An Emerging Threat to Human,
Animal, and Plant Health
LeighAnne Olsen, Eileen R. Choffnes, David A. Relman,
and Leslie Pray, Rapporteurs
Forum on Microbial Threats
Board on Global Health
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
THE NATIONAL ACADEMIES PRESS
THE NATIONAL ACADEMIES PRESS 500 Fifth Street, N.W. Washington, DC 20001
NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.
Financial support for this project was provided by the U.S. Department of Health and Human Services: National Institutes of Health, National Institute of Allergy and Infectious Diseases, Centers for Disease Control and Prevention, Food and Drug Administration, and the Fogarty International Center; U.S. Department of Defense, Department of the Army: Global Emerging Infections Surveillance and Response System, Medical Research and Materiel Command, and the Defense Threat Reduction Agency; U.S. Department of Veterans Affairs; U.S. Department of Homeland Security; U.S. Agency for International Development; American Society for Microbiology; sanofi pasteur; Burroughs Wellcome Fund; Pfizer, Inc.; GlaxoSmithKline; Infectious Diseases Society of America; and the Merck Company Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.
International Standard Book Number-13: 978-0-309-21226-7
International Standard Book Number-10: 0-309-21226-X
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Copyright 2011 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America
The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.
Cover images: Front (upper): Little brown bats with white-nose syndrome, New York, photo courtesy of New York Department of Environmental Conservation; Front (lower): Yellow stripe rust on wheat, photo courtesy of Stephen A. Harrison, Louisiana State University Agricultural Center. Spine: The Panamanian golden frog (Atelopus zeteki), photo courtesy of Wikimedia Commons, photo by Brian Gratwicke, Smithsonian Conservation Biology Institute. Back: Geomyces destructans, shown in a false-color SEM image (fungus hyphae are yellow, green, and orange; spores are blue), image reprinted from Chaturvedi et al. (2010) Morphological and Molecular Characterizations of Psychrophillic Fungus Geomyces destructans from New York Bats with White Nose Syndrome (WNS). PLoS ONE 5(5): e10783. Doi: 10.1371/journal.pone.0010783.
Suggested citation: IOM (Institute of Medicine). 2011. Fungal Diseases: An Emerging Threat to Human, Animal, and Plant Health. Washington, DC: The National Academies Press.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES
Advising the Nation. Improving Health.
THE NATIONAL ACADEMIES
Advisers to the Nation on Science, Engineering, and Medicine
The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.
The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.
The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.
The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.
FORUM ON MICROBIAL THREATS1
DAVID A. RELMAN (Chair), Stanford University and Veterans Affairs Palo Alto Health Care System, Palo Alto, California
JAMES M. HUGHES (Vice-Chair), Global Infectious Diseases Program, Emory University, Atlanta, Georgia
LONNIE J. KING (Vice-Chair), Ohio State University, Columbus
KEVIN ANDERSON, Department of Homeland Security, Washington, DC
RUTH L. BERKELMAN, Center for Public Health Preparedness and Research, Rollins School of Public Health, Emory University, Atlanta, Georgia
DAVID BLAZES,2 Armed Forces Health Surveillance Center, Division of Global Emerging Infectious Surveillance, Silver Spring, Maryland
ENRIQUETA C. BOND, Burroughs Wellcome Fund (Emeritus), Marshall, Virginia
ROGER BREEZE, Lawrence Livermore National Laboratory, Livermore, California
STEVEN J. BRICKNER,3 SJ Brickner Consulting, LLC, Ledyard, Connecticut
PAULA R. BRYANT, Defense Threat Reduction Agency, Medical S&T Division, Fort Belvoir, Virginia
JOHN E. BURRIS, Burroughs Wellcome Fund, Research Triangle Park, North Carolina
ARTURO CASADEVALL,2 Albert Einstein College of Medicine, Bronx, New York
PETER DASZAK, EcoHealth Alliance, New York, New York
JEFFREY S. DUCHIN, Public Health–Seattle and King County, Seattle, Washington
JONATHAN EISEN, Genome Center, University of California, Davis
MARK B. FEINBERG, Merck Vaccine Division, Merck & Co., West Point, Pennsylvania
JACQUELINE FLETCHER, Oklahoma State University, Stillwater
S. ELIZABETH GEORGE,3 Department of Homeland Security, Washington, DC
JESSE L. GOODMAN, Food and Drug Administration, Rockville, Maryland
EDUARDO GOTUZZO, Instituto de Medicina Tropical–Alexander von Humbolt, Universidad Peruana Cayetano Heredia, Lima, Peru
CAROLE A. HEILMAN, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
1 Institute of Medicine Forums and Roundtables do not issue, review, or approve individual documents. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
2 Forum member since September 1, 2011.
3 Forum member until December 31, 2010.
DAVID L. HEYMANN, Health Protection Agency, London, United Kingdom
PHILIP HOSBACH, sanofi pasteur, Swiftwater, Pennsylvania
STEPHEN ALBERT JOHNSTON, Arizona BioDesign Institute, Arizona State University, Tempe
KENT KESTER, Walter Reed Army Institute of Research, Silver Spring, Maryland
GERALD T. KEUSCH, Boston University School of Medicine and Boston University School of Public Health, Boston, Massachusetts
RIMA F. KHABBAZ, Centers for Disease Control and Prevention, Atlanta, Georgia
STANLEY M. LEMON, School of Medicine, University of North Carolina, Chapel Hill
EDWARD McSWEEGAN, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
MARK A. MILLER, Fogarty International Center, Bethesda, Maryland
PAUL F. MILLER,4 Pfizer, Inc., Groton, Connecticut
STEPHEN S. MORSE,5 Center for Public Health Preparedness, Columbia University, New York, New York
GEORGE POSTE, Complex Adaptive Systems Initiative, Arizona State University, Tempe, Arizona
JOHN C. POTTAGE, JR., ViiV Healthcare, Collegeville, Pennsylvania
DAVID RIZZO,6 Department of Plant Pathology, University of California, Davis
GARY A. ROSELLE, Veterans Health Administration, Department of Veterans Affairs, Cincinnati, Ohio
ALAN S. RUDOLPH, Defense Threat Reduction Agency, Fort Belvoir, Virginia
KEVIN RUSSELL, Armed Forces Health Surveillance Center, Department of Defense, Silver Spring, Maryland
JANET SHOEMAKER, American Society for Microbiology, Washington, DC
P. FREDERICK SPARLING, University of North Carolina, Chapel Hill, North Carolina
TERENCE TAYLOR, International Council for the Life Sciences, Arlington, Virginia
MURRAY TROSTLE, U.S. Agency for International Development, Washington, DC
MARY E. WILSON, Harvard School of Public Health, Harvard University, Boston, Massachusetts
4 Forum member until July 31, 2011.
5 Forum member until December 31, 2010.
6 Forum member since September 1, 2011.
EILEEN CHOFFNES, Director
LEIGHANNE OLSEN, Program Officer
KATHERINE McCLURE, Senior Program Associate
COLLIN WEINBERGER, Research Associate (until May 2011)
REBEKAH HUTTON, Research Associate (from June 2011)
ROBERT GASIOR, Senior Program Assistant (until March 2011)
PAMELA BERTELSON, Senior Program Assistant (since September 2011)
BOARD ON GLOBAL HEALTH1
Richard Guerrant (Chair), Thomas H. Hunter Professor of International Medicine and Director, Center for Global Health, University of Virginia School of Medicine, Charlottesville
Jo Ivey Boufford (IOM Foreign Secretary), President, New York Academy of Medicine, New York
Claire V. Broome, Adjunct Professor, Division of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
Jacquelyn C. Campbell, Anna D. Wolf Chair, and Professor, Johns Hopkins University School of Nursing, Baltimore, Maryland
Thomas J. Coates, Professor, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
Gary Darmstadt, Director, Family Health Division, Global Health Program, Bill & Melinda Gates Foundation, Seattle, Washington
Valentin Fuster, Director, Wiener Cardiovascular Institute Kravis Cardiovascular Health Center Professor, Cardiology, Mount Sinai School of Medicine, Mount Sinai Medical Center, New York, New York
James Hospedales, Coordinator, Chronic Disease Project, Health Surveillance and Disease Management Area, Pan American Health Organization/World Health Organization, Washington, DC
Peter J. Hotez, Professor and Chair, Department of Microbiology, Immunology, and Tropical Medicine, The George Washington University, Washington, DC
Clarion Johnson, Global Medical Director, Medicine and Occupational Medicine Department, Exxon Mobil, Fairfax, Virginia
Fitzhugh Mullan, Professor, Department of Health Policy, George Washington University, Washington, DC
Guy Palmer, Regents Professor of Pathology and Infectious Diseases, Director of the School for Global Animal Health, Washington State University
Jennifer Prah-Ruger, Associate Professor, Division of Health Policy and Administration, Yale University School of Public Health, New Haven, Connecticut
Patrick Kelley, Director
Angela Mensah, Program Associate
1 Institute of Medicine boards do not review or approve individual workshop summaries. The responsibility for the content of the workshop summary rests with the authors and the institution.
This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the process. We wish to thank the following individuals for their review of this report:
Beth Bell, Centers for Disease Control and Prevention
Michael Jeger, Imperial College London
Karen Lips, University of Maryland
Victoria McGovern, Burroughs Wellcome Fund
John W. Taylor, University of California at Berkeley
Brett Tyler, Virginia Bioinformatics Institute
Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the final draft of the report before its release. The review of this report was overseen by Dr. Melvin Worth. Appointed by the Institute of Medicine, he was responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.
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The Forum on Emerging Infections was created by the Institute of Medicine (IOM) in 1996 in response to a request from the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). The purpose of the Forum is to provide structured opportunities for leaders from government, academia, and industry to regularly meet and examine issues of shared concern regarding research, prevention, detection, and management of emerging, reemerging, and novel infectious diseases in humans, plants, and animals. In pursuing this task, the Forum provides a venue to foster the exchange of information and ideas, identify areas in need of greater attention, clarify policy issues by enhancing knowledge and identifying points of agreement, and inform decision makers about science and policy issues. The Forum seeks to illuminate issues rather than resolve them. For this reason, it does not provide advice or recommendations on any specific policy initiative pending before any agency or organization. Its value derives instead from the diversity of its membership and from the contributions that individual members make throughout the activities of the Forum. In September 2003, the Forum changed its name to the Forum on Microbial Threats.
The Forum on Microbial Threats and the IOM wish to express their warmest appreciation to the individuals and organizations who gave their valuable time to provide information and advice to the Forum through their participation in the planning and execution of this workshop. A full list of presenters, and their biographical information, may be found in Appendixes B and F, respectively.
The Forum gratefully acknowledges the contributions of the members of the
planning committee1: Gerald Keusch (Boston University), Rima Khabbaz (Centers for Disease Control and Prevention), Lonnie King (Ohio State University), Victoria McGovern (Burroughs Wellcome Fund), Carol Meteyer (United States Geological Service, National Wildlife Health Center), John Perfect (Duke University), Erica Rosenblum (University of Idaho), Kevin Russell (Department of Defense), Fred Sparling (University of North Carolina), and James Stack (Kansas State University).
The Forum is indebted to IOM staff who tirelessly contributed throughout the planning and execution of the workshop and the production of this workshop summary report. On behalf of the Forum, we gratefully acknowledge these efforts led by Dr. Eileen Choffnes, director of the Forum; Dr. LeighAnne Olsen, program officer; Katherine McClure, senior program associate; Collin Weinberger and Rebekah Hutton, research associates; and Robert Gasior and Pamela Bertelson, senior program assistants, for dedicating much effort and time to developing this workshop’s agenda and for their thoughtful and insightful approach and skill in planning for the workshop and in translating the workshop’s proceedings and discussion into this workshop summary report. We would also like to thank the following IOM staff and consultants for their valuable contributions to this activity: Greta Gorman, Jill Grady, Laura Penny, Heather Phillips, Leslie Pray, Elisabeth Reese, Vilija Teel, and Jordan Wyndelts.
Finally, the Forum wishes to recognize the sponsors that supported this activity. Financial support for this project was provided by the U.S. Department of Health and Human Services: NIH, National Institute of Allergy and Infectious Diseases, CDC, Food and Drug Administration, and the Fogarty International Center2; U.S. Department of Defense, Department of the Army: Global Emerging Infections Surveillance and Response System, Medical Research and Materiel Command, and the Defense Threat Reduction Agency; U.S. Department of Veterans Affairs; U.S. Department of Homeland Security; U.S. Agency for International Development; American Society for Microbiology; sanofi pasteur; Burroughs Wellcome Fund; Pfizer, Inc.; GlaxoSmithKline; Infectious Diseases Society of America; and the Merck Company Foundation. The views presented in this workshop summary report are those of the workshop participants and rapporteurs and are not necessarily those of the Forum on Microbial Threats or its sponsors.
1 Institute of Medicine (IOM) planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published workshop summary rests with the workshop rapporteurs and the institution.
2 Sponsor as of October 1, 2010.
Karen H. Bartlett, Sarah E. Kidd, and James W. Kronstad
David S. Blehert, Jeffrey M. Lorch, Anne E. Ballmann, Paul M. Cryan, and Carol U. Meteyer
Aviv Bergman and Arturo Casadevall
Vincent A. Robert and Arturo Casadevall
Peter Daszak, Carlos Zambrana-Torrelio, and Tiffany Bogich
John N. Galgiani
Julie R. Harris
Joseph Heitman, Edmond J. Byrnes III, and John R. Perfect
Steven M. Holland and Donald C. Vinh
Mogens Støvring Hovmøller
Michael Jeger, Marco Pautasso, and James Stack
Luis R. Padilla
David M. Rizzo, Ross K. Meentemeyer, and Matteo Garbelotto
Compton J. Tucker, Karina Yager, Assaf Anyamba, and Kenneth
Vance T. Vredenburg, Cheryl J. Briggs, and Reid Harris
Ché Weldon and Matthew C. Fisher
Gudrun Wibbelt, Andreas Kurth, David Hellmann, Manfred
Weishaar, Alex Barlow, Michael Veith, Julia Prüger, Tamás
Görföl, Lena Grosche, Fabio Bontadina, Ulrich Zöphel, Hans-
Peter Seidl, Paul M. Cryan, and David S. Blehert
Sébastien J. Puechmaille, Gudrun Wibbelt, Vanessa Korn,
Hubert Fuller, Frédéric Forget, Kristin Mühldorfer, Andreas
Kurth, Wieslaw Bogdanowicz, Christophe Borel, Thijs Bosch,
Thomas Cherezy, Mikhail Drebet, Tamás Görföl, Anne-Jifke
Haarsma, Frank Herhaus, Guénael Hallart, Matthias Hammer,
Christian Jungmann, Yann Le Bris, Lauri Lutsar, Matti Masing,
Bart Mulkens, Karsten Passior, Martin Starrach, Andrzej
Wojtaszewski, Ulrich Zöphel, and Emma C. Teeling
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Tables, Figures, and Boxes
|WO-1||The Fungal Gardens of Leafcutter Ants|
|WO-2||Factors in the Emergence of Infectious Diseases|