Americans are increasingly at risk of dying from new, re-emerging or drug-resistant infectious diseases, according to a national study released Wednesday.
Globalization, antibiotic resistance and climate change are major contributing factors, compounded by funding cuts for public health initiatives and the growing number of people choosing not to have their children immunized against common childhood illnesses, according to the report.
The threat of bio-terrorism attacks using lethal organisms such as smallpox or anthrax poses an additional challenge, the study said.
“Americans are more vulnerable than we think we are, and our public health defenses are not as strong as they should be,” warned Jeffery Levi, executive director of the non-profit, nonpartisan Trust for America’s Health, which released the report Wednesday.
Even safe-seeming rural states like Maine are not immune from the trend, said state epidemiologist Dr. Kathleen Gensheimer, who joined Levi in releasing the study at a national teleconference.
“We are not isolated,” Gensheimer said. “What goes on anywhere around the globe affects us at the state and national level.”
Titled “Germs Go Global: Why Emerging Infectious Diseases are a Threat to America,” the study calls for strengthening state, national and global public health systems and investing in vaccine development and distribution.
The study shows that Americans are increasingly vulnerable to outbreaks of exotic diseases such as West Nile virus, monkeypox and dengue fever; old standbys such as tuberculosis and hepatitis; and once-vanquished but now re-emerging threats such as measles, mumps and whooping cough.
In addition, the long-term overuse of antibiotics has led to the emergence of drug-resistant strains of potentially lethal organisms such as Staphylococcus aureus, TB and Clostridium difficile.
Dr. James Hughes, professor of medicine and public health at Emory University in Atlanta and former director of the infectious diseases section of the U.S. Centers for Disease Control and Prevention, said the growth of “megacities” in the developing world favors the development of vector-borne illnesses transmitted by insects, rodents and other creatures.
Unsafe drinking water, inadequate sewage systems and unregulated food production in highly populated areas pose additional threats, Hughes said in the teleconference, and with the speed of international travel and transport, it doesn’t take long for an outbreak to spread.
“The most dramatic example is the SARS outbreak,” Hughes said, referring to the 2002 out-break in China and rapid spread throughout Asia and in Canada of Severe Acute Respiratory Syndrome. The viral disease sickened thousands and took the lives of nearly 800 people before it was contained.
Hughes said public health officials continue to prepare for an overdue global influenza outbreak of the severity of the 1918 Spanish flu that killed tens of millions worldwide. While most governments have made progress in planning for the anticipated outbreak, Hughes warned against “pandemic fatigue” and complacency.
Gensheimer spoke about dropping rates of childhood immunization, faulting state and federal funding cutbacks for eroding the availability of vaccines against dangerous illnesses such as whooping cough, measles and mumps. When cash-strapped parents have to pay the full cost of vaccinating their children, she said, immunization rates “plummet.”
In addition, she said, a growing number of parents are unwilling to have their children vaccinated due to reports that vaccines may be linked to autism and other neurological problems in children.
Gensheimer said such fears are unsubstantiated and must be countered with an aggressive educational campaign. Regardless of why youngsters aren’t getting vaccines, she said, the result is a population of children who not only are vulnerable themselves but who also put others at risk.
Gensheimer also addressed the issue of food safety. She noted that a typical American meal contains foods from six countries that have traveled an average of 1,500 miles. While it is tempting to blame lax agricultural and food processing standards in other countries, Gensheimer noted that recent outbreaks of salmonella and E. coli were traced to produce grown in this country.
While the incoming U.S. president and Congress will face many challenges, including an economy in tatters, “making sure people are protected from disease must also be a priority,” Levi said.
Public education campaigns, disaster planning, high-tech disease surveillance systems, well-equipped public laboratories, modernized vaccine manufacturing processes and an influx of public health professionals all cost money, but the report argues that the investment is not optional. It calls for the U.S. to take a leadership role in developing a global response to the growing threat of infectious diseases.
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