The United States is unprepared to deal with many infectious diseases, members of a U.S. Institute of Medicine panel said yesterday.

“The United States has taken important steps,” said panel leader Margaret Hamburg.  The group released a report yesterday on microbial threats.

“The present reality is that we are unprepared … We still have not done enough in our defense and in the defense of others,” she said.

Influenza could kill hundreds of thousands and damage the U.S. economy but health officials are unprepared to track or treat an outbreak, according to the panel.

“This experience with severe acute respiratory syndrome is just the most recent wake-up call,” said James Hughes, chief of the infectious diseases unit at the Centers for Disease Control and Prevention, referring to a mysterious pneumonia that might have killed nine people and has been reported in seven countries.  The panel recommended that Washington work with other countries to coordinate efforts to detect and treat outbreaks.  The report also called for the United States to fight the use of antibiotics on farm animals if they are also used on humans, which allows diseases to become more potent.

The panel, however, said U.S. efforts to prepare for a biological terrorist attack could help public health systems prepare for infectious disease outbreaks.

“We think we have an unprecedented opportunity in this country to continue to rebuild the systems required to deal with infectious diseases.  We see this report as a call to action,” Hughes said (Maggie Fox, Reuters, March 18).

RAND Report

Infectious diseases can weaken national security and the nation’s military capacity, according to a RAND report.

The report cited South Africa, where one-quarter of the population is HIV positive, as a country that has a weakened security system due to infectious diseases.  RAND called on U.S. intelligence to focus more closely on public health threats, particularly from countries with poorly developed medical systems.

“Considerable policy attention and resources are flowing to build defenses against the relatively unlikely scenario of a large-scale bioterrorist attack.  Responses to more commonly occurring and currently more taxing natural outbreaks remain relatively overlooked and underfunded.  Serious assessments of the threat posed by infectious diseases suggest that this imbalance needs to be addressed, as a matter of both fiscal responsibility and judicious public policy,” the report said.  “Security, conflict, and the definition of general threat have become more diffuse and opaque,” it added (RAND report, March 2003).

Almost 80 percent of attendees at the recent Pediatric Preparedness for Disasters and Terrorism conference in Washington said the United States is not prepared to treat children after a terrorist attack.

Pediatric doses of medicine and specialized training for medical personnel are required, according to experts.

“It’s a matter of national urgency that we move as quickly as possible to protect our children,” said Irwin Redlener, a member of the American Academy of Pediatrics task force on terrorism (Donald McNeil, New York Times, March 19).

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