The watch on the frontier of infection
By Tom Baxter
Among the recent victims of exotic diseases was an Alabama hunting dog named Brennel. The National Veterinary Services Laboratory in Ames, Iowa — the animal version of the Centers for Disease Control — confirmed last week that the dog had contracted the rare pseudorabies virus from a feral pig at a wild hog rodeo.
The virus that killed Brennel has never jumped over into a human host, although commercial hog producers inoculate against it to protect their stock. The attention focused by a government lab on Brennel’s ailment is a sign of the vigilance with which we now patrol the frontier of infection. We’re vastly better prepared to identify and respond to infectious diseases than Europe was in the 14th Century, when the Black Death killed more than a quarter of its population, or the Americas in the 16th Century, when smallpox and other newly introduced European diseases killed a possibly much larger percentage of the population.
But we worry, and with good reason, though we don’t often seem to know what we should be worried about.
Diseases like Ebola, which is ravaging West Africa, or the mysterious enterovirus 68, which may have caused the deaths of as many as five children in this country, stir a primal fear which is only stoked by the patented reassurances of experts that most of us will be okay. Statistically speaking, it’s folly to worry about Ebola if you haven’t had a flu shot, but it’s human nature to overlook the deadlier for the more interesting.
It’s not really one particular bug we should be worried about, but all of them, and government’s ability to hold the line against them over the long term.
As populations become increasingly mobile and the wilderness areas where germs go to hide are penetrated, the stage seems set for the emergence of more infectious diseases. The collapse of formerly stable areas into lawless states has already had an impact, with the re-emergence of polio in Syria.
This puts the CDC, which has had its share of problems recently, at the center of a larger debate over government and the role it will play in the 21st Century world.
Mistrust of government and dread of disease can be a potent combination. We’ve seen a good bit of it already with the reaction to the Ebola epidemic and the growing sense in some quarters that the public is being misled, largely due to the way the case of Thomas Eric Duncan, who became sick in Dallas after coming in contact with Ebola in Liberia, has been handled.
Atlanta, with a substantial international population and one of the world’s busiest airports, should take note of what went wrong in Dallas. Simply having the CDC as your home team is no guarantee things will go smoothly if a dangerous bug lands on your door step.
Embracing the presidentiality of the moment, Texas Gov. Rick Perry has been visible as the situation in his state has developed. On Monday he called for stepped-up federal screening of travelers arriving from countries where the epidemic is spreading and announced a “Texas task force” to access the readiness of hospitals in his state to deal with epidemic disease and monitor those who might be at risk.
But while local preparedness is needed, this isn’t primarily a local or state problem. It requires a very high degree of coordination at the federal and international level, which again puts it in volatile contact with the prevailing anti-government sentiment. The CDC, which has come under fire for wasteful spending and misplaced priorities, nevertheless holds a position of trust which some government agencies have lost. It’s likely to face much more severe tests of that trust in the years to come.
This is a nation divided over the most fundamental questions of how medical care should be provided, facing a future in which a united response to new and unfamiliar diseases will be absolutely necessary. The integrity and effectiveness of the CDC will be an important factor in how that plays out.