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Back to the future.

I admit it, I am a product of the 60's. When I was going to school and early into my career when I was so impressionable, it was pounded into my head that disease was largely environmentally induced. Apart from genetics, everything from the food we ate to the air we breathed enabled nasty chemicals to initiate carcinogenic processes, and on and on.

Looking back, it's interesting that during this same era, we witnessed the first major outbreak of the Ebola virus, machupo plague, lassa fever, marburg disease, and of course here in the United States, legionnaires' disease. Yet despite these developments, environmentally related infectious disease was no match for the barrel of hazardous waste featured on the literature of environmental activist organizations everywhere. Little wonder the following declaration received such little notice.

In the book, The Coming Plague, written by Laurie Garrett, medical historian Robert Huntington of the University of Kansas stated in the aftermath of the legionnaires affair,

When we grant that our knowledge of existing microscopic pathogens is deficient, we necessarily grant the possibility at least of a return to the great epidemics of the past...the possibility exists that a deadly and common organism could emerge that is easily spread from person to person and that might be aloof to all therapeutic and preventive methods... The Philadelphia event remains unsettling because it shows the very real limitations of our tools for investigating an apparently new microbial disease. If we are to retain public confidence in the face of some future serious epidemic, it is important that our limitations be widely understood. As a medical community, there is no cause to feel humiliated by the legionnaires affair. It is altogether proper that we be humbled.

Today, in a world plagued by AIDS and scared by an array of emerging pathogens ranging from new outbreaks of Ebola to the hantavirus to E. coli 0157:H7, etc., there can be no question that the prominence and relevance of infectious disease has recaptured both the public's and this profession's attention. From 1980 to 1992, mortality attributable to infectious disease rose a whopping 58%! Add to this recent and alarming stories having to do with evolving pathogenic microbes developing resistance to some of our strongest antibiotics, and one really has legitimate cause for concern.

Irrespective of the sensational work that has been done over the last two decades to better understand carcinogenic, teratogenic, and mutagenic compounds in our environment, it can no longer be denied that environmental health must also include on its agenda the threat of infectious diseases. This is particularly true given that many of these "new" diseases appear to have become a threat to humanity by virtue of ecological disruptions. The fascinating stories of many of these new diseases are tales of previously dormant and quiet pathogens suddenly emerging in human populations because of changes in otherwise stable ecosystems.

I bring all of this up for a couple of reasons. In my last column, I shared that through the Journal of Environmental Health and other NEHA programs such as the Annual Educational Conference (AEC), we are making a concerted effort to inform this profession and to prepare it for a future that today we only vaguely see. As I indicated in that column, we take our responsibility to both understand change and help you prepare for its inevitable outcomes very seriously. Anymore it cannot be questioned that our responsibility in environmental health embraces both microbiological concerns as well as disease-causing chemicals and toxic substances. We will cover both because you do.

My second reason for briefly exploring this topic with you is to announce that by virtue of a special grant that NEHA both applied for and received, our AEC next June in Chicago will feature a very special conference track devoted entirely to emerging pathogens within an environmental health context.

This is perhaps the most unique educational program that we have ever delivered. We are, as I write, in the process of defining the program and through the funding provided by the grant, lining up the best faculty that we can assemble to teach you about this dimension of environmental health. We expect that this area of interest is going to occupy a significant piece of the future agenda for this profession.

By alerting you to this program now, we hope that we are giving you ample time and opportunity to make your plans to come to the AEC. In addition to our regular programming, which covers the spectrum of this incredibly interesting field, and which alone should be well worth your attendance, we want to make double sure that you are aware of this added feature as well.

Before I took my first university environmental course, I recall well my parents' concern over sanitation, hygiene and cleanliness. After that course and the ones that followed, those cautions from my parents seemed like worthless relics of history. Now all of a sudden, environmental health professionals are tracking down mysteries like the hantavirus. Come to Chicago for a trip back to the future!
COPYRIGHT 1996 National Environmental Health Association
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 1996, Gale Group. All rights reserved. Gale Group is a Thomson Corporation Company.

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Title Annotation:infectious diseases as an environmental health concern
Author:Fabian, Nelson
Publication:Journal of Environmental Health
Date:Mar 1, 1996
Words:845
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