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. 2013 Jun 24;368(1623):20120137.
doi: 10.1098/rstb.2012.0137. Print 2013 Aug 5.

Towards the endgame and beyond: complexities and challenges for the elimination of infectious diseases

Petra Klepac  1 , C Jessica E Metcalf, Angela R McLean, Katie Hampson
Affiliations

Towards the endgame and beyond: complexities and challenges for the elimination of infectious diseases

Petra Klepac et al. Philos Trans R Soc Lond B Biol Sci. .

Abstract

Successful control measures have interrupted the local transmission of human infectious diseases such as measles, malaria and polio, and saved and improved billions of lives. Similarly, control efforts have massively reduced the incidence of many infectious diseases of animals, such as rabies and rinderpest, with positive benefits for human health and livelihoods across the globe. However, disease elimination has proven an elusive goal, with only one human and one animal pathogen globally eradicated. As elimination targets expand to regional and even global levels, hurdles may emerge within the endgame when infections are circulating at very low levels, turning the last mile of these public health marathons into the longest mile. In this theme issue, we bring together recurring challenges that emerge as we move towards elimination, highlighting the unanticipated consequences of particular ecologies and pathologies of infection, and approaches to their management.

Keywords: immune escape; susceptible build-up; vaccination coverage; vaccine refusal.

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Figures

Figure 1.
Figure 1.
The number of countries endemic for (a) smallpox, (b) rinderpest and (c) polio. Vertical line indicates the beginning of global eradication initiative for respective diseases. (Online version in colour.)
Figure 2.
Figure 2.
Smallpox and polio elimination in the USA—the total number of cases. (a) Total reported number of smallpox and polio cases per year in the USA. (b) Epidemic tail for smallpox and polio in the USA in years. Epidemic tail—years with less than 200 reported cases. (Online version in colour.)
See this image and copyright information in PMC

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