Review PaperSurveillance of infectious diseases in the Arctic
Introduction
The Arctic region extends north of 60° north latitude, borders the Arctic Ocean and includes all or northern parts of eight nations. Endemic and epidemic infectious diseases have been documented across Arctic populations.1, 2 The introduction of antibiotics and vaccines and the establishment of robust public health systems targeting multiple diseases including tuberculosis (TB) and sexually transmitted infections (STIs) have greatly reduced the morbidity and mortality of infectious disease problems in many Arctic countries. Despite these interventions, high rates of invasive diseases are caused by bacterial pathogens such as Streptococcus pneumoniae,3, 4 Haemophilus influenza,5, 6, 7 Helicobacter pylori,8, 9, 10, 11 and group A streptococcus.12, 13
Skin and soft-tissue infections14, 15 and TB1, 2, 16 continue to persist. In addition, the emergence of antibiotic resistance among bacterial pathogens once easily treated with commonly used antibiotics,14, 17, 18, 19 the specter of pandemic influenza20, 21, 22 or the sudden emergence and introduction of new viral pathogens23, 24 are of increasing concern to residents, governments and public health authorities of all Arctic countries.
A small group of infectious disease epidemiologists and international health experts who have worked together collaboratively in the field of International Circumpolar Surveillance (ICS) for greater than a decade reviewed the literature over the past 2 decades looking at Arctic living conditions, antibiotic use and Arctic surveillance for infectious diseases. This review will describe pertinent issues in the social and physical environment. It will also review how crowded living conditions and overuse of antibiotics can affect the health of Arctic populations. Finally, it will look at the important role that surveillance plays in preventing and controlling infectious diseases in this region.
Section snippets
The role of surveillance in prevention and control of infectious diseases in the Arctic
As in other parts of the world, a key component of prevention and control of infectious diseases in Arctic regions is surveillance. Basic surveillance functions include detecting and reporting cases of disease. Other functions include analyzing and confirming information received to identify disease outbreaks or longer term trends and applying this information to implement prevention and control strategies. Effective surveillance can facilitate timely control of outbreaks, inform public health
Social and physical environment
People of the Arctic and sub-Arctic regions live in social and physical environments which differ substantially from those of their more southern dwelling counterparts. The circumpolar region can be defined as a region that extends north of 60° north latitude, borders the Arctic Ocean and includes all or northern parts of eight nations: the USA (Alaska), Canada, Greenland (part of the Danish kingdom), Iceland, Norway, Sweden, Finland, and the Russian Federation. Climate in the Arctic varies
Arctic change and infectious diseases surveillance
Since the 20th century, Arctic Indigenous people have undergone tremendous changes in regards to their way of life, moving from traditional hunters societies to more western lifestyles. This includes marked changes in transportation patterns with communities once isolated now being linked by air to larger urban centres providing daily access to not only to secondary and tertiary health care but also to national and international transportation, tourism and trade. Such change of increasing
Future directions
The ICS provides a model for international surveillance of infectious diseases and collaboration between clinical hospital and public health references laboratories and public health centres and institutes. The system currently provides standardized laboratory and epidemiologic data on invasive bacterial diseases that is comparable across borders and can be used to evaluate intervention strategies. However, the system also provides an infrastructure which can be used to monitor and respond to
Acknowledgements
The authors would like to acknowledge the following Chairs, co-Chairs and workgroup members: Tom Hennessy, Prabhu Gounder, Brian McMahon, Annie-Claude Bourgeois, Alan Parkinson, and Shalini Desai. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
Ethical approval
No Institutional Review Board review was required because there were no research subjects and all information/data came from
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Lower respiratory tract infection hospitalizations among American Indian/Alaska Native adults, Indian Health Service and Alaska Region, 1998–2014
2021, International Journal of Infectious DiseasesCitation Excerpt :Rates of LRTI-associated hospitalizations and characterization of hospitalization length of stay and associated diagnoses were analyzed overall, and LRTI hospitalization rates for Alaskan AI/AN were compared with LRTI hospitalization rates from other IHS regions. Traditionally, the state of Alaska has been under-developed in regards to roads, rural housing, and sanitation compared to the rest of the US and has also seen higher rates of infectious diseases for greater than half a century (Bruce et al., 2016; Koch A, 2017). Hospital discharge data from the IHS Direct and Contract Health Services Inpatient Dataset, IHS National Patient Information Reporting System (NPIRS; https://search.usa.gov/search?affiliate=indianhealthservice&query=Trends2014book) for AI/AN adults ≥18 years of age who were hospitalized at an IHS-operated, tribally operated, or contract hospital with an LRTI-associated diagnosis during 1998–2014, were analyzed.
A prospective cohort study of immunogenicity of quadrivalent human papillomavirus vaccination among Alaska Native Children, Alaska, United States
2020, VaccineCitation Excerpt :Prior analyses from 4vHPV trials showed high immunogenicity across a broad range of racial/ethnic groups [18]. This is the first 4vHPV immunogenicity study to be conducted in Alaska or specifically among AI/AN; in general, few HPV vaccination studies worldwide have been conducted among Indigenous peoples [19–22] who tend to experience gross health disparities compared to non-Indigenous populations [23–25]. The primary aim of this study was to determine the serologic response, using a multiplex ELISA, following each of the 3 doses of 4vHPV (given at time 0, 2 months, and 6 months), as well as the serologic response at one year and two years post series completion, to assess immunogenicity and persistence of detectable antibody in AI/AN children.
Human infectious diseases and the changing climate in the Arctic
2018, Environment InternationalCitation Excerpt :Similarly, people spend more time outside (i.e. in forests and public places for picnics and other free time activities), increasing the likelihood of contracting a tick-borne disease (Chashchin et al., 2017). Additionally, changes in climatic factors can expand a disease-vector's geographic range, or enlarge its population, for example more vector species and individuals survive though the winter (Bruce et al., 2016; Burmagina et al., 2014; Chashchin et al., 2017; Mesheryakova et al., 2014; Parham et al., 2015; Yastrebov et al., 2016). Increases in public and health personnel education, vaccination programs, and hygiene, however, help combat the spread of disease, potentially reducing infections even though opportunities for infection may increase as a result of climate change.
Epidemiology of invasive Haemophilus influenzae serotype a disease in the North American Arctic, 2006–2017
2022, International Journal of Circumpolar Health