Global Alert on Budding Epidemics Urged

Alarmed by evidence that diseases once thought virtually wiped out are staging a comeback, public health officials from the United States and Europe agreed Tuesday to establish a global early warning network to alert doctors and governments about budding epidemics.

The network--established by a U.S.-European Union task force on communicable diseases--will start by registering outbreaks of “food-borne” diseases like hepatitis and the E-coli bacterium, which can turn hamburgers into deadly poison. Officials said that if the plan works, it will be extended to cover all communicable diseases.

Relatively small outbreaks of disease often grow into global epidemics because local governments try to cover them up, and doctors in the rest of the world fail to recognize the microbes as they are spread by jetliners and other kinds of modern transportation, said Nancy Carter-Foster, director of the State Department’s emerging infectious diseases program, and Georgios Gouvras, head of the EU’s public health policy unit.

“These diseases know no borders,” Carter-Foster said. “For diseases, it is truly a one-world village.”

Under current procedures, the World Health Organization requires governments to report outbreaks of just three diseases--cholera, plague and yellow fever. A deadly disease like Ebola is not covered. And diseases on the list sometimes fall through the cracks, such as when India recently tried to cover up cases of plague.

“I’m not sure that the WHO or any other organization has the resources to do the job,” Gouvras said.

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Under the new plan, U.S. and European governments would report outbreaks on their territory, as well as those that happen elsewhere that come to their attention. Other governments would be encouraged to participate, in part by promises of aid to battle epidemics.

As a first step, the network will establish an extensive list of diseases defined not by name but by a list of clinical symptoms. The object, officials said, is to make sure that nothing is overlooked because physicians do not recognize it as a serious disease.

Carter-Foster said the idea was to make sure that “we don’t get caught where there is no [agreed] protocol for Ebola, so Ebola goes unreported.”

A Clinton administration report presented to the panel said world health officials virtually wrote off communicable diseases in the 1960s because antibiotic drugs, vaccines against childhood diseases and improved sanitation seemed about to render them extinct.

“As it turned out, our understandable euphoria was premature,” the report said. “New microbial threats are appearing in significant numbers, while well-known illnesses thought to be under control are reemerging.”

Overuse of antibiotics, in particular, caused the germs to evolve into drug-resistant strains. The health care profession grew complacent and missed emerging diseases like AIDS, which was known--although largely ignored--in Africa for more than a decade before it was first seen in the West.

Carter-Foster said the new network and related U.S.-EU programs are designed to help medicine keep up with the microbes.

“We have to learn to adapt and deal with various diseases,” she said. “So far, the diseases have just learned to adapt to deal with us.”

Gouvras added that the effort is not just aimed at exotic diseases. Common food poisoning is just as deadly and more often overlooked, he said.

“It’s not man-eating microbes that are the trouble,” Gouvras said. “It is a beef burger that went wrong or the strawberry on top of your cake.”