Isle speaker connects
ecosystems to health

The Halloween Eve flooding in Manoa Valley caused more than $100 million in damage and sickened several people with leptospirosis.

But a few million dollars in watershed improvements could have prevented those problems, underscoring the importance of caring for our natural habitat, an expert in infectious diseases said yesterday.

"We can't separate the health of our ecosystems from human health," said Dr. Bruce Wilcox, director of the University of Hawaii's Asia-Pacific Center for Infectious Disease Ecology.

Speaking at a news conference yesterday with other health leaders, Wilcox said the Manoa flood was a prime example of the need for an integrated approach to public health problems.

The ecology center is part of a new Asia-Pacific Institute of Tropical Medicine and Infectious Diseases and directed by Dr. Duane Gubler in the UH John A. Burns School of Medicine.

The institute is hosting 65 professionals from 15 countries at a three-day conference at the East-West Center. The conference, which ends today, is focusing on social-ecological systems that affect infectious diseases.

The fight against leptospirosis, dengue fever and HIV/AIDS would benefit from an approach that includes genetic, biological, social, economic, political, ecological and physical environmental factors.

A dramatic resurgence of infectious diseases and global public health problems has come out of Asia in the past decade or so, said Gubler, also interim chairman, Department of Tropical Medicine and Medical Microbiology.

He said Hawaii is an ideal place to develop a center focusing on infectious diseases because of its location, cultural and economic ties with Asia and the Pacific, and long history of training public health people in the region.

"It's hard to predict what the next hot bug is going to be," Gubler said, pointing out SARS (severe acute respiratory syndrome) could just as easily have come here with a traveler as go to Toronto, which had a serious outbreak.

An infrastructure must be built here to protect against any possible threat, he said, mentioning just two: avian influenza, if it starts moving from human to human, and West Nile virus, with implications for human and animal health.

Gubler said the conference is a move toward interdisciplinary partnerships and collaborations to strengthen the public health structure in countries where many infectious diseases are emerging.

State Epidemiologist Paul Effler said Hawaii must be prepared to respond to any new infectious disease, and the state Health Department hopes to be able to apply "practical knowledge" from the institute.

"We have experience with leptospirosis and HIV/AIDS," Effler said, adding that the DOH also recognizes that social, ecological and environmental factors are important for SARS and avian flu.

Wilcox said large-scale environmental changes with urbanization and land developments are linked with increasing emergence of infectious diseases and higher frequency of waterborne diseases like leptospirosis and staphylococcus.

Two people cleaning up at UH after the Manoa flooding were affected with leptospirosis, a potentially fatal disease caused by bacteria in streams.

Nancy Lewis, East-West Center Research Program director, stressed the potential effects of infectious diseases on Hawaii's economy because of Asia-Pacific travel and tourism.

She noted a headline during the SARS outbreak saying, "Asia Sneezes and the World Catches Cold." Emphasizing the potential impact here, she said, "We could add, 'And Hawaii Catches Pneumonia.'"