The magazine of the UW School of Public Health

From the Editor

Spring/Summer 2004 Public Health Tackles Emerging Diseases

aaron.jpgWhen I was a senior in college back in the Midwest (just after the last Ice Age), I set about researching graduate programs that would give me a broad training in public health. Those I talked with recommended the University of Toronto, and so that's where I went. I got what I wanted out of the program, but I found the information imparted by the faculty to be quite dated. When people have asked about my graduate school, I often describe it as having "gained its reputation back in the era of infectious diseases." I meant that derogatorily—after all, I entered the field when the spotlight was on "community health," the organization and financing of health services, and the more "modern" afflictions of heart disease, accidents, chronic disability, and the like. Infectious disease was something in the past, of interest only to a few historians and bench scientists.

My bad!

If I or any of us needed a refresher course that humans remain vulnerable to viruses, bacteria, and other tiny bugs, we have gotten an intensive one over the past few years. If we needed to be reminded that Homo sapiens have enough in common with other animals to share their infections, we've gotten that, too. And, if anyone doubted that "globalization" was as much a biologic as an economic phenomenon, the now well-tracked movements of SARS, West Nile, and influenza across the globe are proof-positive. The Northwest Region at a Glance reveals our vulnerabilities in data about transportation patterns in each state.

These sobering realities certainly challenge our abilities and resources to protect the public's health. But, as William Foege's Viewpoint emphasizes, the more profound thing is that they challenge our way of thinking. Foege, former CDC director, counsels that we can no longer separate global actions from local actions, that we need to consider these realms simultaneously. He suggests that the Northwest is well-situated to be a leader in this approach to public health, with its strong base of local and state public health agencies and research and training institutions whose reach extends around the world, a view shared by Dean Patricia Wahl.

The message of Ann Marie Kimball's lead article, which reviews the factors—what's known and what isn't—that contribute to emergence or reemergence of diseases and infections, is that we have to keep on our toes. Fortunately, we have many public health professionals and organizations doing just that, making progress in efforts to prepare for and respond to infectious diseases outbreaks. The article by Christopher Thomas, Scott Seys, and Joseph Grandpre reports on a successful campaign to educate Wyoming residents about how to avoid West Nile virus and the mosquitoes that carry it. According to Gayle Shirley's sleuth piece, Montana public health officials effectively solicited the public's help in identifying a new tickborne disease; this is a great read that makes tick investigations sound exciting … really!

Of course, many challenges to protecting communities from emerging infections remain. Merilee Karr describes how one public health measure (clean water) can lead to unintended consequences (mosquito breeding habitat). The known infectious diseases hepatitis C and norovirus pose continuing challenges that will require prevention and treatment efforts for some time to come, according to articles by Jack Jourden and Matt Jaqua, respectively. And Alonzo Plough, Jo Ellen Warner, and Michael Loehr remind us that a global or local outbreak can require the extraordinary measures of isolation and quarantine, and we need to prepare for those possibilities now.

I trust you will find this issue of Northwest Public Health interesting and useful. As always, we welcome and encourage your comments.

Aaron Katz, Editor-in-Chief
Director, UW Health Policy Analysis Program