04 April 2014
Nations of the Americas have one of the world’s best records in collaborating to fight disease, and health officials from across the region say their collaboration must grow even stronger in the face of emerging health threats.
Top public health leaders from North and South America discussed shared challenges April 4 in an intercontinental telephone briefing organized in recognition of World Health Day April 7. The Pan American Health Organization (PAHO) hosted the briefing from its Washington headquarters.
PAHO is the Western Hemisphere affiliate of the World Health Organization (WHO), which coordinates the annual event. Activities in 2014 focus on preventing vector-borne diseases — with the slogan, “Small bite, big threat.” Each year 1 billion people are infected and sickened by one of the many diseases that are carried by mosquitoes, ticks and other pests. WHO estimates that these ailments kill 1 million people each year.
The Western Hemisphere was the first region of the world to overcome smallpox, a disease now eradicated worldwide. The region came close to beating the most fatal vector-borne diseases — yellow fever, malaria and dengue — in the mid-20th century, said PAHO’s director, Dr. Carissa Etienne. Lessons of the past must also inform future public health decisionmaking, she cautioned.
“Unfortunately, but also predictably,” Etienne said, “[these diseases] re-emerged after countries cut back on investment in vector control.”
Millions of people throughout the hemisphere remain at risk for malaria and dengue, but new diseases also challenge public health officials. Chikungunya, a mosquito-borne virus originating in Africa, made its first appearance in the Caribbean in December 2013. Since that arrival in the Americas, it has already spread to nations from Brazil to Canada, probably because of the many travelers from throughout the hemisphere who visit tropical island vacation spots.
The director of the U.S. Centers for Disease Control and Prevention (CDC) urged health care providers to be mindful of the capability of microbes to travel aboard airplanes along with vacationers. Dr. Tom Frieden said all patients who appear with fever and joint pain should be considered candidates for chikungunya infection if they have recently visited another country where it has appeared.
Frieden said nations of the hemisphere must maintain disease-tracking skills and equipment “so we can detect and stop outbreaks and prevent further spread.”
West Nile virus is another rapidly spreading disease that is a vector-borne newcomer to the Western Hemisphere, arriving in 1999. Also transmitted by mosquitoes, West Nile has caused 3 million cases in the United States alone since its first appearance, Frieden says.
Though as many as 80 percent of humans infected will not show symptoms, West Nile virus can sometimes lead to years of disability or even a fatal neurological condition.
Chikungunya and West Nile virus are just two examples of new disease threats.
“We, as a world, are in some ways more vulnerable than ever,” Frieden said. “And that means we, as a world, must collaborate more effectively than ever.”
Frieden said the United States looks forward to further collaborations with other nations of the hemisphere to strengthen public health systems to better contain disease.
In the face of these new threats, public health officials are heartened by recent progress in reducing the occurrence of malaria, another vector-borne disease. In Latin America and the Caribbean, malaria cases have decreased by 60 percent in the last eight years.