Fighting Disease: Health At The End Of The Millennium Another Wired Curriculum from The United Nations CyberSchoolBus
		Dr David Heymann Live The World Health Day Live Chat The following is an edited transcript of a live on-line conversation between students and Dr David Heymann. Dr Heymann is director of the World Health Organization's division of Emerging and Other Communicable Diseases Surveillance and Control. He joined the chat from the headquarters of the WHO in Geneva, Switzerland. The event was a joint project of the UN CyberSchoolBus and Turner Educational Services. <Moderator1> Welcome to our chat with David Heymann, Director of the World Health Organization's division of Emerging and Other Communicable Diseases. Mr Heymann can you give us a little background information about yourself, the World Health Organization, and why today is a special day for your organization. After this we will begin taking questions. <David> Infectious diseases are becoming an increasing problem in today's world because there has been a decrease in resources for surveillance and control. Here at WHO we have set up a new programme to respond to the consequences caused by this decrease in resources. I am the Director of this programme called Emerging and other Communicable Diseases Surveillance and Control. <Moderator1> We'll open the floor for questions now :) Q: Dr Heymann, is the small pox virus still around? in a lab? <David> Yes, the last stock of smallpox virus or variola virus, is still stored by two WHO Collaborating Centres. Q: Dr Heymann, does storing them present a risk? Why not destroy them? Who decides on this? <David> Storing presents a cost as they are stored under maximum security. As long as the virus still exists, there is a theoretical risk. A WHO group of experts has recommended that the viruses be destroyed. The decision of destruction will be taken by WHO Member States in May 1999 and we hope the viruses will be destroyed on 30 June 1999. Q: What is the advantage of destroying the virus? <David> The complete elimination of any risk that the virus escapes into the world community which is no longer immunized against smallpox... Q: Can the virus return naturally? <David> Because the smallpox virus had no reservoir outside humans, the virus cannot return naturally. Q: Why not keep the virus for registration purposes? or for further investigation for possible further cures? <David> This has been the argument for not destroying the virus and which has delayed the initial recommendation that it be destroyed by December 1993. The virus has been completely sequenced and different pieces of sequence are available for scientific study and diagnostic purposes, if needed. Q: What is the WHO doing to prevent the spread of diseases like Ebola and AIDS? <David> Regarding Ebola and HIV/AIDS there is no vaccine available for either of these infections. Fortunately, Ebola can be prevented from person-to-person spread by strict isolation of patients and HIV can be prevented by use of condoms and rapidly treating other sexually transmitted diseases which facilitate the transmission of HIV. This can be accomplished by intensive health education and rapid diagnosis and treatment of STDs. Q: What is a sequence? <Moderator1> This relates to the small pox answer above. <David> The nucleic acid composition of the genetic material of the virus. Q: Will we ever be able to control infectious diseases? or will new ones keep popping up and old ones mutating? <David> Micro-organisms will survive man so we will continue to be exposed to infectious diseases both those we know today and those which are certain to appear through mutation or by breaching the gap between animals and man. Q: Where is the Ebola virus located? <David> We don't know the natural host of the Ebola virus but all cases have been associated with tropical rain forest in Africa. Some have been transmitted from chimpanzees to humans. But as chimpanzees die like humans, we don't believe these are the natural host of the Ebola virus. Q: Dr. Heymann what do you hope to accomplish with this day? <David> Sensitize the world to the need to continue to put resources into, and high priority on, the surveillance and control of infectious diseases. We also wish to encourage young people to take an interest in infectious diseases. Q: What is the process of isolating and identifying the host in this case? of the Ebola? <David> WHO is supporting a study in Cote d'Ivoire looking for possible animal hosts of the virus. So far we know that the chimpanzee is one host but probably not the one where the virus hides in nature. So the study is to see how the chimpanzees get infected by observing their habits and studying the animals they are in contact with. Q: Students ask, "Where are the last two laboratories of the Smallpox disease?" <David> Let's keep it clear - it is the virus that is kept. The two laboratories are in USA and the Russian Federation. <Moderator1> The US location is the Centers For Disease Control and Prevention (CDC) in Atlanta, Georgia. Q: "How do new viruses get created, naturally?" <David> [Lost]... mutate many times. Antibiotic resistance is another feature which applies to bacteria which mutate to protect themselves against antibiotics. <Moderator1> It takes a little time for Mr Heymann's response to register...he's in a time zone with a 6 hour difference--in Europe :) Q: Is the sequence of the viruses similar to the cloning they did with the sheep? <David> Sequencing is just to study in the laboratory the composition of the chromosome of a virus, for example. Cloning is insertion of existing genetic material into a living organism replacing that organism's genetic material. Q: Sent earlier: Does WHO have enough resources to battle diseases? Are other areas getting higher priority? <David> WHO receives its funding from its Member States. Resources have not been increasing over the past five years although the work required has dramatically increased. The challenge will be to maintain sufficient resources in infectious disease control while meeting the new challenges in the 21st century which include diseases related to aging and tobacco use. Q: 7th grade students requested information about WHO by email last week. Can you help to get us more information? <David> Who did they send their request to? WHO receives an enormous amount of e-mail requests and sometimes replies are late or unfortunately overlooked. <Abou> As you know, we are running some health units on our site. You can try that. Also, WHO's web site has an enormous amount of information. <Moderator1> Do we have any other questions for Mr. Heymann? Q: Is it realistic to think that polio will be eradicated as planned? <David> Yes, polio is already eradicated from the Americas, and there are probably no more than 3000 cases in 1996, which is about one tenth of what was reported five years ago. Great efforts are dedicated to countries where polio still exists to immunize all children. We anticipate that by the year 2000 polio will be eradicated if the present pace continues. Q: Question from 6th grade: Can you, through genetics, cure cancer now? <David> About the cure for cancer: Cancer can not yet be cured in all cases but many can be prevented by not smoking and by preventing infectious diseases such as hepatitis B virus. Genetics in cancer is dealt with by the International Centre for Cancer Research in Lyon,France which is a WHO centre. Q: 6th grades asks, "Are you near to discovering a vaccine for AIDS?" <David> There are several vaccines under study for safety in humans, and to see whether they produce long lasting antibody. Soon these vaccines will be studied for effectiveness. But it is likely that these studies will take many years to complete. Q: Is the hepatitis A outbreak in the US something that WHO deals with? Is it something to be seriously concerned about? <David> WHO is following the outbreak with our colleagues in the US. Whenever an epidemic is caused by contaminated food it is a great concern, especially if that food crosses international borders. Q: Is Ebola the number 1 emerging infectious disease? Do you have a list of diseases that you look out for? Does this only include fatal diseases? <David> Ebola is only one of many emerging diseases which are of great concern. Others include hepatitis C which causes liver disease, E. coli O157 which causes diarrhoea and kidney disease with death in children. Equally, or more important, are re-emerging diseases, that is diseases which were once under control, such as yellow fever, meningitis, and dengue. Q: 6th grade students ask about a disease that makes the blood go out of the pores of the skin?? What is this? <Moderator1> Do you have any idea on this Mr Heymann? <David> Any disease which interrupts the normal clotting of blood or increases the ability to leak out of blood vessels can cause those symptoms. There are many viral and bacterial infections which can cause this. <Moderator1> That's the last question. <David> Thank you. We have enjoyed chatting with you. <Moderator1> Dr Heymann, thanks for taking the time out of your busy schedule to chat with Students! We appreciate it :) Thanks everyone for coming this morning. We appreciate it:)
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