Textbook Notes (362,730)
Canada (158,028)
Geography (140)
GGRB28H3 (32)
Chapter 2

Chapter 2

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University of Toronto Scarborough
Mark Hunter

2 Rethinking Emerging Infectious Diseasesy The syndromes caused by Hantaan viruses have been known in Asia for centuries but now they have seem to be spreading beyond that continent as a result of ecological and economic transformations that increase contact bt humans and rodents y The phenomenology of neuroborreliosis had been tackled long before the monikers Lyme disease and Borrelia burgdorferi were coined and before suburban reforestation and golf courses complicated the equation by creating an env agreeable to both ticks and affluent humans y Hemorrhagic fevers including Ebola were described long ago and their etiological agents were in many cases identified in previous decades y Still other diseases grouped under the emerging rubric are ancient and well known foes that have somehow changed either in pathogenicity or distribution y Multidrug resistant TB and invasive or necrotizing Group A streptococcal infectionthe flesh eating bacteria of the popular pressare cases in point y Concept ofemerging infectious diseases helped to marshal sense of urgency notoriously difficult to arouse in large bureaucracies y Funds have been channeled conferences convened articles written and a dedicated journal founded y A subtle and flexible understanding of emerging infections would be grounded in critical and reflexive study of how our knowledge develops y Units of analysis and key terms would be scrutinized and regularly redefined y These processes would include regular rethinking and not only of methodologies and study design but also of the validity of causal inferences and they would allow reflection on the limits of human knowledge y The study of such processes known as epistemology happens in retrospect y Many of the chief contributors to the growing literature on emerging infectious diseases accustomed to debate abt microbial nomenclature have shown exceptional self awareness in examining the epistemologic issues surrounding their work y In a 1995 review one of the prime movers in the field of a virologist noted that the emergence of a newly recognized or novel disease is rarely a purely virological event without identifiable causative cofactors y Even in cases of microbial mutations we often find signs that human actions have played a large role in enhancing pathogenicity or increasing resistance to antimicrobial agents y Emergence of Rift Valley fever is attributed to a possible change in virulence or pathogenicity and this cause is enumerated after other social factors for which better evidence exists y First step in understanding the epistemologic dimension of disease emergence involved as Eckardt argues developing a certain sensitivity to the terms we are used to
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