Dr. James Hughes, director of the National Center for Infectious Diseases, noted that of the 57 million deaths worldwide in 2002, about a quarter were caused by infectious diseases. The top five infectious causes of death were lower respiratory tract infections such as influenza and pneumonia (3.8 millions), HIV/AIDs (2.8 million), diarrhea (1.8 million), tuberculosis (1.6 million) and malaria (1.2 million). Hughes noted that one feature of these five leading killers is a "propensity to acquire drug resistance."
"Infectious disease outbreaks are increasingly recognized to impact on national security and the global economy," said Hughes. "Local outbreaks and problems are recognized to have much wider implications and rapid and collaborative response are much better appreciated as being essential and, in fact, are expected."
Among the factors cited in a 1992 report, Emerging Infections, that have contributed to new infectious disease outbreaks, Hughes noted, are changes in demographics and behavior, technological and industrial changes, economic development and changes in land use patterns, the growth of international travel, microbial adaptation and change, and breakdowns in public health measures. A 2003 Institute of Medicine report also cited climate change and alterations in weather patterns, poverty and social inequalities, changes in ecosystems, war and famine, lack of political will and the intent to harm.
Hughes reviewed the spread of, and reaction to, SARS from Feb. 10, 2003, when ProMed reported a pneumonia outbreak in Guangdong Province, China through March 12, when the World Health Organization issued a global alert about an atypical pneumonia to March 18, when CDC reported 11 suspect cases in the United States. Hughes noted that CDC's response to the SARS outbreak involved more than 800 staffers. He also briefly reviewed outbreaks of West Nile Virus, Monkeypox and last year's flu, which killed more than 100 children.
Hughes stressed the need for alertness in the medical and research community, and for rapid communication about suspected problems.