NYT article about disease spread.
June 2, 2000
Disease Spread Is Traced to Many Agents
By DENISE GRADY
WASHINGTON, June 1 _ Parents who
shun vaccines, patients who demand
antibiotics for every sniffle, farmers
who use penicillin to fatten their cows and
people who wash with antibacterial soaps are
all contributing to the spread of disease and
the emergence of dangerous, drug-resistant germs, researchers said today at
a press briefing on infectious diseases held by the American Medical
Association.
Worldwide, infectious disease is the leading cause of death. In the United
States, it is the third-leading cause, after heart disease and cancer, and deaths
from infection increased from 1980 through 1995.
A speaker at the meeting also warned that the health care system in the
United States was not prepared for a bioterrorist attack, in which hundreds or
thousands of people might flood hospitals, needing treatment for diseases like
anthrax, plague or smallpox, which most doctors in this country have never
seen.
Dr. Bruce G. Gellin, executive director of the National Network for
Immunization Information at Vanderbilt University School of Medicine in
Nashville, said unfounded theories ostensibly linking vaccines to disorders
like diabetes and autism were needlessly alarming parents and making some
reluctant to vaccinate their children.
When a child falls ill shortly after being vaccinated, even though it is almost
certainly a coincidence, it is human nature for parents to suspect the vaccine,
and Dr. Gellin acknowledged that their stories make powerful, frightening
anecdotes. But he said there was no evidence that any vaccine could cause
autism or diabetes. Asked to comment on recent Congressional hearings
about the possibility, he said, "passion overtook science."
Dr. Gellin warned that even a small drop in the vaccination rate could lead to
a resurgence of diseases like measles and whooping cough, both of which
can be severe and even fatal. But young parents today may not take the threat
seriously because they themselves were vaccinated and have no memory of
how severe those diseases can be. Even chickenpox, which many people
consider minor, leads to 15,000 hospitalizations and 100 deaths a year, he
said.
Declines in the vaccination rate have led to measles epidemics this year in the
Netherlands, with more than 3,000 cases, and in Dublin, with more than 700.
Several deaths have occurred in each country.
Another speaker, Dr. Stuart Levy, director of the Center for Adaptation
Genetics and Drug Resistance at Tufts University in Boston, said antibacterial
soaps and sprays, popular for washing hands and spritzing kitchen counters,
may actually encourage the growth of ever-hardier, drug-resistant germs.
Dr. Levy said consumers should buy only products without antibacterials,
and manufacturers should leave out the antibacterials and go back to making
plain, old-fashioned soap and detergent.
Dr. Levy said he had made his concerns known to manufacturers. Some
seemed to take him seriously, he said, but others, he suspected, "wish people
like me would just go away."
He said the problem with antibacterials was a simple matter of "survival of
the fittest." Rather than killing all bacteria, the products destroy only the
weakest, leaving stronger ones to survive and multiply.
If people acted like surgeons and scrubbed for 10 minutes or left the spray
on their kitchen counters for a half hour, the chemicals might actually kill
more germs, he said. But nobody does that.
His research has shown that bacteria resistant to antibacterials are also
resistant to some antibiotics used to treat infections in people, and so, he said,
widespread use of the products may be contributing to the rise in infections
that are difficult or impossible to treat.
Overuse of antibiotics is also a factor in the development of resistance, Dr.
Levy said, citing patients who pressure doctors for antibiotics that are not
needed and farmers who use the drugs as pesticides on fruit trees and
growth promoters in livestock.
Dr. James Hughes, director of the National Center for Infectious Diseases at
the Centers for Disease Control and Prevention, attributed the rise in death
rates from infectious disease partly to lax monitoring, because of the
mistaken belief that such diseases had been largely wiped out in the United
States.
Dr. Hughes also warned that the world had truly become a global village, and
that the United States must pay more attention to diseases elsewhere and
"expect the unexpected," meaning outbreaks of illnesses that have not
occurred here before. The outbreak of West Nile encephalitis in the New
York area last year was an example, he said, noting that the disease had
previously been reported only in Europe, Western Asia and Africa.
Dr. Michael Osterholm, chairman of a private company, Infection Control
Advisory Network, in Eden Prairie, Minn., said terrorists could easily obtain
infectious organisms and the means to grow and disseminate them. For
instance, Dr. Osterholm said, crop-dusting airplanes can be bought over the
Internet.
Dr. Osterholm predicted that some sort of germ attack was bound to occur,
but, he said, the United States was not prepared.
He said stockpiles of drugs and vaccines were needed, along with plans and
systems for quickly diagnosing diseases and treating huge numbers of
victims.
Copyright 2000 The New York Times Company |
