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Moderated by Allan Rosenfield
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text highlights from each speaker's presentation.
Speakers
C.J. Peters, University of Texas Medical Branch, Galveston
Special Pathogens in Three Cultures
Marcelle Layton, NY City Department of Health
SARS and Public Health Systems
John La Montagne, National Institute of Allergy and Infectious Diseases, Bethesda
A View from the Field and the Bridge
Panel 4 Discussion
Summary
Ebola. West Nile. And now SARS. "Every year or two we see a new virus, an old virus that wasn't supposed to be here, or an old virus doing something new," noted C.J. Peters, M.D., professor of microbiology, immunology, and pathology at the University of Texas Medical Branch in Galveston. He described how viruses travel with their hosts, bringing them to areas they may not have been able to get to on their own. "Viruses can't just pick up and go—they are ecologically constrained. The age of exploration started mixing viruses. But today we don't have to wait for Columbus—there's the airplane."
Peters explained how the genetic variability of viruses, multiple ecologic niches, urbanization, and global travel have combined to create evolutionary opportunities for viruses. But we have to learn to understand social, cultural, and economic differences among populations in order to control viruses effectively. "We have to find a way to get ahead of this. If SARS gets into certain areas of the world, we will not eradicate it," he contended.
When SARS does strike, especially in a major urban area, an effective public health response is critical for controlling its spread, said Marcelle Layton, M.D., assistant commissioner for communicable diseases for the New York City Department of Health. Such a response includes prompt detection of the outbreak, notification of key partners (including the medical community and law enforcement agencies), epidemiologic surveillance, medical and public health interventions (such as mass treatment or mass prophylaxis), and—most importantly—accurate and ongoing public communication. "Effective communication underlies every aspect of a successful response," emphasized Layton. "If you don't communicate well, and if you lose trust with misinformation, it's extremely hard to regain."
"We really are facing an important problem," added John La Montagne, Ph.D., Deputy Director of the NIAID. "SARS is an unpredictable and serious disease with dramatic impacts. It could have happened here (in this country)—we're very lucky." La Montagne supported continued collaboration both nationally and internationally, and credited the toils of SARS investigators. "It is an unbelievable testimony to the effectiveness of our public health institutions—not just nationally, but globally—that so much work and so much progress have been achieved in such a short period of time."
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