Tuesday, June 02, 2015

MERS: A Rude Awakening

# 10,132

Although it is currently Korea's national public health and political nightmare, infectious diseases like MERS, Ebola, and novel influenza are just a quick plane ride away from anywhere in the world, and few places are truly prepared to deal with their arrival.

Whatever failures have occurred in the handling of MERS by the Koreans over the past few weeks (and there appear to have been many)  could easily have been duplicated - or at least matched - had the virus landed unannounced practically anywhere else in the world.

Call it a loss of innocence, or a rude awakening, but we are no longer protected by vast oceans or prolonged travel times from the importation of potentially deadly and exotic infectious diseases.

Our highly mobile society, interconnected by thousands of flights each day, provides millions of opportunities for novel pathogens to travel globally every day.

Over the past 18 months we've seen H5N1 imported into Canada by a nurse returning from China, H7N9 in Vancouver brought back by a couple (again from China), Ebola introduced into the United States on several occasions, Lassa Fever brought to Minnesota and New Jersey, and two introductions of MERS into the United States.

The fact that we haven't seen a major outbreak from one of these introductions is probably more a matter of good timing and luck, than of skill.  The notion that `it couldn't happen here', or `we'd be better prepared' is misguided optimism.

It can happen here. And the odds are it will at some point. 

The introduction of Chikungunya into the Americas in late 2013 - which has led to more than a million infections in the Caribbean and Central and South America - is an excellent example of how well a novel virus can adapt to new surroundings.

Luckily, it has a very low fatality rate, although it can cause permanent disability.  And Chikungunya will likely become a problem in North America in the years to come. 

A year ago February, in The Global Reach Of Infectious Disease, we looked at rationale behind several national and international initiatives designed to deal with the growing threat of the international spread of infectious diseases. 

  • In WHO: IHR & Global Health Security, we looked at the large number of member states which have yet to meet the core surveillance and response requirements of the International Health Regulations that went into force in 2007.
  • And just last week, in Be Prepared For Surprises (Redux), we looked at calls for further extensions on implementing the IHR core requirements.
  • An Assessment by the Director of National Security last year (see DNI: An Influenza Pandemic As A National Security Threat) found the global spread of infectious diseases – along with cyber attacks, terrorism, extreme weather events, WMDs, food and water insecurity, and global economic concerns.- constitutes a genuine threat to national security.
  • While in CIDRAP On The Global Health Security Agenda, we looked at a 26 nation initiative to improve global health surveillance & emergency response in this age of rising infectious diseases. 

You’ll find more on the CDC’s Global Health Website at:

Why Global Health Security Matters

Disease Threats Can Spread Faster and More Unpredictably Than Ever Before
A disease threat anywhere can mean a threat everywhere. It is defined by
  • the emergence and spread of new microbes;
  • globalization of travel and trade;
  • rise of drug resistance; and
  • potential use of laboratories to make and release—intentionally or not—dangerous microbes.
(Continue . . .)

As we discussed in The New Normal: The Age Of Emerging Disease Threats, the reality of life in this second decade of the 21st century is that we are probably more vulnerable to global disease threats now than we have ever been before.

Yet,  somehow we’ve been lulled into a false sense of security. A belief that it won't happen here, or anytime soon, and if it does . . .  it won't be that bad. 

Unfortunately, viruses don’t read calendars, or play by `mostly likely worst-case scenario rules’ that are adopted by most planning committees.

The time has come to take pandemic planning seriously again.  

Not so much because of what is happening with MERS right now, but because there’s a growing list of pathogens with pandemic potential queuing up around the globe, and one day we're going to find one of them is ready for prime time. 

No comments: