Infectious diseases

Mary Pickett, M.D.

Global cooperation needed to stop the spread of Ebola virus disease

The news and images out of West Africa, the center of an outbreak of deadly Ebola virus, are a bit scary. In the three countries affected by the outbreak —Liberia, Sierra Leone, and Guinea — more than 1,300 people have been sickened by the virus and more than 700 have died. Liberia closed its borders in an effort to prevent the infection from spreading. Images of health workers in protective gear ministering to patients and disinfecting the dead flash across screens. The Peace Corps has pulled all of its volunteers out of the three countries, and U.S. health officials have issued a warning not to travel to this area. We live in an interconnected world in which air travel can spread contagious infection thousands of miles away in a few hours. The director-general of the World Health Organization has warned that this outbreak is moving faster than our efforts to control it and it comes with a high risk of spread to other countries. If Ebola does spread, containing the epidemic will take a level of cooperation on the part of the global public that we’ve never before needed.

Anthony Komaroff, M.D.

Not quite a threat yet, but MERS merits watching

In 2012, after the CDC declared SARS presented a threat to the public’s health and safety, public health and infectious disease experts took note of a new viral respiratory disease that was also caused by a coronavirus, Middle East Respiratory Syndrome (MERS). So far, roughly one-third of the people with confirmed cases of MERS have died. Until recently, most cases of MERS occurred in countries in the Arabian Peninsula. But this month, two cases of MERS have been confirmed in the United States. At the most recent meeting of WHO’s Emergency Committee members expressed growing concern about MERS, but since there is currently “no evidence of sustained human-to-human transmission” the situation doesn’t yet meet the criteria for a Public Health Emergency of International Concern.

Lori Wiviott Tishler, M.D.

Drug-resistant bacteria a growing health problem

Antibiotic-resistant bacteria sicken more than two million Americans each year and account for at least 23,000 deaths. The main cause? Overuse of antibiotics. A new report from the Centers for Disease Control and Prevention, Antibiotic Resistance Threats in the United States, 2013, details the health and financial costs of antibiotic resistance in the United States. In terms of health, antibiotic resistance should be in the CDC’s top 15 causes of death. It also adds as much as $20 billion in direct health-care costs. And the problem could get worse before it gets better. Antibiotic resistance is a problem because commonly used antibiotics will become less able to treat common infections. The CDC identified three types of bacteria as urgent hazards: Clostridium difficile, Enterobacteriaceae, and Neisseria gonorrhoeae. Decreasing the use of antibiotics and preventing infection in the first place are two key steps to halting the problem.

Patrick J. Skerrett

Lyme disease 10 times more common than thought

The 30,000 cases of Lyme disease reported to the Centers for Disease Control and Prevention (CDC) each year are just the tip of the iceberg. According to a new CDC estimate, more than 300,000 Americans are diagnosed with the tick-borne disease each year. The new number was presented at the 2013 International Conference on Lyme Borreliosis and Other Tick-Borne Diseases, being held in Boston. Although the disease has been diagnosed in almost every state, most cases reported to the CDC are in the Northeast and upper Midwest—96% of cases come from 13 states. The new estimate comes from a multi-pronged approach: gathering case reports from doctors, sifting through health insurance claims, analyzing data from clinical laboratories (which do the tests necessary to diagnose Lyme disease), and surveying the public for self-reported Lyme disease.