From news stories about real-world outbreaks to fictional scenarios in TV shows like The Last of Us, our media channels are filled with cautionary tales of just how quickly an infectious disease can spread – and the dire consequences it can bring. The COVID-19 pandemic has changed the way we think about infectious diseases,1,2 and the world remains alert for threats that could lead to future outbreaks.1,2 So what are the biggest healthcare threats causing the spread of disease right now? And how can in vitro diagnostic (IVD) testing help to combat them?
Several key factors have been driving the spread of infectious diseases for many years, including:3
In this article, we’ll discuss each of these factors in more detail.
International travel and commerce
For decades now, scientists have been discussing how factors like international travel can contribute to the spread of disease.3,4 A paper published in 1995 predicted that:
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“New infections will continue to emerge, and known infections will change in distribution, severity and frequency. Travel will continue to be a potent factor in disease emergence. The current world circumstances juxtapose people, parasites, plants, animals, and chemicals in a way that precludes timely adaptation. The combination of movement at many levels and profound change in the physical environment can lead to unanticipated diseases spread by multiple channels. In many instances, the use of containment or quarantine is not feasible.” 3 |
The COVID-19 pandemic is the most widespread recent example of how travel causes disease to spread.5 In this case, the world was forced to suspend travel and enforce quarantines, and we saw how profoundly such a widespread lockdown can impact the global economy and healthcare sector.6,7
However, even before COVID, air travel in particular was a major factor in the spread of disease, including respiratory diseases (such as SARS, MERS and influenza) and tropical diseases (such as Ebola, dengue, Zika and chikungunya).4 Animals and plants being transported can also spread diseases to new locations.4
How IVD can help: Setting up temporary IVD testing centers at international airports can prevent infected passengers (including those who don’t have symptoms yet) from spreading a disease.8
Microbial adaptation and change
We can’t talk about infectious diseases without discussing antimicrobial resistance (AMR). AMR happens when microbes (bacteria, viruses, fungi and parasites) gradually stop responding to the medications that are supposed to kill them.9 This occurs when those medications are incorrectly used or overused.9 Other causes of AMR may include lack of sanitation and poor disease control measures, which cause microbes to spread.9
Resistant microbes are spreading further around the world, and international air travel is again a big reason for this.4 Travelers returning from areas with high AMR rates can easily bring these organisms back to their home country.4 In this way, resistant bacteria, viruses, fungi and parasites start to spread diseases far from where they originally started.4
AMR makes it harder to treat infections effectively, and the World Health Organization recognizes it as a major global health threat.9 The spread of ‘superbugs’ (microbes that are resistant to multiple medications) is especially concerning.9
How IVD can help: Rapid and accurate diagnosis can prevent the over prescription of medications like antibiotics and can also improve disease control.10
Environmental changes
Certain diseases are more likely to break out in areas affected by climate change, where higher temperatures and precipitation levels create an environment that promotes the spread of vector-borne diseases.11 Examples include malaria, cholera and rotavirus.11
Climate change is also linked to natural disasters.12 Extreme weather events like floods and earthquakes may kill hundreds or even thousands of people immediately, but many more lives are lost later, due to infectious disease outbreaks caused by issues like poor sanitation, overcrowding, lack of healthcare access, and exposure to disease-carrying organisms.13,14
Read more about natural disasters and infectious diseases.
How IVD can help: After a natural disaster, hospitals and clinics are quickly overwhelmed with patients, and many people in need can’t access healthcare facilities due to infrastructure problems.15 IVD tests are extremely valuable in this scenario, because they can be used in point of care (PoC) situations, where testing is done at or near the site of patient care, using mobile equipment to quickly detect a range of infectious diseases.15,16 PoC testing makes it easier to diagnose, effectively treat and monitor diseases under these challenging conditions.15,16
Breakdown in public health measures and surveillance
Recently, we’ve seen diseases that were previously under control start to re-emerge.17 This re-emergence can be caused by breakdowns in healthcare access and delivery, for example when conflict or natural disasters lead to forced migration and/or reduced vaccination coverage.13,14,17 The rise in cases of a disease can also be the result of factors like low vaccination rates, microbial adaptation, human population growth and planned migration.17,18
Notable examples of diseases re-emerging or rising in prevalence because of healthcare disruptions include the following:
Measles outbreak caused by lower vaccination rates: Over the course of 4 decades, immunization programs helped to reduce measles-related deaths by 96%.18 But since 2017, countries around the world have been experiencing a resurgence in measles.18 During the first half of 2019, the number of reported cases was at its highest point in 13 years.18 This has been caused by a drop in the number of people being vaccinated against measles, mumps and rubella (MMR).18
In some countries, the lower rate of vaccination is caused by lack of access to healthcare, which can happen in times of war, political conflict and socio-economic collapse.18 In other countries, it can be caused by vaccine hesitancy.18
Cholera outbreak caused by ecological changes/natural disaster: Haiti experienced an outbreak of cholera in October 2010, after an earthquake devastated the country nearly 10 months earlier.19 This was a resurgence after more than 3 years with no reported cholera cases in Haiti.19 The outbreak caused over 820 000 cases of cholera and killed nearly 10 000 people.19
Rising STI rates caused by limited healthcare access: The COVID-19 lockdown disrupted routine healthcare and had a major impact on screening and care for sexually transmitted infections (STIs).20 This was partly because shelter-in-place/lockdown orders meant many patients stopped going to clinics for testing and partly because STI program resources were redirected to COVID-related activities.20 Data shows that, between 2019 and 2021, gonorrhea cases increased by 15% and primary and secondary syphilis cases increased by 38%.20
How IVD can help: IVD point of care tests help with disease diagnosis and control in unstable or resource-limited scenarios, like natural disasters.15,16 IVD testing also makes at-home diagnosis easier – for example, home COVID testing has become second nature to people around the globe.21 We can expect to see an increase in demand for home diagnostic testing, most likely for respiratory infections like RSV (respiratory syncytial virus) and influenza.21 This would mean fewer patients would need to go into a clinic or urgent care for testing, which in turn would reduce the risk of spreading infections.21 At-home STI testing would also be beneficial to patients who are worried about stigma or embarrassment associated with their condition.21
Medix Biochemica's Covid Response and Pandemic Preparedness
During the pandemic, Medix Biochemica was faced with high demand for excellent IVD products, in large quantities and at a rapid rate.21 We delivered, expanding on our existing materials to provide a range of sensitive, specific reagents for use in COVID testing.21 We constantly worked to improve our products during this time, keeping up with emerging COVID variants to produce suitable testing reagents.21
Medix Biochemica is also able to offer a quick turnaround time on products, to meet urgent customer needs.21
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Case report: In the early days of the pandemic, Medix Biochemica received a request to produce a kilogram of a certain antibody which binds to human Immunoglobulin G (IgG). With our highly scalable cell culture process and production capacity, we were able to meet this requirement. According to this large multinational customer, we were the only antibody supplier able to accommodate this request, “and we asked everyone”.22 |
We believe in being prepared, and keep a broad range of products in our portfolio in the event of future outbreaks when quick, accurate diagnosis might be crucial:21
Read more about the importance of differentiating between bacterial and viral infections.
COVID has changed the face of healthcare forever, and the Medix Biochemica team brings a spirit of innovation and adaptation to this new on-alert-for-infections world. We look forward to partnering with present and future customers, to make IVD testing more accessible and beneficial than ever before.
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References:
Laura-Leena Kiiskinen. Email communication. April 26, 2023.