key: cord-327264-j0efi5vc
authors: Waterer, Grant
title: Respiratory infections in the Asia‐Pacific region
date: 2017-05-24
journal: Respirology
DOI: 10.1111/resp.13077
sha: 
doc_id: 327264
cord_uid: j0efi5vc

nan

I frequently tell young prospective research students that respiratory infections are a great area to develop expertise in because unlike cancer or cardiovascular disease they can be guaranteed the problem will not be solved and go away in their lifetime. The burden of respiratory infectious disease is large, not only acutely, but also due to their chronic complications. Lower respiratory tract infections remain the number one cause of death in the developing world. 1 In the developed world, lower respiratory tract infections are still the fifth leading cause of death. 1 The increasing age of the general population in most countries, our ability to keep people from succumbing to chronic organ failure and the ever increasing array of immunosuppressant drugs being used in a variety of neoplastic and immune diseases ensure that there is an ever increasing pool of vulnerable hosts.

As well as host factors, it is the speed of adaptation of the pathogens that makes it most likely that we will not conquer death from respiratory infection any time soon. While some progress has been made in reducing pneumococcal disease with the newer conjugate vaccines, 2 there is evidence that the speed of adaptation (as measured by the proportion of strains not covered by the vaccines) is increasing. [3] [4] [5] Adaptation in other pathogens is posing challenges in multiple areas including drug-resistant tuberculosis, pan-resistant Gram-negative pathogens and ever increasing rates of community-acquired methicillin-resistant Staphylococcus aureus in many Western countries.

Not only is there adaptation of existing pathogens, the progressive encroachment of humans on other habitats has seen the rise of new pathogens such as coronaviruses causing severe acute respiratory syndrome and Middle East respiratory syndrome, as well as novel influenza strains such as H1N1 09 and the avian H5, H7 and H9 strains. With the notable exception of H1N1 09, all of these viral infections are associated with severe disease and high mortality rates.

In this series on respiratory infections in Respirology, many of the above-mentioned challenges will be covered including the burden of disease due to respiratory pathogens (both acute and long-term), drug-resistant pathogens and newly emerging pathogens. Other reviews will focus on key areas such as the evidence around what is best practice in caring for patients with respiratory infections and key differences in respiratory pathogens in different areas of particular relevance to the Asia-Pacific region. I hope readers of Respirology will find these reviews a useful resource clinically and an inspiration to get involved in research as since the bugs will not stand still, neither can we! Disclosure statement G.W. has been paid to attend advisory boards for Menarini Pharmaceuticals.

School of Medicine, The University of Western Australia, Perth, Western Australia, Australia

World Health Organisation. The top 10 causes of death

hospitalizations for pneumonia after a decade of pneumococcal vaccination

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