“Endemicity and the Environment”

MDR Tuberculosis is highly prevalent in countries such as India, South Africa and Ukraine, but virtually non-existent in others.

Metallo-beta-lactamases, such NDM1, are imported into New Zealand, but so far have not become endemic.

Measles is a major killer in sub-Saharan Africa but reduced to the odd sporadic case in other parts of the world.

Just because a micro-organism is successful in one environment, it does not mean it will thrive in another. Like everything else in life, they look for niches.

…and when I talk about environment, I am thinking about everything from Infection Control, Antibiotic Stewardship, Public Health infrastructure, vaccination coverage, even population density.

I think as a microbiologist, using the expertise and experience that has been acquired, you get a feel about how an emerging disease would “cope” in your local environment.

Which leads us onto the major topic of the moment, Ebola. Ebola transmission is currently intense in Liberia, Sierra Leone & Guinea, but struggles to gain a foothold in other countries, despite the importation of sporadic cases.

I think NZ has an environment that Ebola would struggle to become endemic in, although as with other countries, we are always at risk of imported cases and even secondary infections, as experienced in the USA.

However that is not the whole story. Zoonotic micro-organisms, and particularly those ones that are relatively naive in the human host (such as Ebola), have the ability to adapt and change, and make fools of us all….


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