In our continuing series on communicable world diseases and how they are being combated, we now take a look at the people who track outbreaks and hunt for new diseases. As Amy Katz reports, their work helps create new vaccines and also helps prevent epidemics.
Disease hunters in action, just outside Washington, DC, at the U.S. Defense Department's Global Emerging Infections System, known as GEIS. They are working to track, prevent and cure infectious diseases. In one laboratory doctors are working with Sand Flies, which carry Leishmaniasis, a parasitic disease that usually infects the skin, but can also infect internal organs.
Scientists also are working with mosquitoes that carry malaria. Chemists are working on new treatments and vaccines for a number of communicable diseases.
Captain Joseph Malone is the director of GEIS. "We play a supportive role in both outbreaks within the United States and are also helpful partners in outbreaks that may affect populations of people overseas, whether they be military or civilians."
GEIS is a military facility and it works to deliver the best possible health care to America's armed forces, who are spread across the globe. It cooperates with the CDC -- the U.S. Centers for Disease Control -- as well as the WHO -- the World Health Organization -- in tracking diseases.
The GEIS network of overseas medical research laboratories in Egypt, Kenya, Thailand, Indonesia and Peru play an important role. Most epidemiologists track emerging diseases by going to the places where infections have broken out.
Dr. William Raub, Deputy Assistant Secretary of Public Health Emergency Preparedness for the CDC, says it is difficult work. "There are often no short cuts -- just getting out there and tracking down the information. But the Epidemic Intelligence Service has distinguished itself over many decades of being able to come and supplement the resources of local communities on short notice and do that kind of analytical detective work that is often the difference between success and failure -- or particularly a quick understanding which leads to some kind of preventive measure."
The work can be risky and also emotionally draining. CDC epidemiologists were deployed to Uganda for the Ebola outbreak five years ago. More than half of its victims died -- many of them bleeding to death. Because the disease was so deadly and highly contagious, health care workers had to wear protective clothing and follow strict procedures to protect themselves.
The CDC's Scott Harper was among them. Some of his patients were the same age as his own children. "We had this huge boundary between them, and we could hardly touch them. We were completely gowned and gloved and had of these barrier precautions in place and kind of looked like spacemen, and it must have been terrifying for them. But to try to get the message across to them that we were trying to do all we could for them, and that we really cared for them, was a big challenge."
It is work that is crucial to preventing or halting major health threats -- according to the director of the CDC's Epidemic Intelligence Service, Douglas Hamilton. "It really is a detective kind of process where you gather bits of information, there is deductive reasoning, and you come up with a proposed plan."
A delayed understanding of an outbreak could result in many people getting sick -- and some dying.
Dr. Patrick Kelley, former director of GEIS and now with the National Academy of Sciences, says the work is especially important in this globalized age, when diseases can spread rapidly and the consequences can affect society and the economy.
"We saw that with SARS,” says Dr. Kelley. “SARS killed a relatively small number of people, less than a thousand, which is small compared to many global outbreaks, but it had huge economic effects on China, with lost tourism, lost trade. It also affected our ability to do business in that country."
There are several systems now in place to prevent such crises -- by finding emerging diseases before they spread.
Among them: the doctors and scientists at GEIS are analyzing data that is collected from American military bases around the world. If a disease is emerging in the region around a base, it will likely appear in the military community -- an early indicator of a potential outbreak. Cases can then be tracked and steps can be taken to limit the spread of the disease.
The same is true of the Global Public Health Intelligence Network -- which gathers and disseminates preliminary reports of public health significance -- 24 hours a day, seven days a week, in seven languages. The secure, internet-based system was developed by Canadian health officials in cooperation with the WHO and the Washington-based Nuclear Threat Initiative.
Diseases like SARS and avian influenza have prompted the strengthened global collaboration and communications -- positive steps in the global war against communicable diseases.