Miami Herald (MH) - Wednesday, March 4, 1998
John Stamper; Herald Washington Bureau

The U.S. death rate from infectious diseases, excluding HIV/AIDS, rose by 22 percent from 1980 to 1992, Satcher said, because of outbreaks of new diseases, a resurgence of longtime killers like tuberculosis and development of antibiotic-resistant strains of other infections.

"Emerging infectious diseases are a continuing threat to the health of U.S. citizens and of people around the world," Satcher told a congressional hearing. "They cause suffering and death and impose an enormous financial burden on society."

Infectious diseases are the third-leading cause of death in the United States, Satcher said, and the No. 1 killer worldwide, causing more than 17.3 million deaths in 1997.

An outbreak of a previously unknown strain of influenza, known as the Hong Kong bird-flu, raised awareness of infectious diseases around the world last year, and there were several multistate outbreaks of food-borne diseases affecting strawberries, raspberries, apple juice and ground beef in the United States last year.

Satcher said new technologies that allow people and food to travel thousands of miles across the world in a matter of hours helped set the stage for the recent surge of outbreaks.

"Changes in food production have led to new safety concerns," he said. "Many foods, previously thought to be safe, such as eggs and fruit juice, have both transmitted salmonella in recent outbreaks."

More resources are needed to permit increased monitoring, more vigorous responses to outbreaks and to train doctors in developing countries, Satcher told a Senate Labor and Human Resources subcommittee.

The National Institutes of Health have launched a $1.9-million program to provide infectious-disease training for scientists in developing countries, where infectious diseases kill two-thirds of all children under age 5, Satcher noted.

And he said the Centers for Disease Control and Prevention in Atlanta are working with the World Health Organization and others to establish a network for global surveillance and investigation of disease outbreaks.

The numbers of infectious diseases has grown by more than three dozen since the mid-1970s, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Some of these new diseases and syndromes include: AIDS, liver disease from hepatitis C, tick-transmitted Lyme disease, the respiratory disease known as hantavirus and food-borne illness caused by E. coli.

Satcher said protection from biological terrorism has become increasingly important over the past few years, and that the public health system is working on early warning detection systems, training medical workers on how to respond and making sure appropriate counteragents are available.

Along with new killers, decades-old diseases are making a comeback in the United States and around the world as they mutate and become resistant to drug therapies.
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