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Review
. 2024 Sep 17:11:20499361241274206.
doi: 10.1177/20499361241274206. eCollection 2024 Jan-Dec.

Public health trends in neurologically relevant infections: a global perspective

Jackson A Roberts  1   2 , Ronak K Kapadia  3 , Daniel M Pastula  4   5 , Kiran T Thakur  6
Affiliations
Review

Public health trends in neurologically relevant infections: a global perspective

Jackson A Roberts et al. Ther Adv Infect Dis. .

Abstract

Neuroinfectious diseases represent a growing threat to public health globally. Infections of the central nervous system remain challenging to diagnose and treat, partially driven by the fact that a high proportion of emerging pathogens are capable of causing neurological disease. Many of the trends driving the emergence of novel pathogens, including climate change, ecological degradation, urbanization, and global travel, have accelerated in recent years. These circumstances raise concern for the potential emergence of additional pathogens of pandemic potential in the coming years, necessitating a stronger understanding of the forces that give rise to the emergence and spread of neuroinvasive pathogens and a commitment to public health infrastructure to identify and treat these diseases. In this review, we discuss the clinical and epidemiological features of three types of emerging neuroinvasive pathogens of significant public health consequences that are emblematic of key ongoing trends in global health. We first discuss dengue viruses in the context of climate change, considering the environmental factors that allow for the expansion of the geographic range and seasonal population of the viruses' vector. We then review the rising prevalence of fungal meningitis secondary to medical tourism, a trend representative of the highly globalized nature of modern healthcare. Lastly, we discuss the increasing prevalence of antibiotic-resistant neurological infections driven by the intersection of antibiotic overuse in medical and agricultural settings. Taken together, the rising prevalence of these conditions necessitates a recommitment to investment in public health infrastructure focused on local and global infectious disease surveillance coupled with ongoing development of novel therapeutics and vaccines for emerging pathogens. Such emerging threats also obviate the need to address the root causes driving the emergence of novel infectious diseases, including a sustained effort to address anthropogenic climate change and environmental degradation.

Keywords: dengue; drug resistance; meningitis; neuroinfectious disease; public health.

Plain language summary

Public health trends in neurologically-relevant infections: a global perspective Globally, infections that impact the central nervous system, referring to the brain and spinal cord, are of significant public health concern. In the medical setting, these infections are challenging to diagnose both because of the overall difficulty of diagnosing any neurological infection but also because many infections of the nervous system are caused by newly emerging pathogens that lack reliable tests for diagnosis. Some of the trends contributing to emergence of new pathogens are the result of increasing globalization combined with climate change, destruction of the natural environment, increased growth of cities, and global travel. In our review, we discuss three types of infections that can affect the nervous system in the context of these trends. We discuss dengue viruses, which are spread by mosquitoes, in the context of climate change that increases the range at which dengue-carrying mosquitoes can live. We also discuss fungal meningitis, referring to fungal infections of the lining of the brain, resulting from patients traveling globally for surgical procedures. We lastly discuss the increase in neurological infections resistant to antibiotic treatment, which has resulted from overuse of antibiotics in medical and agricultural settings. As a whole, these trends show the need to invest further in public health systems at monitor for newly emerging diseases, as well as a commitment to developing vaccines and treatments for these diseases. The threats of these pathogens also make clear the need to address the underlying causes leading to their emergence and spread, including climate change and environmental degradation.

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