Bugs from past that pose threat to the future

THIS IS THE year of the 'Killer Bug': the year when the developed world was shaken by an apparent explosion of epidemics of diseases which it thought medical science had consigned to the history books.

The Black Death or bubonic plague, and its highly infectious variant, pneumonic plague, are apparently sweeping western India, and being hyped into a major international health threat.

In May, an outbreak of the 'flesh-eating bacterium', the scourge of the Royal Navy in the 18th century, claimed lives throughout Britain and left scores of others disfigured. Tuberculosis has been declared a global health emergency by the World Health Organisation, and Russia is battling measles and diphtheria.

Cholera has been affecting parts of Latin America for two years, and eastern Europe for a year. A new outbreak was reported yesterday in the capital city of North Korea. Leprosy will cripple 6 million people this year, and drug-resistant strains of malaria are defeating normal treatment regimens.

The marketing men have grabbed the initiative and a spate of alarmist books with names like The Hot Zone and The Coming Plague are due to cross the Atlantic, to be followed by Stephen King's television series, The Stand, about a fatal 'superflu'. Bugs have replaced dinosaurs as icons of popular culture.

However, the sight of health officials boarding flights from India this week to check passengers and spray them with disinfectant has brought home the potential horror of infectious disease to people who take long-distance travel to exotic places for granted.

The reassurances of the World Health Organisation and Dr Kenneth Calman, Britain's Chief Medical Officer, that pneumonic plague is 'highly unlikely' to be transmitted here, that all necessary precautions were in place, have taken second place to speculation about the plague threat and suspected victims.

'What we don't know is how all these diseases evolved in the past,' Dr Barbara Bannister, consultant in infectious and tropical diseases at the Royal Free Hospital in London, said. 'The first epidemiologists made their reports only 150- 200 years ago.'

Diseases have their cycles: meningitis peaks every 10-15 years, infectious hepatitis every 10 years. We may be seeing a natural fluctuation in TB, Dr Bannister says. 'We just don't know.'

An epidemic of the pneumonic plague bacterium, Yersinia Pestis, among rodents in India, fuelled by a long, hot summer and recent natural disasters in India, is drawing to its logical conclusion, Dr Bannister said. 'I don't want to underplay the seriousness for India; it is a very real problem there but it is a local problem.

'Here in Britain we have long experience as a centre of travel. We have a well-integrated system of experts in communicable diseases throughout the country. There is something of a panic elsewhere.'