Dealing with epidemics can be a complicated and devastating task – the recent cholera outbreaks in Haiti and Papua New Guinea  are just one example of health workers pushed to their limits in an attempt to contain the disease.

Although well known diseases with existing treatments, like cholera, can erupt into epidemics, recent years have also seen global outbreaks of new pathogens including sudden acute respiratory syndrome (SARS) and the H1N1 influenza (swine flu).

In these instances, the digital age of instantaneous communication played a significant role in the rapid and effective response to these outbreaks.Scientists across the world were able to share results almost instantly, creating a global digital laboratory. The causative pathogens were rapidly identified and the progress of the spread of the diseases was closely monitored and necessary instructions for containment were almost instantly available around the world.

But there is a delicate balance between scientific advancement and our modern lifestyles when it comes to susceptibility to the spread of epidemics.

Last year, a report  tabled at the Prime Minister’s Science, Engineering and Innovation Council looked at factors affecting the spread of epidemic diseases and how Australia might prepare for future outbreaks.

The report stated that the rate of mass public, local and international travel means a group of individuals can be exposed to a disease and spread to all corners of the globe long before the first symptom is reported to a doctor, let alone before a new disease and its potential ramifications are identified or understood.

Modern high-density living and food production methods are also quite literally a breeding ground for new infectious diseases.

Furthermore, increased desire for meat based diets means that humans are in closer contact with species such as pigs and birds which can be a source of potential pathogens. Higher density animal husbandry also means that multiple species can be in close contact in large numbers facilitating the transmission of diseases, in turn providing greater opportunity for mutation and the emergence of new and potentially more infectious strains.

All these factors mean that there is increased likelihood of serious epidemics to occur. The cause, geographic origin, severity, impact and other factors cannot be predicted.

Epidemics are not a modern phenomenon and have the potential to escalate. The Spanish Influenza pandemic which began in 1918 quickly swept the globe and resulted in more deaths in a shorter time than the World War which preceded it. It was a devastating pandemic at a time when viruses and how best to treat them were not yet well understood scientifically or medically.

Spanish Influenza is just one example of the many deadly outbreaks of infectious disease to hit the human race in recent centuries. In fact, even diseases that we now vaccinate against were once huge killers world wide like measles, polio and smallpox.

Small pox was a devastating illness that not only caused significant numbers of deaths, but also left many survivors with serious complications including disfiguring scarring and blindness.

It also represents a serious battle and one of the first major triumphs of science over an ancient disease which decimated populations and changed the course of human history.

Early observations showed that those who survived the disease were not susceptible to further infection. As a result, initial preventative treatment methods included inoculation – applying material from the sores of people with active illness under the skin of healthy individuals. This method usually resulted in a mild case of smallpox but one that still proved fatal in a number of cases, albeit it far less frequently than natural infection.

After a noticing a link between milkmaids who had been exposed to cowpox and immunity to smallpox, English scientist and country doctor, Edward Jenner, experimented with the use of cowpox as a vaccine. This was demonstrated, in what were arguably the world’s first clinical trial, to provide immunity without the risk of serious smallpox infection.

Even with vaccines, diseases with epidemic potential can be hard to eradicate Despite the fact that the breakthroughs in smallpox vaccination occurred in the 1700-1800s, it was not until 1980, after a global vaccination campaign, that the World Health Organisation was able to declare the world free of smallpox. This announcement was made by Australian scientist Professor Frank Fenner, who was chairman of the Global Commission for the Certification of Smallpox Eradication and played a key role in the investigations that proved the disease was gone.

To learn more about epidemics, or how Australia can prepare, you can download the report ‘Epidemics in a Changing World’ here.

At the twentieth meeting of the Prime Minister’s Science Engineering and Innovation Council (PMSEIC) held on June 5 2009, an Expert Working Group presented a report titled Epidemics in a Changing World.  This report considered the factors that prompt the emergence of infectious diseases, and that alter the frequency, location and spread of disease in a changing global environment.  It was noted that humans are the key contributor to this change, through population growth, climate change and associated environmental impacts.

The report also identified that the infectious agents that cause such diseases constantly evolve. This makes the prediction of future threats very difficult — so we must expect to be surprised. The report identified several key ways for Australia to strengthen its capabilities to prevent and manage epidemics.

The Expert Working Group members came from a wide range of scientific disciplines and organisations.  Many of the members had been previously or were currently actively engaged in operations or research associated with animal or human epidemics in Australia and overseas.  They drew heavily on their extensive scientific knowledge and expertise in considering the topic, in fields including virology, entomology, epidemiology, medical science and veterinary science.

The recommendations

Science and innovation will provide the key to safeguarding Australia’s future. The report focused on ensuring that Australia is well placed to deal with the effect of global changes on the occurrence and spread of human and animal epidemic diseases.

The Expert Working Group noted that Australia’s current operational response to disease control is effective — and has been in recent times for disease events which have not resulted in major global epidemics.  The recommendations presented were seen as providing Australia with the preparedness and agility to cope with the unknown challenges of a future world that may provide a substantively different environment for epidemic disease.

In order to underpin Australia’s preparedness to deal with emerging epidemic diseases the Group recommended that:

1. Australia possesses the human capacity to combat potential epidemics

The nation must be prepared and sufficiently agile to deal with unexpected epidemics. This requires that we develop, maintain and retain skilled people through:

• conducting ongoing national workforce planning for expertise in human and animal epidemic diseases; and
• boosting higher education and research training in areas of need.

In order to provide early warning of the emergence of epidemic diseases the Group recommended that:

2. Australia possesses a long term biosecurity information collection, analysis and interpretation capability

Capability must be developed and maintained to collect, analyse and interpret disease surveillance information.   This must be secured by:

• creating an ongoing, effective national human and animal disease information system; and
• integrating this system with similar systems operating overseas.

In order to enhance Australia’s wider ability to deal with emerging epidemic diseases the Group recommended that:

3. Australia develops forward regional engagement to mitigate potential epidemic.

Australia needs to commit human and other resources to engage our region on disease surveillance, preparedness and mitigation, through capacity building and collaboration.  This requires that we develop political, scientific and technical relationships with our neighbours, at multiple levels, to reduce human and animal disease risk to Australia and the region by:

• establishing an active ongoing cross portfolio mechanism involving PM&C, DFAT, DoHA, DAFF, DIISR, DEEWR and other relevant agencies dedicated to managing and supporting effective regional engagement; and
• assisting regional countries to meet their obligations under the WHO International Health Regulations and the World Organisation for Animal Health requirements through:
  • supporting development of collaborative regional surveillance and early warning systems; and
  • developing regional expertise through professional training and higher education in Australia and in the region.

In order to secure the front-line defences needed to deal with emerging epidemic diseases the Group recommended that:

4. Australia has a self-sufficient vaccine development and production capacity

Australia needs to retain and enhance its onshore development and production capacity for vaccines. This is essential for domestic preparedness and, as importantly, to enable access to the latest overseas expertise and technology in this field.  The focus should be on the onshore development and production capacity for:

• contemporary influenza vaccines; and
• niche vaccines, particularly in the context of future Australian needs.

In order to better coordinate our ability to deal with emerging epidemic diseases the Group recommended that:

5. The Government establishes the cross-portfolio arrangements essential for effective implementation of Recommendations 1, 2 and 3 as a matter of immediate priority.

Please visit the PMSEIC website to view the full report.