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Reuters Health
Dr. Stephen Ostroff from the National Center for Infectious Disease, in Atlanta, pointed to the spread of West Nile virus as an example of both the need for funding and the potential for success when enough resourcres are allocated.
"This is an imported disease into a new ecosystem where we had no understanding of what its potential was for spread or its implications for human health," Dr. Ostroff told Reuters Health. "I would venture to guess that in the last 22 months, we've learned more about West Nile virus than we had in the previous 60 years, because the resources were made available."
He pointed out that the number of cases in birds, horses, other mammalian species and mosquitoes increased dramatically in 2000, but there were fewer human illnesses than in previous years. "So we must have done something right, because that was not an accident, not the natural biology of the disease," he added. "When resources are pumped into the public health system it can make an impact."
The potential fro tragedy is exemplified by the experience in Israel, where the strain of West Nile virus is identical to that in the US, Dr. Ostroff said. "Last year, Israel experienced a very larg outbreak, approximately 400 cases, with 29 fatalities. It has that potential here in the US as well," he noted.
At a press conference, Dr. Ostroff outlined areas that need to be improved if the US public health system is to react promptly to new outbreaks, such as the need to harness the technology revolution so that states can rapidly diagnose emerging illnesses. Communication capabilities must be expanded, he said, and training opportunities for public health offices are inadequate, as are salaries needed to keep qualified professionals in the field.
"A major problem we found with the West Nile virus outbreak is that many states had dismantled their vector control programs. They had come to see the problem as more of a nuisance than as potential disease vectors."
An additional problem, Dr. Ostroff remarked, is that "Many states don't even have a single public health veterinarian."
I don't want to give the impression that we're impotent," Dr. Ostroff emphasized. "It's clear that we can harness technology, enhance our communication tools, do the training. All of these will put us in a better position to deal with these problems, but we can't do it without resources."
"Unfortunately, infrastructure is not a particularly attractive target for funders, who prefer to give money for specific diseases," Dr. Ostroff added.
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