Diseases Travel Fast, but So Do Tools to Fight Them

Governments around the world are launching medical and clean up operations to protect citizens against swine flu infections.
Washington Post Foreign Service
Wednesday, April 29, 2009

LONDON, April 28 -- Teenagers in New Zealand, honeymooners in Scotland, high-schoolers in New York and tourists in Israel all are sick from the same bug caught just days ago on trips to Mexico.

Their illnesses are the latest example of how diseases, from influenza to tuberculosis to cholera, are spreading ever more quickly in an increasingly globalized world. But so, too, are the tools necessary to combat outbreaks of disease: expertise, medicine, money and information.

"Things move incredibly fast; there has been an exponential rise in the numbers of people who move around the world," said Scott Dowell, a physician and head of global disease detection and response for the U.S. Centers for Disease Control and Prevention in Atlanta.

Although global pandemics are as old as history itself, diseases and the people who carry them have never been able to move so far, so fast. The number of international air travelers grew fivefold, to 824 million passengers per year, from 1980 to 2007.

Spanish explorer Hernán Cortés transported smallpox and measles to Mexico on long sea voyages in the 16th century. The current strain of swine flu leapt from Mexico to the far corners of the world on jumbo jets in a matter of hours.

"That makes it incredibly harder to manage these outbreaks," said Dowell, who is overseeing the CDC's assistance to Mexico on the swine flu case. In New Zealand, for example, officials were trying to track down all 350-plus passengers who were on the same flight as the infected high-schoolers (Air New Zealand Flight 1 from Los Angeles to Auckland on April 25).

Although the world is more vulnerable to the rapid spread of disease, many experts say, it has never been more prepared.

Advances in the understanding of disease, stockpiling of vaccines and global networks of medical surveillance have better equipped health professionals to deal with outbreaks. Instant communications have allowed information on diseases to move faster than the bugs themselves. The swine flu page on the CDC's Web site lets users sign up for e-mail alerts, podcasts and news feeds; more than 36,000 people have signed up for CDC Twitter alerts.

"It's a very different world than it was even 10 years ago," said Robert F. Breiman, a physician and coordinator of the CDC's Global Disease Detection Division center in Nairobi.

The Nairobi center is one of six maintained by the CDC around the world; the others are in Egypt, Thailand, Kazakhstan, China and Guatemala. In each, CDC medical professionals work with local officials to detect disease outbreaks in the region and coordinate their responses.

The centers were established in the wake of the 2003 outbreak of severe acute respiratory syndrome, or SARS, which caused hundreds of deaths around the world.

Dowell said that five CDC staffers, including infectious-disease specialists from the Guatemala office, are in Mexico, and that six more are likely to head there soon.

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