Health Agency Drafting Global Epidemic Battle Plan

Federal health officials, alarmed by increasing reports of infectious disease outbreaks around the world, are drafting a major plan to combat future epidemics, it was learned Sunday.

Officials at the federal Centers for Disease Control and Prevention said they are also worried about growing evidence that many bacteria are developing resistance to conventional antibiotics--the first line of defense--because the drugs have been in such frequent use in recent years.

“There is ample evidence that we have not conquered infectious diseases, and we’ve learned that we will probably continue to be surprised,” Dr. James Hughes, director of the CDC’s center for infectious diseases, said in an interview. “We will continue to confront new syndromes, new agents--or old agents in new areas.”

The CDC, in a summary of its proposed plan, warned that “a new virus that emerges in the developing world is only a short airline flight from the United States.”

Moreover, drug-resistant bacteria “can spread rapidly as a result of overcrowding, homelessness and poor infection-control practices,” said the summary, a copy of which was obtained by The Times.

The agency will hold a special meeting today in Atlanta with infectious disease experts to discuss the proposals, which are still evolving, the CDC said.

Currently, the CDC’s domestic surveillance involves voluntary cooperation by state health departments, which are frequently financially strapped, the agency said. Only limited surveillance for microbial drug resistance is conducted, and international surveillance is “rudimentary,” the agency added.

The CDC’s actions were prompted, in part, by a report issued last fall by the Institute of Medicine, a component of the National Academy of Sciences, which warned that society has become too complacent in believing that the war against infectious diseases has been won.

Instead, the world actually is becoming more vulnerable than ever to emerging microbes poised for an opportunity to strike, the institute said.

Some examples cited by the CDC in documenting the urgency included the critical problem of drug-resistant tuberculosis in the United States and the recent outbreak of food-borne illness on the West Coast, resulting in several deaths caused by restaurant hamburger meat tainted with a strain of E. coli bacteria.

Abroad, cholera has affected virtually all the countries in Latin America, and there are fears that the epidemic will continue to spread, the CDC said.

The plan calls for a network of 15 sites around the world, staffed with epidemiologists and laboratory personnel who would be responsible for studying and identifying infectious disease problems in those regions.

“They would be alert to detecting the unusual, and they would work with U.S. and international agencies to spot trouble before it got out of hand,” said Dr. Ruth Berkelman, assistant director of CDC’s center for infectious diseases.

The plan also said the CDC itself will need more infectious disease experts, citing a 12.5% decline in such specialists during the last decade (excluding AIDS experts).

“We need to maintain our ability to go out and investigate outbreaks and send epidemiologists and lab people when emergencies happen,” Berkelman said. “We sent out five teams of 14 people on this E. coli outbreak to three different states, California, Nevada and Washington. We need that capability to be able to send people out, overseas if necessary. We have to be able to respond to these outbreaks.”

The plan also recommends that the CDC work with the National Institutes of Health to expand laboratory and research efforts, so that scientists can understand new or newly identified organisms better.

“What we’re talking about here is making sure we have good diagnostic tests when new agents are beginning to be identified,” Berkelman said. “We need to be able to get those diagnostic tests out there . . . and also vaccines.”

Berkelman said the plan has been several months in the making, and CDC officials are convinced that the need is great.