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'The Next Pandemic': New Threats, But New Defenses, Too

RAY SUAREZ, HOST:

You don't need to be an epidemiologist to follow the news, but these days it can help. The 21st century has given us an alphabet soup of new diseases - SARS, MERS, H1N1. How contagions are tracked down is a fascinating mix of lab work, powerful computers and sometimes rooting around in the underbrush of a tropical rain forest in search of a mammal whose blood may help unlock a mystery.

Dr. Ali Khan was director of the Office of Public Health Preparedness and Response at the Centers for Disease Control. And in his new book, "The Next Pandemic," Dr. Khan takes us from doctors' offices in the Midwest, where patients are showing up with puzzling symptoms, to the hot zones of Central Africa. And in the process, he helps us figure out how to think about the risk of migrating diseases. Dr. Khan is dean of the College of Public Health at the University of Nebraska. He joins me from member station KVNO in Omaha. Great to have you with us.

ALI KHAN: Thank you very much, Ray.

SUAREZ: Well, the threats are heightened, as you very thoroughly document in the book. Aren't the weapons to fight back better, too?

KHAN: Without a doubt. We have many more weapons to fight back in terms of identifying diseases and then putting together good prevention strategies. So we expect to see diseases emerge. And if you listen to the headlines today you'd think, oh, my gosh, these microbes have gone rogue? And I talk about why we will continue to hear about new diseases emerge. Many of them, like the alphabet soup you described, are associated with animals. And we move out into the forest and track with the environment, we're going to get these. But there's no reason for us to get the epidemics that we see.

SUAREZ: I was just thinking about the last couple of years and jotted down West Nile, chikungunya, dengue, Zika. Five words to make any disease-related story immediately more interesting to Americans are headed for the United States. What threats are on the horizon? And are we taking them seriously enough?

KHAN: A disease anywhere is a disease everywhere. And I think Ebola showed that. We're very fortunate that we only had a single case here in the United States that unfortunately, and tragically, infected two nurses. But the scenario could've been very different. The West Nile virus scenario was very different. It showed up in the United States, and all of a sudden this virus said, oh, I've got birds I like. I've got mosquitoes I like. And it swept across the United States. And it's called West Nile because it doesn't belong in Brooklyn or Queens, N.Y. It belongs back in the Middle East.

SUAREZ: Has speed, mobility, modern transportation made this world - in addition to making us safer on some ways, made the world a more dangerous place in ways that we haven't even considered yet?

KHAN: Absolutely. Nowadays, you could head off to West Africa, attend a funeral of a loved one and then come back to your Monday morning meetings. And you're infected with Ebola. You have no idea that you got infected. So we're always at risk of these diseases. But what's not inevitable is the pandemics and outbreaks. And we do have tools that we should be putting in place to keep these outbreaks from happening. And unfortunately, we don't.

And that's not a function of animals and the environment. That's a function of our social, political, economic structures that do not help us prevent these diseases. You mentioned Zika. We're still today arguing over funding responses at local and state health departments to make sure that these communities are prepared for the inevitable arrival of Zika into the United States. It's already widespread in Puerto Rico. It's not going to be a large outbreak in the United States, but each case in a pregnant woman could be extremely tragic.

SUAREZ: Of all the stories you tell, one that shocked me was the story of an American prairie dog picking up African pathogens, ending up in a Midwestern pet shop and infecting a little boy. I think that's one of the cases where the detective part of this comes in.

KHAN: Many of the stories I talk about sort of what does it really mean to track down patient zero, as I did during the 1995 Ebola outbreak? Or how do you take these infected prairie dogs in the Midwest and then follow them back to a shipment of Gambian rats that came from Ghana that were already infected? So that's the fun, interesting part of being a disease detective. And all of that to one purpose about prevention, prevention, prevention.

SUAREZ: What keeps you up at night as you look ahead to a world where new threats are still forming all the time?

KHAN: From the disease standpoint, a novel influenza strain worries me. Things like SARS and MERS that rapidly spread by the respiratory route, especially within hospitals, and spillover into communities worry me. I worry about another West Nile-like virus that finds the right vectors here in the United States. And I never want to forget to talk about the continued risk of bioterrorism and how that gets easier and easier with advances in synthetic biology and how nowadays you could essentially use a gene synthesizer to recreate smallpox virus if you wanted to.

SUAREZ: That's Dr. Ali Khan. His new book, "The Next Pandemic: On The Front Lines Against Humankind's Gravest Dangers," is out now. Dr. Khan, good to talk to you.

KHAN: Thank you very much. Hope I didn't scare you too much, Ray. Transcript provided by NPR, Copyright NPR.