CDC Chief: Next Pandemic 'Hiding in Plain Sight'

July 23, 2014 - 5:32 AM

tom frieden

Dr. Thomas Frieden, Director of the Centers for Disease Control and Prevention. (Erik S. Lesser/AP File Photo)

( - The next pandemic is "not the thing that we don't know, but something that's hiding in plain sight," Dr. Tom Frieden, head of the federal Centers for Disease Control and Prevention, told a gathering in Washington on Tuesday.

"If we're not careful, we will soon be in a post-antibiotic era. And in fact, for some patients and some pathogens, we're already there," he said in a speech at the National Press Club.

"Antimicrobial resistance has the potential to harm or kill anyone in the country; to undermine modern medicine; to devastate our economy, and to make our health care system less stable." The problem must be confronted quickly and decisively, Frieden said, to continue protecting Americans from the moment they are born:

"But every day we delay, it gets harder and more expensive to reverse it," he warned.

The CDC says two million Americans develop antibiotic-resistant infections each year, and 23,000 die from those infections. Another 14,000 die from infections that develop because of antibiotic use.

Frieden, an infectious disease physician, said there are four things that can be done to stop antibiotic resistance: better detection; better control, especially in hospitals where most drug-resistant germs are born; better prevention; and more innovation.

"On detection, we need real-time systems to find out what's happening around the country," Frieden said. He announced that this week, the CDC is launching the first nationwide system that allows any hospital in the country to electronically track all of the antibiotics it is dispensing as well as the antibiotic-resistance patterns of patients who have infections.

"That will allow doctors to be empowered with the right information, at the right time, to make the right decision, so that they can give a patient antibiotics that are needed, neither too broad nor too narrow," he said. Better detection will improve prescribing practices, identify outbreaks sooner, and allow doctors to see if outbreak-control measures are working.

Infection control must focus on hospitals, where too many antibiotic resistant infections, such as CRE, C difficile and MRSA, are being spread. "We can keep it in the hospital, and we can shrink the numbers and control it," he said. "If we don't, then common infections, like urinary tract infections, may be very difficult to treat, and we may be...looking at what a world was like before antibiotics."

Better prevention includes the appropriate use of antibiotics. According to Frieden, about a third of all antibiotics used in hospitals are either "unnecessary or inappropriate." Prevention also includes improving the susceptibility to infection: "If you're healthier; if you're physically fit; if you get enough sleep -- this improves your overall immune system."

Better innovation includes new drugs to fight the evolving microbes, but those drugs are at least five or ten years away, and developing them will cost money, Frieden said.

He noted that President Obama's budget for Fiscal Year 2015 includes a five-year initiative, costing $30-million a year, that would help CDC develop a bank of resistant organisms that pharmaceutical companies could use to develop more rapid diagnostics, or better ways to treat infections.

"We project, based on real data, that with this initiative, over five years, we would be able to cut our two deadliest threats in half -- both CRE, the nightmare bacteria that's spreading in many of our intensive care units, and C (difficile).

"We can make this succeed across the country, but only with investment. In fact, over five years we project that we could reduce by 600,000 the number of resistant infections, by 27,000 the number of deaths from resistant infections, and by $7.7 billion to health care costs from it.

"Public health is a best buy, but we have to act now," he said.