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Disease dynamics are intimately
connected to biological, environmental
and social processes that take place
at multiple scales and over various
levels of social and biological
organization. Further, in a highly
interconnected world, epidemic outbreaks
become instant potential health
and/or economic global threats with
increasing segments of the population
playing active roles on the transmission
patterns of infectious diseases
like influenza. Individual and/or
group actions and/or decisions and/or
activities can enhance or reduce
the effectiveness of intervention/control
measures in the Information Era.
Travel, social distancing, the availability
of medical supplies (antiviral drugs
and vaccine) and timely diagnostic
tools, and the access to quality
medical care are but some of the
factors that have been identified
as significant during this ongoing
influenza pandemic. A fundamental
challenge, then, is to find ways
of integrating and grasping the
processes and patterns that take
place at key temporal scales and
relevant levels of social and biological
organization and use them to identify
timely and effective intervention
strategies. Despite the myriad of
complexities associated with disease
dynamics, macroscopic epidemic patterns
emerge but finding effective ways
of making use of this knowledge
remain. How do we generate useful
paradigms with the limitations inherent
in reported epidemiological data
or with the challenges posed by
unreported disease data? Further,
diseases experiencing rapid evolutionary
changes, posing a tremendous threat
to the viability of our limited
drug supply. The evolution of resistance
to antibiotics or antiviral drugs
is one of the most important sustainability
challenges that we face today, a
challenge that must be central to
the design and implementation of
global public health policies. Will
evolutionary changes at lower levels
of organization, like cross-immunity,
alter dramatically the epidemiological
landscape at the population level?
In this lecture I will address some
of these challenges in a historical
context starting with the work of
physicians-theoreticians like Bernoulli,
Ross, Kermack and McKendrick. The
lecture will be tied in to the epidemiology
of influenza with examples from
the H1N1 ongoing pandemic.
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