- 22:41 10 October 2013 by Debora MacKenzie
- For similar stories, visit the Epidemics and Pandemics and US national issues Topic Guides
“We are less safe.” So Tom Frieden, head of the US Centers for Disease Control and Prevention in Atlanta, Georgia, announced on Twitter last week, as he prepared to send 8754 of his staff – two-thirds of the world’s biggest body of disease-watchers – home on furlough due to lack of government funding. It was part of the massive shutdown of US federal agencies in the wake of political intransigence in Congress over a budget.
“They protected you yesterday, can’t tomorrow. Microbes [and] other threats didn’t shut down,” Frieden added. But are we really less safe? And if so, how, exactly?
Obviously, this makes less difference if you live outside the US, but the uniquely global reach of the CDC affects us all in some ways. Even in the US, the effect may be subtle, because state governments have primary responsibility for public health. But they have always needed the CDC to marshal them in the face of any threat that crosses state lines – and sometimes even those that don’t.
That became clear earlier this week when CDC had to call back 10 of the people who run PulseNet, a computerised system for genetically tracking germs carried on food. US agriculture inspectors – deemed too important to furlough – had announced that chicken producers in California were the probable source of an outbreak of Salmonella that the CDC had been tracking since March, which has sickened 278 people in 18 states.
The affected states were tracking their own strains. But the PulseNet platform allowed the CDC to put the data together, and find that four of the seven strains of bacteria in the outbreak are novel, many have multiple resistance to antibiotics, and all came from chicken plants in California that have spread some of these bacteria before.
Nearly half the people infected have been hospitalised, twice the usual rate, suggesting these are nastier bugs than normal. Thankfully no one has died in the outbreak, though Salmonella can leave lifelong, debilitating after-effects.
James Wilson of Ascel Bio, an epidemiological consulting firm in Denver, Colorado, believes the CDC should focus its limited resource on the tuberculosis cluster left by a Nevada woman who died, along with her twin babies, of the infection in July.
Of 200 people who had contact with the woman and have been tested, 26 were infected. Nevada state officials had asked the CDC for help testing 140 babies who shared intensive care with the twins, says Wilson. But because of the shutdown, that is now on hold.
So is an investigation of evidence, published this week, that the mosquito-borne virus dengue fever has been spreading unrecognised in Houston, Texas, since 2002. Dengue kills 25,000 people a year across the tropics. It had been absent from the US since the 1950s – but sporadic cases recently have crept back into the south.
It is especially dangerous when people encounter one strain, then another, as this can trigger a deadly immune reaction. Worryingly, the Houston strain is different from one seen in Florida in 2010, meaning encountering both might now be a possibility if they have spread along the Gulf coast. Finding out if they have will require intensive surveillance of people and mosquitoes across the southern US, says Peter Hotez, head of tropical medicine at Baylor College of Medicine in Houston. Only the CDC can do that.
Outside the US, the CDC runs a network of 10 global disease-detection centres, of which eight are now closed. They are often the only modern epidemiology available in tropical countries where novel outbreaks could be brewing, such as the next flu pandemic, or something completely unexpected like MERS, the coronavirus that emerged in Saudi Arabia last year. The annual Hajj pilgrimage to Mecca is now under way, and the CDC would normally be first to help investigate any suspicious disease outbreaks in returning pilgrims across the world. But as long as the shutdown persists, it cannot.
The worst problem for the CDC, however, might turn out to be that nothing really severe happens while most of its staff are forbidden from coming to work.
Political ideologues committed to “small government” could claim that this shows that the world does not need a publicly funded agency like the CDC and its comprehensive disease monitoring and rapid-response capabilities. Yet as New Scientist has reported many times, rapid forms of travel, booming populations of humans and animals, ecological disruption and changing global climate add up to a myriad new disease threats waiting to happen. Electing to stop watching for them because of a political spat does not change that fact.