathogen without getting infected. When humans infect animals, it is called reverse zoonosis or anthroponosis. The term is from Greek: ζῷον "zoon" "animal" and νόσος "nosos" "sickness".
Zoonotic transmission can occur in any context in which there is companionistic (pets), economic (farming, etc.), predatory (hunting, butchering or consuming wild game) or research contact with or consumption of animals, animal products, or animal derivatives (vaccines, etc.).
The strongest evidence linking EBV and cancer formation is found in Burkitt's lymphoma
and nasopharyngeal carcinoma. Additionally, it has been postulated to be a trigger for a subset of chronic fatigue syndrome patients as well as multiple sclerosis and other autoimmune diseases.
Burkitt's lymphoma is a type of Non-Hodgkin's lymphoma and is most common in equatorial Africa and is co-existent with the presence of malaria. Malaria infection causes reduced immune surveillance of B cells immortalized by EBV, resulting in an excessive number of B cells and an increased likelihood of an unchecked mutation. Repeated mutations can lead to loss of cell-cycle control, causing excessive proliferation observed as Burkitt's lymphoma. Burkitt's lymphoma commonly affects the jaw bone, forming a huge tumor mass. It responds quickly to chemotherapy treatment, namely cyclophosphamide, but recurrence is common.
Other B cell lymphomas arise in immunocompromised patients such as those with AIDS or who have undergone organ transplantation with associated immunosuppression (Post-Transplant Lymphoproliferative Disorder (PTLPD)). Smooth muscle tumors are also associated with the virus in malignant patients.
Nasopharyngeal carcinoma is a cancer found in the upper respiratory tract, most commonly in the nasopharynx, and is linked to the EBV virus. It is found predominantly in Southern China and Africa, due to both genetic and environmental factors. It is much more common in people of Chinese ancestry (genetic), but is also linked to the Chinese diet of a high amount of smoked fish, which contain nitrosamines, well known carcinogens (environmental).
Epstein–Barr can cause infectious mononucleosis, also known as 'glandular fever', 'mono' and 'Pfeiffer's disease'. Infectious mononucleosis is caused when a person is first exposed to the virus during or after adolescence. It is predominantly found in the developing world, and most children in the developing world are found to have already been infected by around 18 months of age. Infection of children can occur when adults mouth feed or pre-chew food before giving it to the child. EBV antibody tests turn up almost universally positive. In the United States roughly half of five-year-olds have been infected.
Porcine circoviral disease (PCVD) and Porcine circovirus associated disease (PCVAD), is a disease seen in domestic pigs. This disease causes illness in piglets, with clinical signs including progressive loss of body condition, visibly enlarged lymph nodes, difficulty in breathing, and sometimes diarrhea, pale skin, and jaundice. PCVD is very damaging to the pig-producing industry and has been reported worldwide. PCVD is caused by porcine circovirus type 2 (PCV-2).
The North American industry endorses "PCVAD" and European use "PCVD" to describe this disease.
Cat flu is the common name for a feline upper respiratory tract disease. While feline upper respiratory disease can be caused by several different pathogens, there are few symptoms that they have in common.
While Avian Flu can also infect cats, Cat flu is generally a misnomer, since it usually does not refer to an infection by an influenza virus. Instead, it is a syndrome, a term referring to the fact that patients display a number of symptoms that can be caused by one or more of the following infectious agents (pathogens):
1. Feline herpes virus causing feline viral rhinotracheitis (cat common cold, this is the disease that is closely similar to cat flu)
2. Feline calicivirus—(cat respiratory disease)
3. "Bordetella bronchiseptica"—(cat kennel cough)
4. "Chlamydophila felis"—(chlamydia)
In South Africa the term cat flu is also used to refer to Canine Parvo Virus. This is misleading, as transmission of the Canine Parvo Virus rarely involves cats.
A list of the more common and well-known diseases associated with infectious pathogens is provided and is not intended to be a complete listing.
A contagious disease is a subset category of transmissible diseases, which are transmitted to other persons, either by physical contact with the person suffering the disease, or by casual contact with their secretions or objects touched by them or airborne route among other routes.
Non-contagious infections, by contrast, usually require a special mode of transmission between persons or hosts. These include need for intermediate vector species (mosquitoes that carry malaria) or by non-casual transfer of bodily fluid (such as transfusions, needle sharing or sexual contact).
The boundary between contagious and non-contagious infectious diseases is not perfectly drawn, as illustrated classically by tuberculosis, which is clearly transmissible from person to person, but was not classically considered a contagious disease. In the present day, most sexually transmitted diseases are considered contagious, but only some of them are subject to medical isolation.
Infections associated with diseases are those that are associated with possible infectious etiologies, that meet the requirements of Koch's postulates. Other methods of causation are described by the Bradford Hill criteria and Evidence-based medicine. Koch's postulates have been altered by some epidemiologists based upon sequence-based detection of distinctive pathogenic nucleic acid sequences in tissue samples. Using this method, absolute statements are not always possible regarding causation. Since this is true, higher amounts of distinctive pathogenic nucleic acid sequences would be in those exhibiting disease compared to controls since inoculating those without the pathogen is unethical. In addition, the DNA load should drop or become lower with the resolution of the disease. The distinctive pathogenic nucleic acid sequences load should also increase upon recurrence.
Other conditions are met to establish cause or association including studies in disease transmission. This means that there should be a high disease occurrence in those carrying an pathogen, evidence of a serologicalresponse to the pathogen, and the success of vaccination prevention. Direct visualization of the pathogen, the identification of different strains, immunological responses in the host, how the infection is spread and, the combination of these should all be taken into account to determine the probability that an infectious agent is the cause of the disease. A conclusive determination of a causal role of an infectious agent for in a particular disease using Koch's postulates is desired yet this might not be possible.
The leading cause of death worldwide is cardiovascular disease, but infectious diseases are the second leading cause of death worldwide and the leading cause of death in infants and children.
An airborne disease is any disease that is caused by pathogens that can be transmitted through the air. Such diseases include many of considerable importance both in human and veterinary medicine. The relevant pathogens may be viruses, bacteria, or fungi, and they may be spread through breathing, talking, coughing, sneezing, raising of dust, spraying of liquids, toilet flushing or any activities which generates aerosol particles or droplets. Human airborne diseases do not include conditions caused by air pollution such as volatile organic compounds (VOCs), gasses and any airborne particles, though their study and prevention may help inform the science of airborne disease transmission.
Acute: The acute form is a sudden onset of the disease at full-force. Symptoms include high fever, anemia (due to the breakdown of red blood cells), weakness, swelling of the lower abdomen and legs, weak pulse, and irregular heartbeat. The horse may die suddenly.
Subacute: A slower, less severe progression of the disease. Symptoms include recurrent fever, weight loss, an enlarged spleen (felt during a rectal examination), anemia, and swelling of the lower chest, abdominal wall, penile sheath, scrotum, and legs.
Chronic: The horse tires easily and is unsuitable for work. The horse may have a recurrent fever and anemia, and may relapse to the subacute or acute form even several years after the original attack.
A horse may also not appear to have any symptoms, yet still tests positive for EIA antibodies. Such a horse can still pass on the disease. According to most veterinarians, horses diagnosed EIA positive usually do not show any sign of sickness or disease.
EIA may cause abortion in pregnant mares. This may occur at any time during the pregnancy if there is a relapse when the virus enters the blood. Most infected mares will abort, however some give birth to healthy foals. Foals are not necessarily infected.
Studies indicate that there are breeds with a tolerance to EIA.
Recent studies in Brazil on living wild horses have shown that in the Pantanal, about 30% of domesticated and about 5.5% of the wild horses are chronically infected with EIA.
Before puberty, the disease typically only produces flu-like symptoms, if any at all. When found, symptoms tend to be similar to those of common throat infections (mild pharyngitis, with or without tonsillitis).
Originally, the term referred as sometimes been broadened to encompass "any" communicable or infectious disease. Often the word can only be understood in context, where it is used to emphasise very infectious, easily transmitted, or especially severe communicable disease. They could be very dangerous.
The signs and symptoms of infectious mononucleosis vary with age.
Equine infectious anemia or equine infectious anaemia (EIA), also known by horsemen as swamp fever, is a horse disease caused by a retrovirus and transmitted by bloodsucking insects. The virus ("EIAV") is endemic in the Americas, parts of Europe, the Middle and Far East, Russia, and South Africa. The virus is a lentivirus, like human immunodeficiency virus (HIV). Like HIV, EIA can be transmitted through blood, milk, and body secretions.
Transmission is primarily through biting flies, such as the horse-fly and deer-fly. The virus survives up to 4 hours in the vector (epidemiology). Contaminated surgical equipment and recycled needles and syringes, and bits can transmit the disease. Mares can transmit the disease to their foals via the placenta.
The risk of transmitting the disease is greatest when an infected horse is ill, as the blood levels of the virus are then highest.
Brazilian hemorrhagic fever (BzHF) is an infectious disease caused by the Sabiá virus, an Arenavirus. The Sabiá virus is one of the arenoviruses from South America to cause hemorrhagic fever. It shares a common progenitor with the Junin virus, Machupo virus, Tacaribe virus, and Guanarito virus. It is an enveloped RNA virus and is highly infectious and lethal. Very little is known about this disease, but it is thought to be transmitted by the excreta of rodents.
There have only been three documented infections of the Sabiá virus, only one of which occurred naturally and the other two cases occurred in the clinical setting. The only naturally occurring case was in 1990, when a female agricultural engineer who was staying in the neighborhood of Jardim Sabiá near São Paulo, Brazil contracted the disease. She presented with hemorrhagic fever and died. Her autopsy showed liver necrosis. A virologist who was studying the woman's disease contracted the virus but survived. Ribavirin was not given in these first two cases. Four years later, in 1994, a researcher was exposed to the virus in a level 3 biohazard facility at Yale University when a centrifuge bottle cracked, leaked, and released aerosolized virus particle. He was successfully treated with ribavirin.
Ribavirin is thought to be effective in treating the illness, similar to other arenaviruses. Compared to the patients who did not receive ribavirin, the patient who was treated with it had a shorter and less severe clinical course. Symptomatic control such as fluids to address dehydration and bleeding may also be required.
The Sabiá virus is a Biosafety Level 4 pathogen.
This virus has also been implicated as a means for bioterrorism, as it can be spread through aerosols.
Coughing and rattling are common, most severe in young, such as broilers, and rapidly spreading in chickens confined or at proximity. Morbidity is 100% in non-vaccinated flocks. Mortality varies according to the virus strain (up to 60% in non-vaccinated flocks). Respiratory signs will subdue within two weeks. However, for some strains, a kidney infection may follow, causing mortality by toxemia. Younger chickens may die of tracheal occlusion by mucus (lower end) or by kidney failure. The infection may prolong in the cecal tonsils.
In laying hens, there can be transient respiratory signs, but mortality may be negligible. However, egg production drops sharply. A great percentage of produced eggs are misshapen and discolored. Many laid eggs have a thin or soft shell and poor albumen (watery), and are not marketable or proper for incubation. Normally-colored eggs, indicative of normal shells for instance in brown chickens, have a normal hatchability.
Egg yield curve may never return to normal. Milder strains may allow normal production after around eight weeks.
Infectious pancreatic necrosis (IPN) is a severe viral disease of salmonid fish. It is caused by infectious pancreatic necrosis virus, which is a member of the Birnaviridae family. This disease mainly affects young salmonids, such as trout or salmon, of less than six months, although adult fish may carry the virus without showing symptoms. Resistance to infection develops more rapidly in warmer water. It is highly contagious and found worldwide, but some regions have managed to eradicate or greatly reduce the incidence of disease. The disease is normally spread horizontally via infected water, but spread also occurs vertically. It is not a zoonosis.
Both PMWS and porcine dermatitis and nephropathy syndrome (PDNS) are associated to PCV-2. Many pigs affected by the circovirus also seem to develop secondary bacterial infections, like Glässer disease ("Haemophilus parasuis"), pulmonary pasteurellosis, colibacilosis, salmonellosis and others. Postmortem lesions occur in multiple organs, especially in lymphoid tissues and lung, giving rise to the term "multisystemic". Lesions may also affect the skin, kidney, reproductive tissue, brain, or blood vessels.
Wasting pigs is the most common sign of PMWS infection, increasing the mortality rate significantly.
Fifth disease starts with a low-grade fever, headache, rash, and cold-like symptoms, such as a runny or stuffy nose. These symptoms pass, then a few days later the rash appears. The bright red rash most commonly appears in the face, particularly the cheeks. This is a defining symptom of the infection in children (hence the name "slapped cheek disease"). Occasionally the rash will extend over the bridge of the nose or around the mouth. In addition to red cheeks, children often develop a red, lacy rash on the rest of the body, with the upper arms, torso, and legs being the most common locations. The rash typically lasts a couple of days and may itch; some cases have been known to last for several weeks. Patients are usually no longer infectious once the rash has appeared.
Teenagers and adults may present with a self-limited arthritis. It manifests in painful swelling of the joints that feels similar to arthritis. Older children and adults with fifth disease may have difficulty in walking and in bending joints such as wrists, knees, ankles, fingers, and shoulders.
The disease is usually mild, but in certain risk groups it can have serious consequences:
- In pregnant women, infection in the first trimester has been linked to hydrops fetalis, causing spontaneous miscarriage.
- In people with sickle-cell disease or other forms of chronic hemolytic anemia such as hereditary spherocytosis, infection can precipitate an aplastic crisis.
- Those who are immuno-compromised (HIV/AIDS, chemotherapy) may be at risk for complications if exposed.
Erythema infectiosum or fifth disease is one of several possible manifestations of infection by parvovirus B19.
The name "fifth disease" comes from its place on the standard list of rash-causing childhood diseases, which also includes measles (1st), scarlet fever (2nd), rubella (3rd), Dukes' disease (4th, however is no longer widely accepted as distinct) and roseola (6th).
The U.S. Centers for Disease Control and Prevention (CDC) publishes a journal "Emerging Infectious Diseases" that identifies the following factors contributing to disease emergence:
- Microbial adaption; e.g. genetic drift and genetic shift in Influenza A
- Changing human susceptibility; e.g. mass immunocompromisation with HIV/AIDS
- Climate and weather; e.g. diseases with zoonotic vectors such as West Nile Disease (transmitted by mosquitoes) are moving further from the tropics as the climate warms
- Change in human demographics and trade; e.g. rapid travel enabled SARS to rapidly propagate around the globe
- Economic development; e.g. use of antibiotics to increase meat yield of farmed cows leads to antibiotic resistance
- Breakdown of public health; e.g. the current situation in Zimbabwe
- Poverty and social inequality; e.g. tuberculosis is primarily a problem in low-income areas
- War and famine
- Bioterrorism; e.g. 2001 Anthrax attacks
- Dam and irrigation system construction; e.g. malaria and other mosquito borne diseases