Epidemics and Outbreaks/Happy Earth Day!

As I stated in the blog post titled "Beware the Bewildering Bug" on Feb. 25, 2017, my area of concentration while a grad student earning a Masters of Public Health degree was on the epidemiology of infectious diseases. During my studies, I completed a three-month internship at the Erie County Health Department's Bureau of Disease Control, conducting case workups of communicable diseases required by state law to be reported to the New York State Health Department, participating in a rabies vaccination event for cats and dogs, and even assisting on an investigation of a Salmonella outbreak at an area ox roast event. I also worked as an inspector for four years at the USDA's Food Safety Inspection Service, whose main mission is to protect the nation's food supply and prevent food-borne diseases. So the prevention and investigation of epidemics and outbreaks is a topic for which I have intense interest and a great deal of personal academic and professional experience. That is why an article I saw in last week's Buffalo News struck me so hard.

The headline read "Trump administration is ill-prepared for a global pandemic" (written by Lena H. Sun of The Washington Post, reprinted in The Buffalo News, April 9, 2017). The article reported on the Trump administration's laggard effort in hiring qualified people to upper management positions in various government departments and agencies, but focusing specifically on those that deal with public health. The lack of high-ranking policymakers is "leaving the nation ill-prepared to face one of its greatest potential threats: a pandemic outbreak of a deadly infectious disease... after 11 weeks in office, the Trump administration has filled few of the senior positions critical to responding to an outbreak. There is no permanent director at the CDC- Centers for Disease Control and Prevention- or at the U.S. Agency for International Development. At the Department of Health and Human Services, no one has been named to fill sub-Cabinet posts for health, global affairs, or preparedness and response." This is very troubling because no one can predict when the next major epidemic will occur or where it will originate.

Until the development of antibiotics and vaccines, infectious disease was the number one killer of humankind. Throughout history, epidemics of bubonic plague, cholera, tuberculosis, typhoid, polio and AIDS have killed millions of people. Many infectious diseases have been eradicated or at least greatly reduced to the point where most people don't even think about them anymore. However, mumps, measles and whooping cough cases have been increasing in recent years due to parents refusing to have their children vaccinated. Antibiotic-resistance is a problem I believe is only going to get worse with time. And then there are the various microbes that either have no specific treatment or are just emerging, and so little is known about their pathophysiology. Just since the turn of this century there have been outbreaks/epidemics of SARS (severe acute respiratory syndrome, that came out of nowhere in 2003, sickened thousands around the world, and fortunately, disappeared just as fast and has not returned), Ebola virus, avian/bird flu (which not only can wipe out whole flocks of domesticated fowl, but can infect and kill humans who come in close contact with diseased birds, and there is always the chance that a bird flu strain may mutate into a form that spreads from person-to-person, which if and when it happens can cause a global pandemic), hanta virus in the southwest U.S., and of course, Zika virus, which emerged last year in Latin America, especially in Brazil, prior to the Summer Olympics, and has resulted in hundreds, if not thousands of babies born with microcephaly, brain deformities and possible learning disabilities that won't be fully realized for years. My point is not to cause undue alarm, but to wake readers up to the fact that despite all the medical progress made in the last century, we do not live in a post-infectious disease world and we need to remain vigilant.

While the U. S. and other wealthy, developed nations have a superior public health infrastructure and clinical care system compared to poor, developing countries, where many epidemics originate and proliferate, modern, rapid transportation makes every nation susceptible to an epidemic. While hospitals and clinics can treat infectious diseases, if not through antibiotics, then at least through supportive measures like IV fluids, blood transplants and ventilators to keep patients alive until their immune systems can defeat the pathogen, it is generally up to governments and international agencies, like the World Health Organization, to prevent, control and ultimately end epidemics and outbreaks. This is not a partisan issue. Bacteria, fungi, viruses and parasites are equal opportunity killers. Microorganisms don't give a damn if you are a Republican or Democrat, conservative or liberal, or who you voted for in any election. While President Trump has spent seven of his first 13 weekends at his estate in Florida, at a cost of several million dollars to U.S. taxpayers, critical positions across the federal government have gone unfilled- and Republicans cannot entirely fault "obstruction" by Democrats- since many of these positions do not require Senate confirmation.

I'll conclude with a quote from Bill Gates, the co-founder of Microsoft and wealthiest man in the world, who has donated millions of dollars to international efforts to fight infectious diseases, in the same aforementioned article: "a pandemic threat needs to be taken as seriously as other national security issues. Imagine if I told you that somewhere in this world, there's a weapon that exists- or that could emerge- capable of killing tens of thousands, or millions of people, bringing economies to a standstill and throwing nations into chaos. Whether it occurs by a quirk of nature or at the hand of a terrorist, epidemiologists say a fast-moving airborne pathogen could kill more than 30 million people in less than a year." A wall along the Mexican border, whose effectiveness to prevent illegal immigration is up to debate, will do nothing to prevent the spread of a pandemic. Furthermore, it is not a good look when this presidential team is so much farther behind in filling critical upper management positions three months into its term compared to other recent administrations, while Trump has the time to meet with Sarah Palin, Ted Nugent and Kid Rock at the White House and play golf more than a dozen times since his inauguration day after declaring during his campaign that if he won the election he would be too busy to play golf. As an old saying goes and I think is apropos to the current state of the Trump administration: "Nero fiddles while Rome burns."

P.S. In honor of Earth Day, I have volunteered to participate in the Buffalo Niagara Riverkeeper's annual Shore Sweep event to help clean up one of Western New York's many waterways today. It is a rather small gesture, but at least I am doing my part to contribute to this fine organization's mission to beautify local aquatic environments. Hopefully, you dear reader will participate in some positive ecological activity on this day wherever you may live. Think global, act local!

#MastersofPublicHealth #infectiousdiseases #epidemiology #USDA #epidemic #pandemic #Trumpadministration #CDC #antibiotics #vaccines #SARS #Ebola #Zika #hantavirus #birdflu #WHO #EarthDay #BuffaloNiagaraRiverkeeper

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© 2017 by Peter McNeela.