The epidemiological triad of pathogen transmission defines the dynamic state of disease pathway. From the environment that promotes the exposure of a pathogen, a disease causing agent in the absence of a vector could be transmitted to a reservoir or host (Gordis, 2009; Schneider, 2010). In some cases, where the environment promotes or harbors environmentally-fit vectors, pathogens or disease-causing agents are transmitted to the reservoir or the host via vectors (Gordis, 2009; Schneider, 2010). Thus, within an “environment”, agents/pathogens with or without a “vector”, and a “host” are inextricably linked.

The viability of a pathogen depends both on the intrinsic and the extrinsic factors. Naturally, organisms are equipped with the organismal mechanism in selecting the best-fitted traits for its environment/habitat. Continually, species undergoes micro-evolution, a state of micro-mutation occurring in a micro-level, a naked eye cannot see. The evolutionary state makes it possible for an organism to adapt and survive its environment or changes in its environment. Therefore, public health policies and health promotion efforts must be continuous efforts and should not be seen as a one-shot or fixed event.

According to Gordis (2009), the 2006 US National Vital Statistics Reports compared the 10 leading causes of death in the 1900s to 2004. The result showed the leading causes of death in the US in the 1900s are infectious diseases. In 1900s, chronic conditions such as heart disease, stroke, kidney, and cancer diseases are the 4^th, 5^th, and 6^th, and 8^th leading causes of death respectively, while accidents/injuries is the 7^th (Gordis, 2009). In a sharp contrast, the 2004 report indicated that heart disease (1st), cancer (2nd), stroke (3rd), respiratory disease (4th), and accidents (5th) are at present the leading causes of death in the US (Gordis, 2009). Influenza and pneumonia (infectious diseases) are now the 8th leading causes of death in the US (Gordis, 2009). Comparatively, the leading causes of deaths (infectious diseases) in developing countries are similar to the US 1900s’ report (Gordis, 2009).

Infectious diseases are associated with living organisms that constantly mutate and evolve. Therefore, it is strictly important and necessary for the public health surveillance programs to incorporate a proactive monitoring system for pathogens and their evolutionary state. In a good way, most developed countries are not exposed to the variety of infectious pathogens present/persistent in developing nations. The reduction or elimination of exposures, limits the scale of the human intrinsic adaptation or herd immunity to pathogens. Alternatively, the exposure processes could be achieved through vaccination.

In addition, the nutritional and chemical toxicity in the food chain weakens human immune system. For instance, the European Food Safety Authority (EFSA) found a cauliflower mosaic viral sequence (Gene VI) in the commercial GMO crops in the US (PharmNest, 2013b). The cauliflower mosaic virus promoter (CaMV 35S promoter) contains Gene VI, which is a multifunctional gene the virus uses to disarm the host defense system in plants or inhibits the immune systems in animals (Latham, & Wilson, 2013). Perhaps, making the hosts’ susceptibility to infectious pathogens a very severe situation.

Another concern is the emergence of superbugs, Carbapenem Resistant Enterobacteriaceae (CRE), an infectious bacterium that is resistance to all known antibiotics (HPSC, n.d.). In the US, the first known case of CRE was at a North Carolina hospital reported in 2001 (Eisler, 2013). While the first cases of CRE in John Hopkins Hospital were identified in 2007 (Eisler, 2013; PharmNest, 2013a). The possibility that the health care systems are overly medicating patients with antibiotics should not be demised. The constant/continuous process of antibiotic use could promote the selection of resistant strains/traits. The emergence of superbugs is an imminent threat to public health efforts for infectious disease control, a threat that should be taken very seriously. Public health awareness programs must re-enforce, fund, and support a continuous effort for infectious disease surveillance and intervention programs.

References

Eisler, P. (2013). A USA TODAY review finds that deadly CRE bacteria are showing up in hospitals and other health care facilities across the country and there is virtually nothing to stop these “superbugs” at this point. Retrieved from http://www.usatoday.com/story/ news/nation/2012/11/29/bacteria-deadly-hospital-infection/1727667/

Gordon, L. (2009). Epidemiology 4^th ed. Philadelphia: Saunders Elsevier.

Health Protection Surveillance Center. (HPSC) (nd). Carbapenem resistant enterobacteriaceae (CRE). Retrieved from https://www .hpsc.ie/hpsc/Publications/InformationLeafletsfo rtheGeneral Public/File,12778,en.pdf

Latham, J & Wilson, A. (2013). Regulators Discover a Hidden Viral Gene in Commercial GMO Crops. Retrieved from http://independentsciencenews.org/commentaries/regulators-discover-a-hidden-viral-gene-in-commercial-gmo-crops/.

PharmNest. (2013a). Antibiotics resistance super-bug (CRE) on the rise [Video file]. Retrieved from https://pharmnest.com/2013/06/09/antibiotics-resistance-super-bug/

PharmNest. (2013b). Hidden viral gene in GMO crops. Retrieved from https://www.pharmnest .com/2013/08/07/hidden-viral-gene-in-gmo-crops/

Schneider, M.J. (2010). Introduction to public health 4^th ed. Burlington, MA: Jones & Bartlett.