Rewriting the Book on Infectious Disease

“If you think in terms of emerging infectious diseases in general, 70 percent of them originate in animals. SARS is a perfect example of how viruses can move from the animal population into humans.”— – W. Ian Lipkin, MD

“If you think in terms of emerging infectious diseases in general, 70 percent of them originate in animals,” Dr. Lipkin said. “SARS is a perfect example of how viruses can move from the animal population into humans. We’re talking about one physician, who picked up the virus in China, checked into a hotel in Hong Kong and, over the course of a few days, disseminated this virus widespread.”

Dr. Lipkin said this illustrates the need for rapid diagnostic systems to be available and accessible to physicians if similar, or more serious, outbreaks are to be avoided. And the technological weapons that physicians need in the war against infectious disease may be just around the corner.

When it comes to diagnosing the often misleading manifestations and defining the puzzling pathways behind these and many other diseases, today’s physician must be part scientist, part sleuth.

Developing Tools for Detection

“One of the things that we have been trying to do in my group now, for more years than I care to think about, is to develop a variety of tools that will allow us to find footprints of infectious agents,” he said. “When thinking about acute diseases and cryptic diseases and how to approach these kinds of problems, we set up a project to develop rapid, high-throughput tools so that we can characterize and investigate outbreaks of acute disease and survey animals for diseases that might emerge into the human population.”

Among the most promising tools coming online involve advancements in polymerase chain reaction (PCR) and gene-chip technologies, which will allow physicians to look at numerous different infectious agents at one time in both a timely and cost-effective manner. Currently most of the funding for the research and development of these technologies is coming from government sources, such as the Department of Homeland Security, to be used for viral hemorrhagic fevers and for poxviruses, but Dr. Lipkin believes these tools will soon be available in clinical practice, and not a moment too soon.

“Over the past decade, all of these emerging infections have been described worldwide and they all have the capacity to spread around the world,” he said. “There are unknowns, like SARS, that are going to be cropping up all the time. Once something starts here—because of globalization, tourism, and trade—it can spread from one hotel and a single individual returning home from a trip and go every which way.”