Better Surveillance Urged to Deal with New Disease Outbreaks
Washington, DC, August 21, 2003 (PAHO)—The nations of the Americas must strengthen their surveillance mechanisms to deal with newly emerging diseases ranging from SARS to West Nile Virus and yellow fever.
Experts of the Pan American Health Organization (PAHO) Monday cautioned against being complacent regarding critical communicable diseases and their spread in the Americas.
They told a briefing held as part of a PAHO health ministers conference here this week that in some regions there has been a dramatic increase in the cases of dengue fever and in the threat of outbreaks of urban-based yellow fever. The experts also predicted that the West Nile Virus, up to now present mostly in North America and some Caribbean areas, has begun to spread southward in the Americas.
In the case of SARS (or Severe Acute Respiratory Syndrome), there were 8,422 cases between Nov. 1, 2002, and Aug. 7, 2003. Nearly 50 percent of these involved health workers. Moreover, 916 of them died. Faced with the possibility of a new outbreak, the experts stressed the need to have good systems of risk assessment and surveillance, based on the following three components:
- Risk assessment
- SARS alert
- Stronger surveillance and special studies to detect the SARS virus in humans and animals
The experts said that to be prepared to deal with new outbreaks is not only a matter of health care, but also an economic and financial issue. The emergence of this new disease in Hong Kong cost that Chinese dependency $7 billion, or about 4 percent of its Gross National Product.
The Americas is among the low-risk regions of the world, but its influenza – or flu -- surveillance system could be used as a model to deal with or prevent new outbreaks of SARS.
As for the West Nile Virus (WNV), there have been 4,578 cases in the United States since the first outbreaks of this epidemic in 1999. Over the past two years, there have also been reports of cases of WNV in the Cayman Islands, Mexico, Jamaica and the Dominican Republic. In addition, there was one suspicious case in the Bahamas.
The PAHO experts noted that the international public health community has learned the following from the SARS outbreak:
- In the world today, an infectious disease in one country is a threat to all.
- Experts in laboratory, epidemiology and patient care can work together for the public health good despite heavy pressure to publish academically.
- Emerging infectious diseases outbreaks often have an unnecessary negative economic impact on tourism, trade and travel.
- Infectious disease outbreaks reveal weaknesses in public health infrastructure.
- Emerging infections can be contained with high-level government commitment and international collaboration if necessary.
Jungle Yellow Fever outbreaks this year were noted in Bolivia, Brazil, Peru, and the border of Colombia and Venezuela, totaling about 200 cases. To halt the spread of yellow fever, the experts cited prevention strategies from a PAHO technical advisory group that include vaccination of all residents in enzootic areas, immunization of all travelers to those areas, and control of the Aedes Aegypti mosquito to prevent transmission of urban yellow fever.
PAHO was established in 1902 and is the world’s oldest public health organization. PAHO works with all the countries of the Americas to improve the health and the quality of life of its people. It serves as the Regional Office for the Americas of the World Health Organization (WHO).
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