An invisible army, difficult to defeat
Washington, DC, December 26, 2002 (PAHO) -- Viruses and bacteria that are becoming more resistant are soldiers of an invisible army, difficult to defeat. Today, public health faces old and new diseases, such as malaria and AIDS, as well as others believed eradicated but that have returned with renewed strength, such as dengue. Facing this scenario, the countries have to strengthen their control, surveillance, and prevention.
According to experts, basically these diseases are divided into three categories: new diseases, or those described for the first time, such as AIDS; emerging diseases, those which in recent years acquired epidemic character as influenza, and reemerging, those which were believed eradicated or controlled but that, for different causes, they recurred, as dengue or yellow fever.
For PAHO, the magnitude of the problem of emerging and reemerging infectious diseases is manifested in several areas of public health: the ability of the national epidemiological surveillance systems to detect and investigate the appearance of new pathogens; the efficiency of laboratories to determine the etiology of these agents; and the capacity to notify, and speedily respond with effective interventions against the outbreak threat.
"The emergence of cases of serious diseases caused by hantavirus, E. coli O157 or the West Nile virus are recent examples of the risk represented by these diseases. Mutant microorganisms have led to antimicrobial resistance, often multiple, of strains of Mycobacterium tuberculosis, Streptococcus pneumoniae and Plasmodium falciparum, wich is an obstacle for the control of infections caused by them," notes a PAHO report on health promotion in the Americas.
Dr. George Alleyne, director of PAHO, noted that the Organization addresses the problem of emerging and reemerging infectious diseases from a regional and multisectoral perspective, in view of the fact that these disorders no longer affect the countries in isolated way; some have a focal geographical distribution, while others are widely disseminated in the Region.
For example, as a result of the increase in international travel, people who are infected when they are abroad can, in a matter of hours, introduce a new disease to another region. In addition to migratory movements, other factors that influence the appearance or expansion of viruses include: huge increases in the world’s population, with nearly 6 billion people alive today; ecological changes that can induce expansion of mosquito habitats; and mutations in microorganisms as their genetic structures change.
PAHO, along with other organizations in the Americas, participates in global networks to respond to threats from the globalization of international travel and the food trade. Networks cover verification of rumors of outbreaks, surveillance of influenza, and resistance to antimicrobial drugs, all on the Internet. In these efforts, the International Health Regulations are a useful instrument in international surveillance.
Activities also include the creation of two surveillance networks for emerging diseases, one in the Southern Cone and another in the Amazon region. The purpose of both networks is to exchange information on a timely basis; link epidemiological research with reliable laboratory results; carry out quick technology transfers, and to implement common surveillance protocols for specific diseases using the same laboratory procedures and quality control.
In Bolivia and in Chile protocols were prepared and workshops were held in surveillance and laboratory diagnosis of influenza, hemolytic uremic syndrome, and Hantavirus Pulmonary Syndrome. PAHO cooperation included the provision of standardized reagents for those pathogens. A Central America network is also being established with similar purposes, to train specialists in outbreak investigations, refine surveillance systems; and improve laboratory infrastructure and community participation in disease control.
In the case of Hantavirus, the guides pointed out the necessary steps to reduce occupational risk in transmission of the virus and the need for community participation to control the rodent that is the reservoir of the virus. As an example, in accordance with a technical recommendation, in February 2000 the population of Panama agreed to cancel a popular celebration, which helped reduce the risk of an outbreak of Hantavirus Pulmonary Syndrome.
PAHO, which was created in 1902, has been working for 100 years to improve the health and raise the living standards of the peoples of the Americas.
For more information, please contact: Daniel Epstein, Office of Public Information, (202) 974-3459, e-mail: epsteind@paho.org.
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