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Modern world ripe for infections

Tim Mutrie

The world may see a vaccine for HIV/AIDS early this century, or it may never see one, an expert in the field of infectious disease told an Aspen audience last night.

Infectious disease specialist Dr. Robert T. Schooley offered his insights on “Emerging Infections in the 21st Century,” during a free lecture at the Given Institute.

Schooley is director of the University of Colorado Health Science Center’s Infectious Disease Division and chairman of the executive committee of the National Institute of Health’s AIDS Clinical Trials Group. He discussed three prevalent diseases that are presently evolving throughout the world: HIV/AIDS, hantavirus and Creutzfeldt-Jakob Disease, or CJD.

“The only thing constant in the world is change. The last 20 years has shown us … that we haven’t seen anything yet,” Schooley said. “And these diseases may be closer to Aspen than you realize.”

Schooley offered an estimate that 35 to 40 million people in the world are presently infected with HIV/AIDS, and it’s spreading at a pace of about 16,000 new cases per day, 90 percent of which occur in developing countries.

“If we’re lucky, we’ll have an [HIV/AIDS] vaccine by 2010; if we’re not lucky, we’ll never have one,” due, he said, to variations in the virus. “The other issue is that it’s transmitted sexually, in most cases, and those types of diseases – herpes and gonorrhea – we’ve been working on vaccines for nearly 100 years with very little success.”

In the case of hantavirus, Schooley chronicled a 1993 epidemic in New Mexico that was first identified when a couple, suffering from pneumonia-like symptoms, abruptly died within a few days of each other. Within a month, 24 similar cases had sprung up – resulting in a very high mortality rate – among patients who lived in close proximity to one another and in many cases had contact with one another.

“It was found that this was a new virus, related to ones found in the Far East and South America,” he said, “with the most common host being the deer mouse, which is found in the Four Corners area.”

Schooley identified several factors that led to the identification of hantavirus, even though it’s been carried in deer mice and other rodents for a very long time: the migration of people into previously unsettled areas; the medical world’s recognition of the hantavirus epidemic as an “outbreak,” leading to close examination; and breakthroughs in technology that enabled researchers to scientifically pinpoint the virus.

Creutzfeldt-Jakob Disease, a progressive neural disease, is similar to many diseases prevalent in animals, such as wastings disease found in the elk populations of Wyoming and Colorado. Referencing the Mad Cow Disease epidemic in England – the result of cows being fed other cows’ remains, and similarly, the ingestion of neural matter – Schooley said CJD disease control is now improving because of reforms made in farming, medical and dietary practices.

Schooley said in the modern world, which features increasingly rapid intercontinental travel and people moving into new geographic habitats, the medical and scientific worlds must be more vigilant in detecting and identifying outbreaks.

“My prediction is that we’ll see more of these episodes,” Schooley said. “Interchange between populations of humans has been largely beneficial, but there are tradeoffs.”

“And we need to make public health decisions based on medical knowledge, not politics,” he said.


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