WASHINGTON -- President Clinton will soon propose a $25 million initiative to combat the spread of infectious diseases, including virulent new strains of microbes that resist treatment by antibiotics and other drugs, administration officials said yesterday.
Public health officials have become alarmed about the emergence of such "superbugs" and more generally about the increasing incidence of infectious diseases once thought to be under control.
The extra money will be included in the budget request that Clinton sends to Congress early next year, administration officials said. It represents a 31 percent increase in the federal program to address emerging infectious diseases.
Dr. Jeffrey Koplan, the new director of the Centers for Disease Control and Prevention, said the additional money would be used to investigate outbreaks of infectious diseases, to upgrade the laboratories of state and local health departments, to develop diagnostic tests and to educate doctors and patients about the dangers from excessive use of antibiotics.
In addition, federal officials want to improve communications with city and county health departments.
In a recent test, the Centers for Disease Control found that it was unable to contact nearly half of the local public health departments within 24 hours.
"Over several decades," Koplan said, "the capabilities of state and local health departments have waned. They don't have the resources to do what they can and need to do. Many county health departments don't have computers, don't have e-mail or Internet capabilities. They report serious diseases on paper in the mail to state health departments and to CDC."
Such delays make it more difficult for federal officials to track the spread of disease, identify the causes and take action, Koplan said in an interview.
By analyzing the genetic characteristics of certain bacteria, scientists can sometimes identify a common source, as they did recently with an outbreak of food poisoning from Listeria that killed four people and sickened 40.
Scientists can send the "genetic fingerprints" for such bacteria by Internet to the Centers for Disease Control in Atlanta. Laboratory technicians there can compare the genetic data from different parts of the country, reaching conclusions with fewer cases than in the past.
But, Koplan said, "the whole system is only as strong as its weakest link, which unfortunately is often the county health departments."
The government also wants to beef up its network of doctors, hospitals and laboratories that report cases of infectious disease, so that outbreaks will be detected more rapidly.
Some of the new money would be used to investigate the growing threat posed by germs that are resistant to antibiotics. Sens. Edward M. Kennedy, a Massachusetts Democrat, and Bill Frist, a Tennessee Republican, expressed concern about the problem at a recent symposium on Capitol Hill.
Overuse of antibiotics in the United States and around the world, fueled by patients who demand antibiotics for every bout of the sniffles, has caused microbes to adapt to these drugs, creating "superbugs" that resist the usual methods of treatment. Drug-resistant strains of tuberculosis, gonorrhea and pneumococcal infections -- the most frequent cause of middle-ear infections in children and pneumonia in the elderly -- have become common in recent years.
If Congress approves the president's budget request, the Public Health Service would conduct a national education campaign to encourage more judicious use of antibiotics.
"Many people with a fever and cough assume that antibiotics won't do any harm, but that's not true," Koplan said. "They can do harm. They promote the emergence of drug-resistant bacteria. Moreover, many infections are viral. Antibiotics are of no value in treating them."
Sixty million unnecessary prescriptions are written every year for childhood viral infections that do not respond to antibiotics, and drug-resistant bacteria cause a million ear infections a year, many of them in children, officials said.
The Centers for Disease Control wants to develop new #i diagnostic tests so doctors will know immediately whether a patient's illness is caused by bacteria or viruses, or by some new strain of microorganism.
Officials said they also wanted to investigate the use and possible misuse of antibiotics in home health care, a booming sector of the health care industry that is certain to grow as the population ages.
Officials want to know whether antibiotics have been misused by patients receiving care at home and whether they too are being attacked by drug-resistant bacteria.
Pub Date: 12/27/98