Response to public health warnings key to preventing epidemics

Heeding public health warnings and observing appropriate guidelines will help prevent infectious disease epidemics in Australia.

Urbanisation in the developed world, such as Australia, is fairly well established. In the developing world, however, particularly Asia and Africa, accelerated urbanisation is creating megacities which can become incubators for disease and can alter the epidemiology of zoonotic diseases, bringing animal hosts closer to humans and increasing the likelihood of human-to-human transmission. As a result, we are seeing the emergence and re-emergence of diseases and this is likely to continue. In Australia, we may see the importation of such diseases, through travellers landing on, or returning to, our shores, as we did with Zika in 2016. While these diseases are unlikely to cause epidemics within Australia, we should still be aware and vigilant in our behaviours and responses to public health warnings and guidelines.

The Coalition for Epidemic Preparedness Innovations (CEPI) recently announced a plan to fund vaccination research into three viruses: Middle Eastern Respiratory Syndrome (MERS), Lassa virus (LASV) and Nipah virus (NiV). This decision was not based on any immediate threat of epidemic. However, as a result of the West Ebola epidemic in 2014, and the current Zika situation in the Americas, the epidemic potential of 37 viral species was determined, including the likelihood of emergence and public health risk. From these 37 species, MERS, LASV and NiV were chosen by the CEPI for vaccine development, a process that can often take more than five years from the initial exploratory phase, through preclinical and clinical development, regulatory review and approval, before reaching the manufacturing and quality control stage. The decision by the CEPI to proactively develop vaccines will increase our preparedness in the event of an outbreak while also building on research, development and deployment of vaccines, further preparing us for future disease emergence.

For an outbreak to occur within a population, most viruses rely on a host which is often condition-dependent. For example, mosquito-borne disease caused by a viral species relies on optimal environmental conditions for the mosquito host, and in some cases an intermediate host such as a kangaroo or wallaby. When we know the host, and any intermediate hosts, and are aware of their preferred or required conditions, monitoring and surveillance can provide accurate predictions of the risk of exposure for individuals in a given community.

Appropriate public health warnings, messages and guidelines can then be communicated. While the prevention of the cause is not always achievable, such communications seek to prevent public health emergencies by reducing the risks for individuals. It is, therefore, important to stress that response, on an individual level, is also crucial. In the event of an increased risk or likely outbreak, if individuals respond to public health messages by adhering to appropriate guidelines, they can reduce their risk of exposure.

*Dr Katherine Faull is Program Director, Public Health, Torrens University Australia.

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