What Will Create the Next Epidemic? (10/8/12)
Meningitis, Salmonella, and…
Meningitis arrives through contaminated spinal steroid injections by pain specialists. Salmonella infects hundreds of Americans via Dutch smoked salmon sold by Cisco.
Dozens die. People are again unnerved by infection. Will there be a new form of AIDS, or SARS, or something truly unknown coming to kill us?
And what will we do?
Nature As Innovator
Nature is indefatigably inventive and naturally without scruple. We ignore just have innovative she can be.
In 1979 I sat with Dr. Jonas Shulman, a professor of infectious disease at Emory, as he went through a series of slides. This small boy had been killed by a virus. Another kid had succumbed to a bacterium.
Nobody knew the origin of either pathogen – or how they worked. They were new – and lethal.
New varieties of bugs are created all the time.
Sometimes they morph in the passage from animal to animal, as in influenza and AIDS. Sometimes they appear to come from a vague nowhere. But like everything in biology, organisms are constantly renewed and remade.
One hepatitis B virus in the morning can become 100 billion by the next, thriving in your bloodstream and liver. It takes four hours for a new virus to replicate – and that’s all the time it needs to become genetically different.
Despite the continuous threat from constantly changing pathogens almost all of us are still here.
Our immune system is smart, too. So smart we don’t really know how or how well it works.
Some parts fortunately we do understand.
There is a primary immune system that sees off pathogens well before we are conscious they exist. New work with immune modulators in mice argues this system may be pharmaceutically activated in case a new pandemic comes our way.
Then there is a secondary system – or rather, multiple secondary immune systems. One part engages antibody based immunity.
When a new chemical or foreign organism is sensed, a whole plethora of library chemicals is directed to probe and destroy the assailant. One way this works is through somatic hypermutation – newly evolved antibody chains that by the millions or even billions go forth to find, investigate and often obliterate the new stuff that just arrived.
Our body survives through a programmed form of evolution.
Creationists, take note. Without this system of continuous, forced immune evolution humans might not have made it.
Oppose evolution and you oppose one of the body’s major ways of keeping you alive.
Bugs As Information Bundles
With the human genome getting mapped more effectively and cheaply, we forget how quickly and powerfully many microbes have been surveyed.
Life is a form of information, but understanding how life works – particularly in the smallish critters than have so rapidly killed us throughout human history – is rapidly improving.
AIDS has killed 30 million people. But when it first arrived, people feared hundreds of millions would die. SARS looked ready to decimate entire urban populations, but less than 1000 people died.
Information about epidemics is a lot better than it used to be. Now Twitter feeds and emails fed into intelligent data miners help tell public health experts where the next flu and other epidemics are developing and spreading.
So when the next SARS arrives researchers might know about it in days.
Which makes it easier to combat epidemics with all the old fashioned means – quarantine, sequestration, hospital case isolation, antibiotics, that we have used in the past.
But some types of pandemics may overrun our increasing capacity to combat them.
Human Made Epidemics
One is taught to expect the unexpected, but sometimes the expected can prove truly nasty.
Ken Alibeck was a Russian bioweapons researcher who defected to the U.S. in 1992. He told the CIA that Russian scientists had created a respiratory form of anthrax that was remarkably lethal, and claimed they had worked on enhanced, virulent forms of smallpox.
More recently, researchers have reviewed how bird flu might morph into a major human pathogen, and discovered that just a few mutations appeared required to obtain that purpose. Editors of academic journals were so conflicted that publication of the American and Dutch work was delayed for months.
The Information Revolution has made pathogen surveillance far more effective. It has also made it easier to create and promote new infectious agents.
Will terrorist groups like Al Qaeda find the place and means to create new versions of old pathogens that might kill millions? Will the many different research programs, primarily in developed countries, be sufficiently sophisticated to counter whatever actions they take?
What is different now is that we are indeed in the realm of the Anthropocene – the new human based geological phase changing the entire Earth.
We are destroying old species at unprecedented rates. We are forcing species to evolve quickly or not live evermore.
And we are increasingly changing the genetic patterns of plants, microbes and animals in attempts to increase food production, fight disease, and increase industrial production.
So curiously the newest pathogenic threats to humanity may not come directly from Nature’s endlessly inventive evolution but from works – and living organisms – that are partially manmade.
Such health disasters may never happen. Or they may join the other manmade epidemics – in obesity and diabetes, heart disease and stroke. Lifestyle must always struggle with our long evolved desires.
Yet we may also continue to defeat most epidemics simply – by the daily choices we make in our ordinary, daily lives.
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