‘Paradigm Shift' Needed in Disease Control to Account for Human Mobility

A researcher at McMaster University, in collaboration with a team of international scientists, has proposed that a “paradigm shift” needs to occur in disease control that focuses more on the impact that human travel can have on the moving of drug-resistant infectious diseases around the world.

Douglas MacPherson, an associate professor in the Department of Pathology and Molecular Medicine in the Faculty of Health Sciences at McMaster, and the collaborating research team discuss the relationship between population mobility, globalization, and antimicrobial drug resistance. Citing published data, and using the H1N1 virus and other infectious diseases as examples, the researchers explain that the “complexity of human movement exceeds current international disease control policies and practices.”

"The movement of human beings is introducing many of the greatest risks to our health and health systems today," said MacPherson, a physician and medical microbiology specialist. "For example, if you go down south on a Florida holiday and break your leg and end up in a Florida hospital, when you come home, you’re going to be carrying institutional bugs back to Hamilton and you’re going to introduce that variety of antimicrobial resistance into your local environment. Mobile populations are probably the most common way of moving drug-resistant organisms around the world."

For hospitalists, the findings of this study could mean a change to the way in which patients who are not from the region are treated. One recommendation of the researchers “suggest that an effective response requires engagement at the local level, standardization of practices, partnerships between a variety of sectors and rigorous health information gathering along with threat and risk assessment.” In addition, they suggest that hospitalists and other health professionals take mobile populations, such as tourists or individuals on business trips, into consideration when thinking about drug resistance.

"A shift in the existing paradigm of pathogen-focused policies and programs to include the ‘human factor’ in health and disease would contribute to a healthier future for everyone," MacPherson said. "It’s not just about being reactive or responsive to the problem. We now have the ability to be more proactive in decision making, more integrative and more collaborative. That’s how we’ll get to better solutions.”