Altman, Lawrence K. "Wake Up Call on Threats of Disease," New York Times, 16 October


Altman, Lawrence K. "Wake Up Call on Threats of Disease," New York Times, 16 October
1992, p. A22

A report by the Institute of Medicine of the National Academy is a "wake up," a warning cry that
complacency about infectious disease is misguided. Medical personnel are being warned that of
the possibility of devastating new epidemics from diseases we once believed were "conquered."
The recent outbreak of anti-biotic resistant TB is only one such disease and we don't know what
others are lurking out there.

"Dr. Joshua Lederberg, a co-chairman of the committee and former president of Rockefeller
University in Manhattan, said that after the introduction of antibiotics and vaccines like the one
for polio after World War II, ‘we acted as though we had won the war on infectious disease, but
the fact is, infectious microbes have been around all along and will continue to pose threats to
public health.'"

"The report described a hypothetical outbreak of yellow fever in New Orleans to illustrate what
could happen if the authorities were unprepared for an epidemic from a known virus. Yellow
fever is a viral disease that is spread by mosquitoes. Once a major killer in New Orleans and
many other American port cities, yellow fever has disappeared. But the mosquitoes remain. If the
virus were to be reintroduced, perhaps by a traveler who was infected in Africa or Brazil, it
theoretically could be spread again by the mosquitoes.

"If yellow fever were to break out again among the 500,000 residents of New Orleans and the
earliest cases were not correctly diagnoses - and if a recommendation were made to vaccinate -
the small existing supply of yellow fever vaccine in North America ‘would be exhausted within
several days,' the report said. It would take time to mobilize larger stocks of vaccine in Brazil.

"‘We could predict with some confidence that 100,000 people would become ill with yellow
fever and that 10,000 would die within a 90-day period,' the report said.

"The report added, however that earlier and more effective responses are not likely unless the
worldwide infectious-disease surveillance system, a rudimentary network coordinated by the
World Health Organization, is improved."

"Although current United States and international surveillance efforts can do well in detecting
known communicable diseases, they fall short in their ability to detect new threats, the report
said, adding, ‘There has been no effort to develop and implement a global program of
surveillance for emerging diseases or disease agents.'"

The report urged that the international efforts to surveillance of communicable diseases be
improved, that the budget for the Center for Communicable Disease be increased, that
surveillance of hospitals be improved, and that the center provide computerized databases to
health care personnel.

There's more here that the usual plea for more money and better laboratories. In fact, the
complacency of the public is very real and could be extremely dangerous.

One notable thing about this article: it reappears in the Saturday edition of the Times, on 17
October. Not quite word-for-word but almost. I'm not sure this reflects any importance to the
piece; it may just be that the editor needed to fill up space. Or, someone may have felt the thing
so important as a warning that it was reprinted. The subsequent publication is on 17 October
1992, p. 14.