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. 2017 Sep 14:75:54.
doi: 10.1186/s13690-017-0223-7. eCollection 2017.

Pandemics, public health emergencies and antimicrobial resistance - putting the threat in an epidemiologic and risk analysis context

C Raina MacIntyre  1   2 , Chau Minh Bui  1
Affiliations

Pandemics, public health emergencies and antimicrobial resistance - putting the threat in an epidemiologic and risk analysis context

C Raina MacIntyre et al. Arch Public Health. .

Abstract

Public health messaging about antimicrobial resistance (AMR) sometimes conveys the problem as an epidemic. We outline why AMR is a serious endemic problem manifested in hospital and community-acquired infections. AMR is not an epidemic condition, but may complicate epidemics, which are characterised by sudden societal impact due to rapid rise in cases over a short timescale. Influenza, which causes direct viral effects, or secondary bacterial complications is the most likely cause of an epidemic or pandemic where AMR may be a problem. We discuss other possible causes of a pandemic with AMR, and present a risk assessment formula to estimate the impact of AMR during a pandemic. Finally, we flag the potential impact of genetic engineering of pathogens on global risk and how this could radically change the epidemiology of AMR as we know it. Understanding the epidemiology of AMR is key to successfully addressing the problem. AMR is an endemic condition but can play a role in epidemics or pandemics, and we present a risk analysis method for assessing the impact of AMR in a pandemic.

Keywords: AMR; Antimicrobial resistance; Bacterial infections; Disease burden; Genetic engineered pathogens; Influenza; Pandemic; Public health; Risk; Superbug.

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Conflict of interest statement

Authors’ information

Professor MacIntyre is a Professor of Infectious Diseases epidemiology and Head of the School of Public Health and Community Medicine, UNSW Medicine. She is also an adjunct professor at Arizona State University. She runs a highly strategic research program spanning epidemiology, vaccinology, mathematical modelling, PPE and clinical trials in infectious diseases. Chau Bui is doing a PhD on Avian Influenza epidemiology and has completed a Bachelor of Veterinary Science from USYD (2012) and a Masters of International Public Health from UNSW (2015).

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The paper arose from a commissioned piece of work by AIA life insurance.

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Figures

Fig. 1
Fig. 1
Patterns of disease
Fig. 2
Fig. 2
Impact of AMR on a pandemic
See this image and copyright information in PMC

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References

    1. World Health Organization. Blueprint for R&D preparedness and response to public health emergencies due to highly infectious pathogens - Workshop on prioritization of pathogens (8–9 December 2015). http://www.who.int/medicines/ebola-treatment/WHO-list-of-top-emerging-di.... Accessed 29 Nov 2016.
    1. Chrichton D. The Risk Triangle. In: Natural Disaster Management. edn. Edited by Ingleton J. Tudor Rose, London; 1999.
    1. Joseph C, Togawa Y, Shindo N. Bacterial and viral infections associated with influenza. Influenza Other Respir Viruses. 2013;7(Suppl 2):105–113. doi: 10.1111/irv.12089. - DOI - PMC - PubMed
    1. Papanicolaou GA. Severe influenza and S. Aureus pneumonia: for whom the bell tolls? Virulence. 2013;4:666–668. doi: 10.4161/viru.26957. - DOI - PMC - PubMed
    1. Memoli MJ, Morens DM, Taubenberger JK. Pandemic and seasonal influenza: therapeutic challenges. Drug Discov Today. 2008;13:590–595. doi: 10.1016/j.drudis.2008.03.024. - DOI - PMC - PubMed

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