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Last Updated

08 Apr 2003

Source: Wall Street Journal, April 8, 2003


Flu Shot for the CDC


War and terror have a habit of repeating themselves. So do new infectious diseases. In its wartime debut and insidious spread, the recent outbreak of severe acute respiratory syndrome, or SARS, bears striking similarities to the disastrous 1918 influenza pandemic. But today, the outbreak is in some sense a blessing: It is giving the world a fire drill for how it would cope with any biological attack.

The chemical weapons of World War I brought us the 1925 Geneva Protocol, the treaty that the Bush administration says it is defending in Iraq. Today, the public health lessons we are learning may make all the difference between catastrophe and containment.

The particulars of modern technology and travel have made the SARS situation unlike any we've seen. High-speed jet travel delivered the disease to a world stage within four months. A similar scenario has been imagined in which terrorists with aerosolized stocks of smallpox, anthrax or the plague head to the four corners of the earth. How would we control the spread?

So far, SARS is not as contagious as the 1918 flu -- a blessing, since its mortality rate is actually higher. But the current epidemic underscores the fact that emerging infections will be increasingly and unavoidably global. As we've seen with food-borne epidemics, antibiotic-resistant bacteria, insect-borne diseases such as West Nile virus, and most tragically with AIDS, an outbreak anywhere is a threat everywhere.

With its dense mingling of humans, livestock, and wild and domestic birds, southern China is a notorious cauldron of genetically novel pandemic flu strains. SARS first struck China's Guangdong province last November, moving through Hong Kong, Singapore and elsewhere in Asia. But, largely because of current levels of vigilance, the Centers for Disease Control and Prevention had a quick and comprehensive accounting.

Clearly, the organization has learned from its missteps during the 1999 debut of West Nile virus and the 2001 anthrax scare. If those were, as some observers put it, "failed dress rehearsals" for bioterrorism, the agency's performance with SARS deserves rave reviews. The CDC this time brought crucial information and advice to the public, the media, medical professionals and airline employees.

In a historical moment already wracked with anxiety, CDC officials have turned what could have been epidemic fear into calm, informed reaction.

This is good news for bioterrorism preparedness. In the past year, federal, state and local health departments have learned that only realistic practice exercises can flush out the weaknesses in our public-health defenses. In the past, these weaknesses have included gaps in disease surveillance, laboratory capacity, communications, supply delivery, and especially in the network of personal and professional contacts that smoothes the way for swift institutional cooperation.

New infectious diseases will constantly evolve, taking a higher toll than wars. In 2003 as in 1918, the most dangerous adversary is nature itself.

Ms. Drexler, a Boston-based journalist, is the author of "Secret Agents: The Menace of Emerging Infections," issued recently in paperback by Penguin.