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Ebola Followup NEW!

Hans Andersson hasse at panix.com
Tue Jan 30 14:09:31 EST 1996


In article <4eioo5$hgp at panix.com>, iayork at panix.com (Ian A. York) wrote:

> In article <hasse-2601961920200001 at hasse.dialup.access.net>,
> Hans Andersson <hasse at panix.com> wrote:
> [ ... ]
> 
> OK, I think I now understand your argument, and I'm pretty sure I 
> understand where, and why, we differ.  Your argument is that as far as 
> emerging diseases go, Ebola is a potential danger.  You further argue 
> that the CDC should be monitoring Ebola carefully.
> 
> I agree.  I've never disagreed with that.

Wrong! This is a quote from your own post: 

"I do not want to see journalists advocating research on the latest
flavour of the month. I do not want to see money being thrown at Ebola,
because that money will come from somewhere else..."

--Ian York,"Re:The return to The Hot Zone", January 18, 1996


>But here's where, I think, we
> differ:  You seem to feel that emerging diseases are *more important
> than*, or *as important as*, already emerged diseases; and with that I
> strongly disagree. 
> 
> Look again at your post (the one to which I'm replying).  You are citing
> the CDC in its scenarios, and members of the CDC in their ideas of
> important roles for the CDC.  The CDC is _there to monitor emerging
> diseases_.  What you're doing is looking at the CDC in the context of
> emerging diseases.  What I want you to do is look at the CDC in the
> context of diseases in general. 
> 
> Obviously, the CDC would be negligent if they didn't set up worst-case
> scenarios, and they would be dumb if they didn't consider Ebola a priority
> - and I certainly don't think the CDC is negligent or dumb. But that's a
> priority *in the context of emerging diseases*.  It's not necessarily a
> priority *in the context of diseases in general.*



JAMA and Joshua Lederberh have initiated an international campaign on
infectious diseases. This is how Lederberg presents it:

"JAMA and 35 other journals worldwide will document occurence, causes and
consequences of emerging and reemerging infections".

JAMA, Vol 275, No.3, Jan. 17, 1996, "Infection Emergent", p. 243


And this is an important part of the background:

"Tangible responses by governments in the form of budgetary or staffing
commitments remain negligible...  (Joshua Lederberg, p. 243)

Or, as CDC describes it:

"...the infrastructure to maintain vigilance and to respond to most
emergent or reemergent infectious diseases has generally continued to
deteriorate, Consequently, for domestic problems ranging from outbreaks of
cryptosporidiosis caused by contamination of municipal water supplies to
the currently growing crisis of antibiotic resistance, efforts at
surveillance, prevention, and control  have frequently been delayed or
inadequate. Global capacity to detect and respond to emerging diseases has
also been compromised as surveillance networks have deteriorated and
laboratory capacity for accurate diagnosis has declined in many
countries."

JAMA, Vol. 275/"Adressing Emerging Microbial Threats in the United States"
by Ruth L. Berkelman, MD, Robert W. Pinner, MD and James M. Hughes, MD., p.315


Ian,I've been reading many of these articles - please, listen and consider
this: 

* I haven't found one single article, yet, that are supporting your case -
that there's an opposition between emerging diseases and already emerged
diseases. *

I don't believe there is. And that's why I don't see anything strange at
all, when I see articles like these  - under the same JAMA umbrella:


Hu DJ, Dondero TJ, Rayfield MA, et.al. "The emerging genetic diversity of
HIV: the importance of global surveillance for diagnostics, research, and
prevention.
(JAMA, #275)

Tukei PM. "The threat of Marburg and Ebola viral haemorrhagic fever in Africa"
(East African Medical Journal, #73, 1996)

John TJ. "Emerging and reemerging bacterial pathogens in India"
(Indian Journal of Medical Research, 1996)

Borus P. "Rabies: the emergence of a microbial threat." 
(East African Medical Journal, #73, 1996  

Peters CJ. "Emerging infections -- ebola and other filoviruses"
(Western Journal of Medicine, #164, 1996)

Liu C-C, Lei H-Y, Chiang Y-P. "Seroepidemiology of measles in Southern
Taiwan - two years after the measles elimination program"
(Journal of the Formosan Medical Association/Taiwan, #95, 1996

Beyers AD, Donald PR, van Helden PD, et al. "Tuberculosis research - the
way forward"
(The South African Medical Journal, #86, 1996

Jaax NK, Davis KJ, Geisbert TJ, et al. "Lethal experimental infections of
rhesus monkeys with Ebola-Zaire (Mayinga) virus by the oral and
conjunctival route of exposure" 
(Archives of Pathology and Laboratory Medicine, #120 (February), 1996 

 
* Side by side - TB, Rabies, Measles, Ebola and other infectious diseases.* 

They all have an importance, and I've never said that money for filovirus
research and surveillance should be taken from TB-treatment or research.

What I've been saying is that filoviruses should also be a priority. Not
the highest priority in the world, not more money than AIDS - only, enough
funding for the necessary resarch and surveillance that scientists with
field and/or lab experiences of Ebola, are asking for. 

Are you advocating taking money from cancer treatment and heart diseases
for to finance the measles vaccine program? Are you advocating talking
dollars from AIDS research and putting it into Rabies studies?


> Your post shifted the playing field.  I say, "Baseball affects more people
> than ping pong," and you replied with a solidly documented post explaining
> the importance of paddle selection in ping pong. 
> 
> I repeat, as I've already said, that I think the CDC should have more 
> funding.  But I don't think that Ebola is as important as tuberculosis, I 
> don't think it will ever be as important as tuberculosis is today, and I 
> don't think that Ebola monitoring should be done at the expense of 
> tuberculosis treatment or polio vaccination.

 
If we're talking about sport, baseball or ping pong - doesn't matter much.
It's actually okay to play either, or both. You don't have to chose - or
stop playing baseball because you're invited to a ping pong game.

Honestly, I can't find any support in medical litterature or journals for
your chose-between-Ebola-&-TB or Ebola-research-will-be-at-the-expence-of-
tuberculosis-treatment-or-polio-vaccine.

--Hans Andersson, NYC
hasse at panix.com



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