1996 Richard J. Duma/NFID Annual Press Conference and Symposium on Infectious Diseases
Contact: Terry LaMotte
(301) 656-0003
Embargoed for Release: May 16, 1996, 12:15 p.m.
Infectious Diseases Continue to Cause Significant Illness and Death. Antimicrobial Resistance is a National and Global Threat.
WASHINGTON, D.C.--Many different infectious disease agents, previously considered eliminated as major public health problems, are reemerging, according to Stuart B. Levy, M.D., professor of medicine and of molecular biology and microbiology and director of the Center for Adaptation Genetics and Drug Resistance at Tufts University School of Medicine in Boston. Levy was one of several infectious disease experts speaking at a news conference and symposium on infectious diseases in Washington, D.C., sponsored by the National Foundation for Infectious Diseases (NFID). Speakers covered a broad spectrum of issues, including new and reemerging infectious diseases, antimicrobial resistance, new tools to detect pathogens and bovine spongiform encephalopathy (BSE), commonly known as "mad cow disease."
Levy blames a legacy of years of antibiotic misuse for the problems now being faced with antimicrobial resistance. "Misconceptions about antibiotics have allowed them to be prescribed and dispensed casually, demanded and stockpiled by consumers, and to be taken without the advice of a physician," he said. He also said large numbers of pharmaceutical companies left the antibiotic field in the mid-1980s and are only gradually coming back. "Since drug development takes years, reliance must be placed on the antibiotics that are currently available," Levy added.
With no new antibiotics in production, resistance will only continue to grow, Levy warned. This concern was echoed by Robert W. Pinner, M.D., special assistant for surveillance in the National Center for Infectious Diseases at the Centers for Disease Control and Prevention (CDC). "With dramatic changes in our society and environment, infectious diseases have rapidly emerged and reemerged," said Pinner. In addition, he cited the largest waterborne disease outbreak ever recognized in this country caused by the once-obscure parasite Cryptosporidium, as well as the Hantavirus outbreak in the American Southwest.
Since 1987, the National Academy of Science's Institute of Medicine has published three reports documenting the urgent need for improvement in identifying infectious diseases threats and responding to them effectively. "To meet this urgent need, we must improve the public health infrastructure at the local, state and federal levels and recognize that global surveillance and response for emerging infections is vital to public health," Pinner said.
Infectious diseases now rank third among all causes of death in the United States, increasing from fifth place in 1980, according to a recent article written by Pinner and published in the Journal of the American Medical Association. In 1994, CDC developed and published a comprehensive road map for the prevention and control of emerging infectious disease threats. The CDC recommendations focus on four key areas: surveillance, research, prevention and control, and infrastructure.
But the battle against infectious diseases is not without successes. Newer genetic detection techniques have led to the discovery of the causes of bacillary angiomatosis, cat scratch disease, human ehrlichiosis, Whipple's disease, Hantavirus pulmonary syndrome, Kaposi's sarcoma and new hepatitis agents, said David A. Relman, M.D., assistant professor of medicine, microbiology and immunology at Stanford University School of Medicine and the Veterans Administration Palo Alto Health Care System in Palo Alto, CA. "The advantages of these new molecular methods include a more rapid, sensitive and specific detection of known microbial pathogens, as well as the identification of novel, previously-uncharacterized microorganisms," he said.
Relman also said that widespread use of these methods may reveal new microbial pathogens as well as help in understanding microbial diversity. In addition, the methods may be automated for hospital and commercial clinical microbiology laboratories.
The recent emergence of BSE and the occurrence of a new variant of Creutzfeldt-Jacob disease (CJD) in the United Kingdom have focused attention on a potential new human health hazard, noted Frank O. Bastian, M.D., professor of pathology and director of neuropathology at the University of South Alabama in Mobile.
CJD is a rare but uniformly fatal neurological illness in humans which is similar to transmissible spongiform encephalopathies (TSE) affecting animals. The infectious agent or agents responsible for CJD and related TSE are currently an area of active research investigation.
"The recent BSE stories from England bring attention to the potential threat of this disease to livestock herds and the threat of related diseases to humans," Bastian warned. "An economic impact is already being felt in this country," he added. However, according to Linda Detwiler, D.V.M., in veterinary services at the Animal and Plant Health Inspection Service of the U.S. Department of Agriculture, "BSE has never been diagnosed in the United States.² She added that measures taken to ensure livestock safety have been in surveillance, prevention and education. "Import restrictions on British beef and cattle have been in place since 1989, and active surveillance efforts began in 1990," she said.
The Richard J. Duma/NFID Annual Press Conference and Symposium on Infectious Diseases was sponsored by NFID and was supported in part through an unrestricted educational grant from Eli Lilly and Company. This event was named for former NFID President and Executive Director Richard J. Duma, M.D., Ph.D., director of infectious diseases at Halifax Medical Center in Daytona Beach, FL. Duma is an internationally and nationally renown infectious disease expert.
NFID is a national, nonprofit public foundation established in 1973, to support infectious diseases research, to sponsor public and professional education programs and to aid in the prevention of infectious diseases.