# 4195
Even though the pandemic of 2009 continues, and we don’t yet know how it will turn out, there are other infectious disease threats on the horizon.
Some are flu-related, and others stem from other pathogens. Some have pandemic potential, while others (right now) are only capable of localized outbreaks.
Either way, infectious diseases – once believed on the way to eradication – are on the comeback trail.
TB (Tuberculosis) was a scourge here in the US 60 years ago. My Grandmother had it – and was in a sanitarium for months – back in the 1930s.
When I was a young paramedic, we often saw TB patients. In fact, I transported TB patients to the Lantana TB hospital mentioned in the article below, back in the 1970s.
Gradually, though, TB here in the US receded in the face of new antibiotics, and improved treatment regimens. By the late 1970s, most of the TB hospitals had been shuttered, and many believed the disease would soon be eliminated – at least in the developed world.
Of course, that didn’t happen. TB has learned to evade our first line antibiotics, and in some cases, is becoming to resistant to our higher tier treatments as well.
Yesterday the AP (Associated Press) ran a detailed story about the discovery, and treatment of the first known case of XXDR-TB (Extremely Drug Resistant TB) here in the US.
The story, by Martha Mendoza and Margie Mason is well worth reading.
Danger at home: Rare form of TB comes to U.S.
First U.S. case of extremely drug-resistant strain of tuberculosis diagnosed
While still incredibly rare, many scientists fear this is the future of TB; increasingly drug resistant and difficult to treat.
An excerpt from the AP report. But follow the link above to read it in its entirety.
Forty years ago, the world thought it had conquered TB and any number of other diseases through the new wonder drugs: antibiotics. U.S. Surgeon General William H. Stewart announced it was "time to close the book on infectious diseases and declare the war against pestilence won."
Today, all the leading killer infectious diseases on the planet — TB, malaria and HIV among them — are mutating at an alarming rate, hitchhiking their way in and out of countries. The reason: overuse and misuse of the very drugs that were supposed to save us.
Just as the drugs were a manmade solution to dangerous illness, the problem with them is also manmade. It is fueled worldwide by everything from counterfeit drugmakers to the unintended consequences of giving drugs to the poor without properly monitoring their treatment. Here's what the AP found:
- In Cambodia, scientists have confirmed the emergence of a new drug-resistant form of malaria, threatening the only treatment left to fight a disease that already kills 1 million people a year.
- In Africa, new and harder to treat strains of HIV are being detected in about 5 percent of new patients. HIV drug resistance rates have shot up to as high as 30 percent worldwide.
- In the U.S., drug-resistant infections killed more than 65,000 people last year — more than prostate and breast cancer combined. More than 19,000 people died from a staph infection alone that has been eliminated in Norway, where antibiotics are stringently limited.
"Drug resistance is starting to be a very big problem. In the past, people stopped worrying about TB and it came roaring back. We need to make sure that doesn't happen again," said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, who was himself infected with tuberculosis while caring for drug-resistant patients at a New York clinic in the early '90s. "We are all connected by the air we breathe, and that is why this must be everyone's problem."
More than 2 1/2 years ago I wrote a blog entitled It Isn't Just Bird Flu, where I wrote about a number of possible pandemic and epidemic threats. I opened with:
In this increasingly crowded world of ours, where there are large areas of poverty and poor medical care, there are literally scores of deadly pathogens that could spark the next epidemic, or pandemic. Bird flu, or the H5N1 virus, is high on the list of diseases we watch, but it is by no means the only one out there.
When we prepare for a bird flu pandemic, we are also preparing for any other disease outbreak.
Recently I updated that blog with another called It Isn’t Just Swine Flu. The message remains the same. We live in a world teeming with pathogens, many of which are continually changing and evolving to become more efficient at infecting their hosts.
In October of 2008 Lloyd's issued a pandemic impact report for the Insurance industry, which can be downloaded here.
The Lloyds report takes pains to point out that while we worry about an influenza pandemic the most, there are other candidates out there that could spark a pandemic (or at least an epidemic).
They list:
- Hendra Virus
- Nipah Virus
- Cholera
- Small Pox
- HIV/AIDS
- Bubonic Plague
- Tuberculosis
- Lassa fever
- Rift Valley fever
- Marburg virus
- Ebola virus
- Bolivian hemorrhagic fever
- MRSA
- SARS
I could add Dengue, Chikungunya, and of course Pathogen X, the one we don't know about yet, to this list.
While I can’t tell you which of these threats will end up being the big disease story of 2010, I can assure you there will be plenty of pathogen related news to write about and discuss in the upcoming year.
That’s the thing about blogging about emerging infectious diseases.
Despite the premature proclamation of U.S. Surgeon General William H. Stewart back in 1969.
It’s a growth industry.
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