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Coronavirus Biology and Pathogenesis
On the Front Lines
Approaches to Vaccines and Drug Development
Future Perspectives on Emerging Infections
Special Pathogens in Three Cultures
SARS and Public Health Systems
A View from the Field and the Bridge
Panel 4 Discussion
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SARS in the Context of Emerging Infectious Threats SARS in the Context of Emerging Infectious Threats
Future Perspectives on Emerging Infections
Special Pathogens in Three Cultures

C.J. Peters, University of Texas Medical Branch, Galveston
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Highlights

Emerging Disease Factors
• Exploration and now travel cause mixing of viruses around the world, most notably with Yellow Fever and West Nile Virus.
• West Nile emergence may be understood by considering that it is a phylogenetically-related virus that uses a mosquito vector that hides in toilets of airplanes.
• Many viruses have evolved during and after human urbanization, such as measles and smallpox.
• Factors contributing to emergence have gotten worse in the last ten years, as assessed by an Institute of Medicine report.
• Evolutionary opportunities for viruses generally drive adaptation.

Expected Trajectory for SARS
• Generally with emerging diseases, an individual doctor makes a diagnosis, CDC tracks it through local and state health departments, NIH builds research and knowledge through academia, and industry makes products to fill needs.
• We need to get ahead of this process to beat SARS in a timely and effective way.
• Seasonality, healthcare budgets, and local cultures, particularly in Third World countries, will make eradication difficult.
• Strict U.S. standards may require that drugs or vaccines developed here be manufacture
d and produced overseas.
• There needs to be a group nationally responsible for antiviral or antiinfective drugs and vaccines.

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