Soldiers in a different kind of war - From the Editor

Medical Laboratory Observer, April, 2003

Fall 1918

After four years, the "War to End All Wars" was coming to a close, with the help of American soldiers who had joined the Allies in their effort to defeat Germany and its Axis partners. Then suddenly, in various homes around the world, a new enemy struck with sudden viciousness. People began to sicken and die from an infectious disease of unknown origin that defied treatment and struck hardest at young adults. Some in Allied counties speculated that their enemies might have unleashed a deadly biological weapon never before seen. Others thought the illness might be caused by the mustard gases and smoky fumes rising from the brutal warfare in Europe's trenches. Healthy people were literally sickening and dying within hours. One physician described his blue-lipped patients as struggling for air until they finally suffocated.

This new strain of influenza, later referred to as the "Spanish flu" or "La Grippe," was highly infectious and often led to a virulent form of pneumonia. We now know, of course, that a virus bears the blame. The statistics are unbelievable. One in every five people in the world was infected during the two years that this disease flamed across the globe. Deaths have been estimated at between 20 and 40 million. The influenza pandemic of 1918-1919--which some have called the most devastating epidemic in recorded history--robbed more human beings of their lives than did World War I. More died of this disease in one year than in the entire four-year reign of the Black Death in the 1300s. Cemeteries filled up with the graves of young men and women. There were lots of orphans.

Springtime 2003

As I write, the world is poised at the threshold of another war. We are nearing the end of President Bush's 48-hour ultimatim to Saddam Hussein. The world is anxiously waiting. Our coalition forces are mobilizing for war.

The world is also anxiously waiting for the next development in the saga of another murderous disease caused by a mysterious infectious agent that, at press time, had not yet been conclusively identified. The disease has been dubbed "Sudden Acute Respiratory Syndrome," or SARS. Eerily reminiscent of the Spanish flu, it causes cough, shortness of breath, difficulty breathing and pneumonia. Some of its victims are still breathing only with the help of respirators, and too many are no longer breathing at all.

Clinical laboratories across the world have been charged with finding out what the agent is. Lab professionals just like you are diligently performing rapid tests for bacteria and viruses. They are culturing bacteria. They are doing special tissue and immunohistochemical stains. They are using the most sensitive, up-to-the-minute DNA technology. They are working around the clock to solve the mystery.

By the time you read this editorial, I predict this mysterious infectious agent will have been identified by some of your colleagues, somewhere in the world. A treatment will be found, and the spread of this disease will be stifled before it flares up into another conflagration like Spanish flu or Black Death--or AIDS.

You clinical laboratorians are soldiers on the front lines of a different kind of war. We've seen it over and over again just in the last two years, as our world has faced new threats from anthrax, West Nile virus, malaria and smallpox, and as we've prepared our defenses for biological warfare. And now, you're helping to prevent another horrifying pandemic, by identifying its source, and by performing the diagnostic tests that identify its victims. Soldiers in white lab coats.

Celia Stevens

cstevens@nelsonpub.com