704 



is a gesture of self-protection [not against the disease itself but] 

 against possible reprisals by other countries." *^ This situation is a 

 reminder of exactly how far the world has — or has not — progressed 

 since the quarantine regulations of over a century ago were reluctantly 

 adopted despite ignorance, fear, and vested interests. 



U.S. INVOLVEMENT IN EPIDEMIOLOGICAL PROBLEMS 



Cholera may not be of immediate geographic concern to the Amer- 

 icas, but poliomyelitis is a growing problem in several countries in 

 Central and South America *^ and viral influenza is an annual seasonal 

 hazard in the United States. If the American political and diplomatic 

 community is somewhat indifferent to tropical disease in the tropics, 

 perhaps it should be more interested in Asian disease in the United 

 States. For example, the new strains of influenza virus A2 in the Hong 

 Kong epidemic of 1968 later spread and reached the temperate areas 

 of the northern hemisphere, causing numerous epidemics in the 1968- 

 1969 influenza season. In the United States the outbreak was exten- 

 sive, covering nearly all of the States and "was associated with a large 

 number of deaths from acute respiratory disease." ^° In testimony 

 before the House Subcommittee on National Security Policy and 

 Scientific Developments in December, 1969. Dr. Joshua Lederberg 

 warned that the American public health authorities were not "suffi- 

 ciently sensitive to the possibilitv of a devastating worldwide epi- 

 demic." He used the example of the Hong Kong flu as a foretaste of 

 what could have happened and of what could happen in the future: 



I think there is a considerable amount of sel f -delusion that 

 the antibiotics will take care of any bacterial infection ; we 

 need never worry about the plague again : the plague has been 

 conquered by medicine ; that virus infections will somehow be 

 taken care of, although when you see a pandemic like the Hong 

 Kong flu, you have a foretaste of what really can happen. 



That was a world-wide epidemic. The attack rate was some- 

 thing like 20 to 30 percent of the world's population that was 

 infected by this virus. It was not a particularly lethal one, 

 but it is only a minor accident that it is not a lethal virus. 



Such events are undoubtedly going to occur in the future 

 that will be very much nastier, and we have simply not been 

 oriented to take a sufficiently aggressive and sensitive view 

 about this matter.^^ 



Throughout his testimony. Dr. Lederberar saw public health defense 

 as a global parallel to defense against biological warfare ; he consid- 

 ered pathogenic micro-organisms to be the natural enemies of man, 

 and recommended two measures of worldwide self -protection : 



(1) The establishment of central, international labora- 

 tories to monitor the occurrence of threatening organisms and 



"8 Medical Tribune (September 7, 1970), page 1. 



« "The World's Poliomyelites." The Lancet (September 26, 1970), pa^e 646. 



w WHO Chronicle (June 1970) , pages 263-4. 



^ U.S. Congress. House. Committee on Foreign Affairs. "Chemical-Biological Warfare : 

 U.S. Policies and International Effects." Hearings before the Subcommittee on National 

 Security Policy and Scientific Developments of the . . . November and December 1969. 

 91st Congress, first session. (Washington, U.S. Government Printing Office, 1969), page 128. 



