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Quick new approach catches scary diseases, CDC says

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Courtesy NBC News

In just six months, a pilot program to help Uganda watch out for deadly new health threats such as Ebola helped officials catch cases of West Nile virus, Zika virus, Crimean-Congo Hemorrhagic Fever virus, hepatitis E virus, and a bacteria that causes dangerous meningitis, U.S. health officials reported Thursday.

They say the results justify programs to help developing countries beef up their disease surveillance programs — to protect them and to protect people in the United States.

"We are all connected by the food we eat, the water we drink and the air we breathe, and stopping outbreaks where they start is the most effective and the least costly way to save lives," Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, told NBC News.

"And it's the right thing to do."

New diseases such as bird flu and Ebola popped up seemingly out of nowhere, and continue to flare up in unexpected places. In one of the most recent surprises, a Canadian traveler died of H5N1 after she returned home from a long trip to China. "It does just emphasize that we are all connected — that a virus anywhere in the world is just a plane ride away," Frieden said.

It's of constant concern with thousands expected to travel to the Olympics in Sochi, Russia next month and billions of people in east Asia traveling to celebrate the Lunar New Year.

West Nile virus likely hitched a ride on a jumbo jet, for instance. It quickly took hold in the New York City borough of Queens when it first appeared in 1999 and has now spread across the country to infect more than 37,000 people at last count, killing more than 1,500 of them. 

But it was SARS that got the attention of world leaders. Severe acute respiratory syndrome arose in China and spread around the world in the space of a few months in 2003, infecting close to 8,000 people and killing nearly 800 before it was stopped. Public health experts said catching new viruses like that more quickly would save lives, and a lot of money. "SARS cost over $30 billion in just two months," Frieden said.

CDC experts, working with local governments and health officials, set up two demonstration projects to see if it would be possible to scale up an effective surveillance and response network quickly. They chose Uganda, where Ebola and AIDS are both threats, and Vietnam, where H5N1 bird flu, cholera and enterovirus 71, which causes hand, foot and mouth diseases, all circulate.

Frieden says he was especially impressed with what the project in Uganda was able to accomplish between March and September of last year, building on work being done by the President's Emergency Plan for AIDS Relief (PEPFAR).

"The Uganda Ministry of Health and CDC implemented upgrades in three areas: 1) strengthening the public health laboratory system by increas­ing the capacity of diagnostic and specimen referral networks, 2) enhancing the existing communications and information systems for outbreak response, and 3) developing a public health emergency operations center," the team reports in this week's issue of CDC's weekly report on illness and death.

"Analysis of samples has led to confirmation of cases of infection with West Nile virus, Zika virus (a relative of dengue virus) , Crimean-Congo hemorrhagic fever virus, hepatitis E virus, Neisseria meningitides (which cases bacterial meningitis) and multidrug-resistant (including extensively drug-resistant) M. tuberculosis."

It should be a model for other programs, CDC said. "In less than a year, they were able to transform the system," Frieden said.

Right now, world health officials are keeping an eye on dozens of potentially dangerous new pathogens, from H7N9 bird flu in China, to the MERS virus in the Middle East. "For the Chinese New year there are more than 3 billion trips that will be taken in China," Frieden said. "We are in the middle of a surge of H7N9 flu and we anticipate that there will be more cases as people travel in buses and have more exposure to poultry." 

China has restricted poultry markets in some areas but more than 200 cases of H7N9 have been reported since October and more than 250 in total since H7N9 was first spotted around a year ago. Middle East respiratory virus, or MERS, has infected nearly 200 people since September of 2012 and killed at least 75. The worry is that either or both could acquire the ability to spread easily from person to person. Then they'd almost certainly spread quickly, causing a pandemic.

And there's always something even newer, like a virus that killed two teenagers in Congo in 2009 that looked like rabies, but killed like Ebola. 

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