ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Wednesday, January 17, 1996 TAG: 9601170075
SECTION: NATL/INTL PAGE: A-1 EDITION: METRO
DATELINE: WASHINGTON
SOURCE: Knight-Ridder/Tribune
Deaths from infectious diseases in the United States soared in the 1980s, as new germs emerged and old ones re-emerged, scientists reported Tuesday.
The mortality rate between 1980 and 1992 increased from 41 to 65 deaths per 100,000, a 58 percent increase, according to the Journal of the American Medical Association.
That amounts to more than 50,000 lives.
Implicated in this and the likely scourges to come: poor preventive health, inadequate surveillance for new bugs, travel across international borders, climate change and mammoth changes in biodiversity.
``It's a race between microbial evolution or their genes and our social intelligence or our wits,'' said Joshua Lederberg, professor at Rockefeller University in New York, at a news conference here organized by the American Medical Association.
``It's a race that's winnable,'' he said, ``but we've just been nodding off on the watch.''
Included among the horror house of new or re-emerging diseases are tuberculosis, malaria and cholera; Lyme disease, dengue fever and yellow fever; gonorrhea, syphilis and herpes; ebola and AIDS.
HIV, the virus that causes AIDS, accounts for a large share of the increase in mortality.
Deaths in the 25-44 age group - the age group most affected by the AIDS epidemic - increased more than sixfold between 1980 and 1992, from six to 38 deaths per 100,000.
But even without HIV, the increase in U.S. death rates from infectious diseases was still a substantial 22 percent overall.
Adjusted for the aging U.S. population, the increase in mortality still rose by 39 percent.
The scientists at the news conference timed the release of their announcement with other organizations worldwide, to underline the global implications of the threat of new diseases.
Some of the infectious diseases, such as whooping cough and typhoid, can be prevented by vaccines, but scientists note that immunizations on the scale of polio and smallpox eradication campaigns have proven hard to achieve.
Others, such as tuberculosis and cholera, are not fatal if treated early. But some, such as AIDS, remain stubbornly untreatable.
Many infectious diseases inflict maximum punishment in tropical and subtropical countries, especially in the developing world.
Apart from humanitarian reasons, scientists said the United States had a powerful self-interest as well in stopping these diseases.
Microbes, a generic term for germs, bacteria and all other infectious agents, do not respect international borders. The 1 million travelers who cross international borders by air every day are a potent vehicle for microbes to travel from a tropical town to, say, New York City, in a few hours.
Thousands of refugees drift across international borders, too, often living in camps with inadequate nutrition or sanitation, ripe targets and carriers of disease.
The best example of microbes trekking across the world may be AIDS itself, which scientists speculate may have originated in Africa and then reached the United States and the rest of the world through infected people or through animals imported for scientific research.
Even as humans have become smarter in dealing with microbes, the microbes evolve to get around vaccine and antibiotic defenses, or find new ways to travel from human to human or from animals to humans.
Global warming, for instance, would cause the levels of oceans and lakes to rise and increase the spread of waterborne diseases.
Microbes that can survive only in warmer climes can spread as things heat up everywhere.
``The things that make infectious diseases come and go, emerge and re-emerge are changing all the time,'' said Robert Pinner, a scientist at the national Centers for Disease Control and Prevention in Atlanta, who presented data on the rising mortality rates.
The news is not cause for hysteria. The Ebola virus, for example, isn't knocking on your door right this minute. Nor is a malaria epidemic imminent. Scientists said they want to keep the issues of emerging disease on public and political radar screens.
``The indicators we are presenting today are danger signs,'' said Joseph Plouffe, a scientist at Ohio State University in Columbus. ``It is not cause for panic.''
LENGTH: Medium: 85 lines ILLUSTRATION: GRAPHIC: Chart by KRT: Infectuous diseases on the rise. color.by CNB