By Emily Bregel
Chattanooga Times Free Press
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CHATTANOOGA, Tenn. — Factors such as globalization, overuse of antibiotics and the threat of terrorism are contributing to the potential for spread of virulent strains of disease, but America's public health system also remains vulnerable to infectious diseases such as SARS and pandemic influenza, according to a new report.

If avian bird flu undergos a 'drift' and becomes much more infectious, experts say we could get a pandemic. (AP Photo/ Yonhap, Oh Su-hee)

"What we found in this report is that Americans are more vulnerable than we think we are and that our public health defenses are not as strong as they should be," Jeff Levi, executive director of the Trust for America's Health, said in a conference call Wednesday.

The Trust for America's Health, a nonprofit advocacy group focusing on disease prevention and bolstering the health of Americans, released the report on Wednesday.

A pandemic influenza epidemic could occur if influenza strains undergo a change to a new variety to which no one is immune and which can be easily spread, said Dr. Mark Anderson, local infectious disease specialist and part-time chief quality officer at Memorial Hospital. The last serious pandemic flu occurred in 1918, and the world is overdue for another one, Dr. Anderson said.

"We've been so worried about the bird flu. That's been around now for seven years and it is a deadly virus, but so far it's not easily transmissible between human beings," he said. "But we worry it could undergo a 'drift' and become much more infectious, and then we could get a pandemic."

Americans and U.S. public health programs must not become complacent about the dangers of newly emerging and re-emerging infectious diseases, which kill at least 170,000 Americans annually, the report stated.

State and local health officials and a infectious disease specialist say the public health infrastructure is prepared to handle a pandemic flu epidemic or other outbreaks of infectious disease, either natural or man-made.

The report calls for more support for local and state surveillance programs, as well as greater investments in treatments for emerging diseases, new antibiotics to address drug-resistant infections and vaccines for other infectious diseases such as HIV, tuberculosis and malaria.

Diagnostics and treatment are "outdated" for infectious diseases such as tuberculosis and staph infections, the report said. It attributed the lack of attention to such "third-world diseases" to the perception that these diseases are problems of the past or are serious only issues in the developing world.

Additionally, the report said drug companies don't see vaccines and treatments for these conditions as money-makers.

Local preparations

The Tennessee Department of Health hired about 100 more employees, including epidemiologists and emergency response coordinators, after receiving extra bioterrorism defense funding in the aftermath of the Sept. 11, 2001, terrorist attacks, said state epidemiologist Dr. Tim Jones.

In response to the SARS epidemic in 2002, the local health department partnered with area hospitals to capture emergency department data to detect any increases in broad categories of diseases, such as gastrointestinal problems, flu-like illnesses or upper-respiratory conditions, said Margaret Zylstra, epidemiology manager at the Chattanooga-Hamilton County Health Department. These efforts allow public health officials to catch any SARS-like incidents at an early stage, she said.

As part of regular surveillance of 70 infectious diseases, local health officials now thoroughly investigate the circumstances of how a disease was contracted, focusing on travel history to identify the source of a disease, Ms. Zylstra said.

Overuse of antibiotics has helped the development of drug-resistant strains of pathogens, such as methicillin-resistant Staphylococcus aureus, or MRSA, public health officials said.

Patients must use antibiotics properly, taking all that are prescribed by a doctor to ensure that an infection is killed off fully, Ms. Zylstra said. If the pathogens aren't fully wiped out, surviving bacteria live on with a resistance to the drugs they have encountered, Ms. Zylstra said.

"It's really important to follow a doctor's instruction on completing antibiotics the way they're prescribed," she said.

Copyright 2008 Chattanooga Publishing Company