Emerging Infectious Disease Threats Emerging Infectious Disease Threats Download Brochure CDC'S Plan for Addressing Emerging Infectious Diseases To address the threat of emerging infections, CDC, along with other federal agencies, state and local health departments, academic institutions, international organizations, and medical and public health experts, has developed a strategic plan Addressing Emerging Infectious Disease Threats: A Prevention Strategy for the United States. In the plan, CDC proposes improvements in the public health system that would allow effective detection and prevention of emerging infections and ultimately reduce health care costs. The CDC plan emphasizes four goals: rapid national and international detection and response to new, reemerging, and drug-resistant diseases applied research in disease diagnosis and prevention better communication and implementation of prevention strategies stronger connections between local, state, and federal public health providers to support disease tracking and prevention and control programs CDC's plan reflects its commitment to meeting the challenge of emerging infectious diseases. The need is urgent. Methicillin-resistant Staphylococcus aureus, a common cause of infections in hospitals, could also develop resistance to vancomycin, the antibiotic used as a last resort to treat serious infections caused by this resistant bacteria. Streptococcus pneumoniae, a major cause of bacterial pneumonia, is becoming increasingly resistant to penicillin and many other antibiotics. Changing food industry practices, dietary choices of the American people, and food supplies gathered from every part of the globe bring new challenges to providing a diet safe from microorganisms. CDC's strategy is based on the belief that it is much less costly, in both human suffering and economic terms, to prevent infectious diseases than to react with expensive treatment or containment measures to public health crises. Through the efforts proposed by CDC, the public health system in the United States will be better prepared to address the emerging infectious disease threats we confront. New Infectious Diseases Since the early 1970s, the U.S. public health system has been challenged by AIDS and a number of other apparently new infectious diseases, such as toxic shock syndrome, Legionnaires' disease, Lyme disease, Escherichia coli O157:H7 infection, cryptosporidiosis, hepatitis C, and hantavirus pulmonary syndrome. Reemerging Infectious Diseases A number of familiar diseases, such as cholera, malaria, tuberculosis (TB), dengue, and yellow fever, that were once under control in many parts of the world are increasing and spreading to new regions. The National Foundation for Infectious Diseases estimates that the cost of drug resistance approaches $4 billion per year and is increasing. Drug-Resistant Infectious Diseases The long-term use and misuse of antibiotics has caused many microorganisms to adapt to these drugs. Even antibiotics used to treat common bacterial infections are becoming ineffective; as a result, hospital stays are longer, health care costs are rising, and death rates are increasing. In recent years, new or increasing drug resistance has been discovered in organisms that cause malaria, TB, gonorrhea, meningitis, pneumonia, and ear infections. In addition, fewer new drugs are being developed, and our arsenal of effective drugs is diminishing. Resistance to the Antibiotic Vancomycin in Enterococcal Infections* in U.S. Hospitals Families and communities Changes in dietary habits, food processing and packaging, and availability of food from all parts of the world are contributing to an increase in illnesses due to foodborne diseases. Emerging infections spread by contaminated foods and water supplies may place whole communities at risk. Hamburgers contaminated with E. coli O157:H7 and served at a fast-food restaurant chain caused a multistate outbreak of bloody diarrhea and serious kidney disease in 1993. More than 600 persons got sick, 56 had kidney failure, and 4 children died. Also in 1993, a municipal water supply contaminated with the intestinal parasite Cryptosporidium caused the largest recognized outbreak of waterborne illness in the history of the United States. Over400,000 people in Milwaukee, Wisconsin, had prolonged diarrhea, and approximately 4,400 were hospitalized. The number of deaths is still under investigation. Children in day care facilities Now numbering over 11 million, children in day care facilities are at a much greater risk for intestinal infections, respiratory illnesses, and middle ear infections. Office visits for childhood ear infections, the leading cause of visits to pediatricians, increased 150% between 1975 and 1990, to approximately 24 million per year. Many of these illnesses are carried home and are spread to other family members. As Nobel Laureate Dr. Joshua Lederberg has stated, The microbe that felled one child in a distant continent yesterday can reach your child today and seed a global pandemic tomorrow. Emerging Infectious Disease Threats In the United States and abroad, infectious diseases increasingly threaten our health and raise health care costs. As society and the environment change, infectious diseases also change. Microorganisms adapt to the changing enviromnment and are carried to every corner of the globe by travelers, whose numbers are growing. Advancing technology and changes in the way we live, eat, and interact with others have made us more vulnerable to infectious diseases. New infections are emerging, diseases thought to be under control are returning, and many dangerous microorganisms survive drugs that used to kill them. Examples of New and Reemerging InfectiousDiseases in the 1990's Who is at Risk? People with lowered immunity Emerging infections are particularly serious in the growing number of people with lowered immunity, for example, those infected with HIV or receiving medications for cancer or organ transplantation. Others at higher risk are people with various underlying diseases, the elderly, people in nursing homes, and people with little access to health care, such as the homeless, migrant farm workers, and the poor. International travelers Increased international travel brings diseases once considered exotic to our doorstep. Recently, 75 international airline passengers arriving in California became ill with choleraone died; residents of an affluent area of San Diego County, California, came down with malaria; and troops returning from the Persian Gulf conflict brought with them a potentially new form of the parasitic blood and bone marrow infection leishmaniasis. Influenza travels rapidly around the globe today. Emerging infections can touch people everywhere, regardless of lifestyle, cultural or ethnic background, or socioeconomic status. The Public Health Picture The public health system of this country is not prepared for the emerging disease problems of a rapidly changing world. Current systems for keeping track of infectious diseases here and abroad cannot meet the threat of emerging infections. The nation's early warning system for infectious diseasesthe backbone of U.S. public health programs for more than a centuryis in disarray. Many foodborne and waterborne disease outbreaks go unrecognized or are detected late; drug resistance is not well understood; and global disease surveillance is rudimentary. "In recent years, our antibiotics have become less effective against many infectious agents, and experts in infectious diseases are concerned about the possiblity of a 'post-antibiotic era.' At the same time, our ability to detect, contain, and prevent emerging infectious diseases is in jeopardy." David Satcher, Director Centers for Disease Control and Prevention