Reports

Germs Go Global

Why Emerging Infectious Diseases Are a Threat to America

October 2008

Germs Go GlobalGerms Go Global: Why Emerging Infectious Diseases Are a Threat to America finds that at least 170,000 Americans die annually from newly emerging and re-emerging infectious diseases, a number that could increase dramatically during a severe flu pandemic or yet-unknown disease outbreak.  Factors including globalization, increased antimicrobial (drug) resistance, and climate and weather changes are contributing to the increased threat. 

The report finds that the nation's defenses against emerging infectious diseases are insufficient, creating serious consequences for the U.S. health system, economy, and national security.  Some major threats currently in the U.S. include:

  • Emerging diseases, like the potential of a pandemic flu outbreak or another new diseases like severe acute respiratory syndrome (SARS);
  • Dengue fever sickens 100 to 200 Americans each year, usually brought back by foreign travelers, and is of particular concern along the U.S.-Mexico border;
  • More than 90,000 Americans have been infected by Methicillin-resistant Staphylococcus aureus (MRSA), which is the sixth leading cause of death in the U.S.;
  • An estimated 3.2 million Americans have hepatitis C infections, costing the country an estimated $15 billion annually in health care costs;
  • An estimated 1.2 million Americans are living with HIV/AIDS, and nearly 566,000 Americans have died from AIDS since 1981. Last year total federal spending on HIV/AIDS-related medical care, research, prevention, and other activities was $23.3 billion; and
  • Remerging diseases, which were thought to be nearly eliminated in the U.S., including measles, mumps, and tuberculosis (TB).

Worldwide, infectious diseases are the leading killer of children and adolescents, and are one of the leading causes of death for adults.   According to the National Intelligence Estimate, "newly emerging and re-emerging infectious diseases...will complicate U.S. and global security for the next 20 years.  These diseases will endanger U.S. citizens at home and abroad, threaten U.S. armed forces deployed overseas, and exacerbate social and political instability in key countries and regions in which the U.S. has significant interests."

The Germs Go Global report examines major vulnerabilities in the current U.S. strategy for combating infectious diseases, including:

  • Treatment: While the U.S. government has invested significantly in treatments that could counter an intentional biological attack, new drugs to treat emerging diseases and new antibiotics to address growing antimicrobial resistance have received far less attention. The development of new, improved therapies to treat drug resistant bacterial infections, as well as influenza and other viruses, is essential.
  • Surveillance:  Every state and local health department should be part of a disease surveillance system that is interoperable among jurisdictions and agencies to ensure rapid information sharing. Health information technology (HIT) should be mobilized far more effectively to support public health surveillance. And, the U.S. needs to be a leader in efforts to accurately assess the burden of infectious diseases in developing countries, detect the emergence of new microbial threats, and direct global prevention and control efforts.
  • Diagnostics: New rapid diagnostic tests are needed across the spectrum of emerging infectious diseases.  Improving point-of-care testing is particularly important. 
  • Vaccines: There are still no highly effective vaccines available to prevent three of the world's largest killers: HIV/AIDS, TB, and malaria.  And, a large proportion of the world's children do not have access to currently available, highly effective vaccines.