HealthCommentary

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The Microbial Threat: Why The White House Is Engaged.

Posted on | June 7, 2015 | No Comments

president-obamaImage Credit:Medical Daily.com

Mike Magee

Infectious diseases are all the rage these days. Bird flu and MERS outbreaks are back in the news. Hepatitis C is pervasive in the Appalachian states, tick-borne Lyme disease is heading north and coliform bacteria is finding its way onto college toothbrushes in CT. Water is being boiled in Utah, Blue Bell ice cream comes laced with Listeria, and a common cat parasite, some say, may cause brain disorders in cat owners.

It’s no wonder that the White House is concerned about degrading our disease fighting weapons and promoting a strategy to limit the emergence of antibiotic-resistant bacteria.

Infectious microbes – tiny organisms that include bacteria and viruses – are living entities with a nearly unlimited ability to adapt. Microbes reproduce approximately every 30 minutes. This event allows constant mutation, migration, and adaptation of these organisms, which are the basic building blocks for some of the world’s most virulent diseases. The new forms that survive their predators, which include antibiotics and antivirals, go on to reproduce, multiply, and thrive. Staying one step ahead of these survivors requires surveillance, testing, and the redesigning of strategies through research, development, and distribution of new medicines and vaccines.

We develop antimicrobials in order to control symptoms, to destroy organisms, and to seek to eradicate diseases. With the development of new classes of antimicrobials in the 1950s and 60s, the scientific community prematurely thought it could claim victory over microbes. In fact, in the late 1960s, Surgeon General William H. Stewart stated it was “time to close the book on infectious diseases, declare the war against pestilence won, and shift national resources to such chronic problems as cancer and heart disease”.

Yet over a half-century later, we continue to struggle with highly recognizable foes like malaria, tuberculosis and HIV, and newcomers like SARS, Bird Flu, and MERS. Five distinct threats have emerged in our evolving battle with infectious diseases:

First, the resurgence of endemic diseases, especially in the developing world.

Second, a growing link between microbes and chronic diseases.

Third, drug-resistant microbes.

Fourth, new emerging infections, and fifth, the threat of bioterrorism.

With so many sources for trouble, it’s little wonder that infectious diseases remain a dominant cause of death worldwide. At the turn of this century, infectious diseases caused 26 percent of global deaths. Four million deaths were attributed to respiratory infections; 2.8 million to HIV/AIDS; 1.8 million to diarrhea; 1.6 million to TB; and 1.3 million to malaria.

Several factors have coalesced to make this an ideal time for an emergence of infectious diseases, according to the Institute of Medicine.

The microbes themselves have demonstrated truly remarkable genetic and biologic flexibility. We’re seeing changes in our physical environment, with global warming and weather patterns being favorable to microbes. Social, political, and economic factors, compounded by war and famine, have led to a breakdown in public health measures. Human behavior and activities bring people into contact with species of animals that harbor transmittable diseases. And finally, high speed travel and the threat of terrorism have the world on edge.

Infectious diseases are a critical concern for developing nations, but they are no less active in more developed countries, especially as they associate with an explosion of chronic diseases. In fact, the role of infectious diseases in the creation of chronic diseases is becoming increasingly well defined.

Clearly, greater investment in predictive science and preventive measures will be required if further pandemics are to be avoided. The Spanish Flu Pandemic in 1918 and 1919 killed nearly 50 million people worldwide. The 1957 to 1958 Asian Flu Pandemic and the 1968 to 1969 Hong Kong Flu claimed 1 million and 700,000, respectively. The progressive reduction in the number of deaths was primarily the result of effective antibiotics that controlled secondary bacterial infections.

Today, some believe another massive flu pandemic is conceivable because of the converging elements of a “perfect storm.” These elements include, first, the possible emergence of a strain of influenza that is non-responsive to existing vaccines. Second, the association of the virus with a highly resistant secondary bacterial infection. And third, extraordinarily fast proliferation under the radar screen due to the hyper-mobility of today’s traveler’s. Consider that in 1950 we had 200 million travelers worldwide. Fifty years later, this number increased seven fold to 1.4 billion, and ten years later, those numbers continue to swell. Charles Darwin said, “It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change.”

The White House report not only acknowledges that o manage microbes we need to change faster than they do, but also, that we need to assure that the current weapons we possess to fight infectious diseases are not foolishly degraded by improper overuse. To review their findings and action steps, go HERE.

For Health Commentary, I’m Mike Magee.

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