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Emerging diseases refer to the newly identified pathogens that have been recognized in the past few decades that lead to a new manifestation of diseases. They could also be already existing diseases that are accelerating in terms of geographic range and incidence. Factors that lead to the emergence of these diseases vary from ecological to demographic. People become more susceptible to previously unfamiliar microbes or the natural host. There are two important stages or processes where emergent diseases undergo. The agent first finds the means to get into the host and then its adoption process where further dissemination takes place (Morse).
AIDS (Acquired Immune Deficiency Syndrome) is one of the emergent diseases of our times as very little about it was known before 1980. The term first appeared in the Morbidity and Mortality Weekly Report (MMWR) of the Centers for Disease Control (CDC) in 1982 to describe “… a disease, at least moderately predictive of a defect in cell-mediated immunity, occurring with no known cause for diminished resistance to that disease” (CDC 508). Nowadays it refers to a “collection of symptoms and infections resulting from the specific damage to the immune system caused by the human immunodeficiency (HIV) in humans and similar viruses in other species (SIV, FIV, etc.)” (CDC 509).
The first case of the disease was first reported in June 1981, when five homosexual men in Los Angeles were recorded to have a cluster of Pneumocystis carinii Pneumonia.
Four of the earliest known instances of HIV infection are:
- a sailor from Manchester who died of an AIDS-like illness in 1959, though the authenticity of this case has not been confirmed (Zhu et al.);
- a plasma sample was taken in 1959 from an adult African male (Zhu et al.);
- tissue samples from a St. Louis teenager who died of AIDS in 1969 (Kolata);
- Tissue samples from a young Norwegian sailor who was infected with HIV probably in Cameroon in 1961-2 (Hooper).
There are two types of HIV, that is HIV I and HIV II. HIV II was first recognized in Africa and was initially known as the “slim syndrome”. The origin of HIV I remains unknown up to the present day. It is argued that may be the HIV II could have been contained if surveillance had been done earlier and specimen collected. This would have established the causes of the disease and help in retaining it. Maybe the epidemiologists could have come up with measures to curb it and lives could have been saved (Global Microbial Threats).
HIV I and HIV II differ in their transmission power: HIV I is more easily transmitted than HIV II. HIV I serves as a source for numerous HIV infections throughout the world, whereas HIV II is common in West Africa only.
The symptoms that AIDS patients develop are caused by bacteria, viruses, fungi, and parasites controlled by the immune system elements damaged by HIV. People with AIDS are at risk of developing various cancers; they suffer from systematic symptoms of inflection like weight loss, weakness, fevers, sweats.
AIDS patients often develop opportunistic infections like pulmonary infections, gastrointestinal infections, neurological diseases, tumors, malignancies, and others that present with non-specific symptoms.
For quite a long period (up to the 80-s) people who were treated for these diseases were not tested for HIV, and, therefore, they could not verify whether they were actually suffering from HIV. Such people could transmit the disease to others. During the incubation period that could last for several years, people infected others.
Since 1985 when the first HIV test was implemented to screen blood, the world is happy to celebrate the annual National HIV Testing Days with massive campaigns and testing events carried out throughout the country where the celebration takes place. Various organizations are in charge of the HIV campaigns aimed at encouraging people’s personal control and responsibility for their own health.
HIV testing “means testing for the HIV antibody as opposed to viral load or other testing.” (Scott 25) A testing procedure starts with a highly sensitive screening test, most commonly it is an ELISA (enzyme-linked immunosorbent assay). When there are no antibodies detected by means of this test, the result is “nonreactive” or “negative”. In case when antibodies are detected, more tests are required: an additional ELISA and a more specific confirmatory test – a Western blot, to test once more the presence of antibodies.
People undergo HIV testing to find out whether they are infected or not. Some people are tested as a part of their medical care, others do this when applying for insurance or employment. Some states in the USA oblige federal prisoners, immigrants, some federal employees, pregnant women to face HIV testing which has become an effecting tool for preventing the horrific disease.
To be effective in preventing the disease we should be aware of the factors that contribute to its spread. We will start analyzing these factors from the least obvious at first sight factor – the environment. Though nowadays society has learned to pay attention to the environmental problems, people often fail to realize that the HIV virus is a part of the ecological framework of their lives. Marie Muir in her research The Environmental Context of Aids (1991) claims:
AIDS is an infectious disease, the end stage of a series of events begun by a virus. Infectious disease is a combination of agents (HIV), host (people), and environment. We must not forget that as human beings we, too, are still very much a part of nature; we are a natural organism shaped not only by biology but also by culture. Our environment is not only physical and natural (one part of the environmental equation) but also social, cultural, economic, and political. Because we in North America have been able to alter our environment in such a way as to decrease the threat of many diseases, we have tended to forget the broader definition of environment and its effects on health (13).
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Diseases and health are closely connected to the environment and HIV is not an exception. The virus flourishes where the environmental conditions benefit its methods of transmission (through blood and blood products) and reproduction (in the cellular machinery of the human immune system). Muir (1991) states that the HIV virus
has found its ecological niche in a host whose activities (sexuality, blood transfusion, injection drug use) and environmental conditions (sexually transmitted disease, gay liberation, legal prohibitions against drug use, unsafe sexual practices, international travel) promote its genetic quest for continuance (45).
In this sense, the environment is seen as a combination of factors that affect human health. If we consider environmental factors in their ordinary sense, we should speak of increased intrusion into tropical forests. As the population grows, settlement, mining, farming, and tourism movements reinforce. These movements expose human beings to microbes that could be in infected animals, some of which can cause human diseases. HIV II is believed to have been transmitted to human beings from nonhuman primates. With reduced surveillance and research, it was difficult to contain the virus (Global Microbial Threats).
Changes in human demographics are another factor contributing to the spread of HIV AIDS. With rural urbanization HIV that once appeared in isolated rural areas is now transmitted to larger populations. The newly introduced infection spreads further from the city (Morse).
Another aspect of demographic factor is rapid population growth results in many people living in poor and crowded urban areas. Often the standards of living there leave much to be desired. The urban areas are characterized by “urban decay” which creates a suitable environment for the spread of HIV AIDS. Poverty subjects people to activities like prostitution which promotes the spread of the virus (Global Microbial Threats).
Military conflicts are one more possible reason that causes people to migrate or shift between or within countries in search of peace. These movements may create a channel by which the virus is transported to new geographical areas. Therefore, as civil war and other conflicts emerge among nations, infectious diseases and AIDS, in particular, find a route by which they can travel to new regions. Migration allows infections in isolated areas which could have remained obscure and localized to reach more people.
Changes in human behavior have also exposed people to the virus. It is common knowledge that sex and intravenous drug use have contributed to the emergence of HIV. People have adapted a care-free attitude which increases the risk of infection. Frequenting entertainment places, drinking liquors, having sex without using condoms are common throughout the world. Such factors as sexually arising mass media, increased number of sex-related services of various types and constantly changing lifestyles also led to the lack of risky behaviors awareness.
As people’s knowledge of human behavior is far from answering all possible questions that arise, AIDS prevention in this area presents a significant difficulty. Motivating appropriate individual conduct and constructive action remains one of the main concerns of the institutions striving for AIDS prevention. Effective actions in the sphere of motivating human behavior, both locally and on a larger scale, are essential for controlling AIDS.
More factors that lead to AIDS dissemination are stigmatization and discrimination. They keep people away from being tested and thus acquiring important assistance. Due to the lack of knowledge that one is infected the transmission rates remain high. Those who are tested shy away from disclosing their status for fear that they will be discriminated against in society. They live hidden lifestyles that hinder the effective acquisition of needed resources. At the end of the day, resources remain inaccessible in areas where they are most needed.
Developing countries may lack the resources to cater for the care and treatment of infected people. Adequate training needs to be done to educate people on measures that should be put in place to reduce the spread. Comprehensive care and antiretroviral (ARV) provision could be beyond the affordability of most developing countries that have to rely on funds from the developed countries. Developed countries cannot afford effective and efficient catering for all developing countries, thus, the spread of the virus keeps rising (Garrett 334).
Weak surveillance systems are another factor that contributes to the spread of the virus. A strong surveillance system would ensure that areas in more need of attention are addressed. It is easier to establish the causes of trends of various places and this allows for effective measures to curb or reduce the infection rates. Effective surveillance also paves way for the efficient use of minimal resources.
Governments need to support the prevention and care programs to reach out to the infected and those at risk of infection. Collaborative measures where all countries play their part in eradicating emergent disease will be appropriate. The maximum use of already existing resources should be practiced. Countries should also identify regional and international resources to solve the problem of inadequate resources (Global Microbial Threats).
All countries should put in place effective, inclusive, and collaborative research so that the virus spread can be contained. Collecting data at regional levels down to the local community level will reduce the spread. African countries have reported more frequency of infection and Africa has a large population living with the virus. World Health Organization (WHO) estimates that the number of people living with the virus in sub-Saharan Africa is 68% of the global total (WHO).
Health care systems in most African countries adopt curative rather than preventive measures contributing to the high spread rates of the virus. Eventually, curative care provision is more expensive than preventive measures. These countries also lacked the appropriate infrastructure to effectively solve the pandemic. Inadequate resources lead to the increased spread of the virus.
In most African countries, the poverty levels are high and this results in poor nutrition. Poor nutrition results in higher susceptibility to opportunistic diseases and reduces the effective chances of the disease treatment. The rates of deaths from full-blown AIDS are higher in these countries.
Reliable public health information is a foundation to ensure that effective response measures are put in place to curb the HIV spread (WHO). Accurate information on estimates and trends is important in designing and evaluating programs, especially on prevention. Both individual and collaborative actions are required to stop the spread of AIDS. This health issue has become a global one. Urgent actions are needed to stop the plague of the 20th century.
“Global Microbial Threats in the 1990s.” 2008. Web.
CDC. “Update on Acquired Immune Deficiency Syndrome (AIDS) – United States.”MMWR 1982: 507-14. 2008. Web.
Garrett, L. The Coming Plague: Newly Emerging Diseases in a World Out of Balance. New York, NY: Penguin, 1995.
Hooper, E. “ Sailors and Star-Bursts, and the Arrival of HIV.”Education and Debate. 2008. Web.
Kolata, M. “Boy’s 1969 Death Suggests AIDS Invaded U.S. Several Times.” 2008. Web.
Morse, S.S. “Factors in the Emergence of Infectious Diseases.” 2008. Web.
Muir, Marie A. The Environmental Contexts of AIDS. New York: Praeger Publishers, 1991.
Scott, J. Blake. Risky Rhetoric: AIDS and the Cultural Practices of HIV Testing. Carbondale, IL: Southern Illinois University Press, 2003.
World Health Organization (WHO). “Global HIV Prevalence has Levelled Off.” 2008. Web.
Zhu,T. et al. “An African HIV-1 Sequence from 1959 and Implications for the Origin of the Epidemic.” 2008. Web.