2000 Richard J. Duma/NFID Annual Press Conference and Symposium on Infectious Diseases

Contact: Kathleen Hanrahan
(301) 656-0003 x14

Embargoed For Release: June 20, 2000, 10:00 a.m.

Infectious Disease Concern Heightens

WASHINGTON, D.C.--Global travel, the use of antibiotics, and changes in lifestyle are significantly impacting the rise of infectious diseases, officials warned today at a press conference sponsored by the National Foundation for Infectious Diseases (NFID). The increased resilience of bacteria to antibiotics; outbreaks of foodborne and vectorborne diseases over wide geographic areas; and the continued global spread of acquired immunodeficiency syndrome without a vaccine available, continue to challenge global public health efforts. However, they stressed that active campaigns to educate the public, improved diagnostics and surveillance, restrictions on the use of antibiotics, and vaccines will help to reduce and control epidemics.

Will West Nile Virus Cause Annual Summertime Epidemics?

Viral persistence found in overwintering mosquitoes collected in New York City during January and February and three infected crows in New York State and New Jersey this spring indicate the West Nile Virus infections may reappear in New York and other areas of the United States this summer. Normally seen in the Middle East and some parts of Europe and Asia, this flavivirus produced an outbreak of encephalitis in the New York Metropolitan area in 1999. A total of 62 cases of encephalitis/meningitis, with seven deaths were diagnosed in New York City and adjacent Long Island and Westchester County. "This outbreak marked the first recognition of this virus in the Western hemisphere, demonstrating the ease of movement of microbes in an era of global travel and commerce," said Stephen M. Ostroff, M.D., associate director for Epidemiologic Sciences, National Center for Infectious Diseases, Centers for Disease Control and Prevention. The virus normally circulates in birds and mosquitoes. Humans and other mammals become infected when bitten by an infected mosquito. West Nile infections are mild or asymptomatic and surveys have shown that 2.5% of residents in the hardest hit area of Queens, New York had become infected. Severe disease is more common in elderly or immunocompromised persons. "The outbreak highlights the need for better communication between medical, public health, and veterinary communities," said Dr. Ostroff. States on the eastern bird flyway have received federal funding to conduct monitoring activities and perform diagnostic assays. This effort will be expanded nationwide.

Growing Concern About Antibiotics as Growth Promoters

Current trends suggest that with enough time and sufficient antibiotic exposure, bacteria can develop resistance to virtually any antibiotic. "The key question would appear to be 'how long before resistance develops,' not 'will resistance develop,'" said J. Glenn Morris, Jr., M.D., MPH, professor and chairman, Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine. Use and (overuse) of antibiotics in hospitals and by community physicians is clearly a major driving force for emergence of antibiotic resistance in human bacterial pathogens. At the same time, an estimated 40% of all antibiotic usage in the United States is in animals. Much of this usage is in animal feeds as growth promoters or enhancers. This usage has been paralleled by increasing problems with resistance in certain food borne pathogens. The impact of agricultural antibiotics in agriculture use on human health has been the subject of increasing public and scientific concern. "In parts of Europe, these concerns have been sufficient to result in a ban on the use of antibiotics as growth promoters and restrictions on therapeutic use of key antibiotic classes in animals," said Dr. Morris. There have been demonstrable decreases in levels of resistance in certain pathogens coincident with these restrictions.

Same Bacteria Causing Stomach Cancer May Protect Against Esophogeal Cancer

Now, for the first time in human history, individuals are reaching adulthood and old age without Heliocobacter pylori in their stomach. The reasons for this include changes in lifestyle, clean water, smaller families, and the use of antibiotics. Consistent with the decline of H. pylori in Western populations have come declines in the incidence of both peptic ulcer disease and of gastric cancer, especially the type involving the lower stomach. However, diseases of the esophagus, such as gastro-esophageal reflux disease, Barrett's esophagus, and adenocarcinoma of the esophagus, have been increasing. Once rare, adenocarcinoma of the esophagus is the fastest increasing cancer in the U.S., rising at a rate of 11% a year. Over the past four years, a body of evidence has been growing that the disappearance of H. pylori is related to the rise of esophageal diseases, including cancer. "Changes in our indigenous bacterial flora (microecology) have been occurring over the last century, and these changes may have clinical consequences," says Martin J. Blaser, M.D., chairman, Department of Medicine, New York University School of Medicine.

The Future of HIV

The total number of patients infected or dead from HIV reached 50 million as we entered this millennium and while the infection rate is dropping in the western world, it is exploding elsewhere. There appears to be no effective vaccine on the horizon. This epidemic will continue to expand for at least the next ten years and it will leave possibly hundreds of millions infected and dead and nearly 50 million orphans. The current hot spots include Southeast Asia, the states of the former Soviet Union, and the southern part of the African continent. "There appears to be lethargy on the part of the western societies even in the face of the exploding epidemic in the emerging world," noted Merle A. Sande, M.D., chairman of the Department of Medicine, University of Utah School of Medicine. "The impact of this infectious disease could significantly alter progress that has been made in our civilization in the next ten years," warned Sande.

About the Press Conference

The 5th Richard J. Duma/NFID Annual Press Conference and Symposium on Infectious Diseases was sponsored by NFID and was supported, in part, through unrestricted educational grants from AlphaVax Human Vaccines, Inc., AstraZeneca Pharmaceuticals, Aventis Pharmaceuticals, Glaxo Wellcome Inc., Ortho-McNeil Pharmaceutical, Pfizer Inc., and Pharmacia Corporation. 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. Dr. Duma is an internationally renowned infectious disease expert.

NFID is a national, not-for-profit foundation established in 1973 to support public and professional education about and research into the causes, cures and prevention of infectious diseases.