The next pandemic
"The deaths from the next great plague could have begun in a village last week, or could begin next year, or a year before we learn to deal with new viral illnesses promptly and effectively. With luck, the plague will wait until a year after." _Unbounding the Future_ pp 222-223.
What if we are not lucky?
From the Cryonet maillist
Message #21485
Date: Thu, 27 Mar 2003 13:03:04 -0500 (EST)
From: Charles Platt <cp@panix.com>
Subject: Bad SARS numbers
Today's SARS increase reported by W.H.O. is very disturbing. Globally and
in Hong Kong, the number of new cases reported on 3/27 is TWICE the
average daily number of new cases reported from 3/21 through 3/25.
(Source: W.H.O. web page.) In other words, we now see the first instance
of doubling of new cases, and the doubling has occurred within a 2-day
period.
I would like to think that this could be attributable to better reporting,
since hospital staff are now more alert for the SARS symptoms. On the
other hand if hospital staff are more alert, they should also be taking
more precautions. I wonder if SARS is now escaping into the general
population, and we have a last chance to contain it at this time. As usual
this would involve draconian measures which most nations would find
unacceptable (e.g. quarantine, physical examination of all air travelers).
--CP
It's the flu we should dread
April 5 2003
The SARS scare is only a taste of the horror of the coming flu pandemic, writes Amanda Dunn.
Face masks are disappearing from pharmacy shelves. Travel plans are being postponed or cancelled. Reports emerge daily of sick people being quarantined and closely monitored in Australian hospitals.
Inciting these jitters is the mysterious - and so far untreatable - severe acute respiratory syndrome, a killer atypical pneumonia that has swept though parts of Asia, particularly China and Hong Kong, and touched other countries.
For now, the risk posed to Australians from SARS remains relatively low, although it appears to have reached our shores. One probable case has been reported to the World Health Organisation, and three young Canadian children remain in hospital at Monash Medical Centre, suspected of having the virus.
But what ought to worry us much more than SARS, the experts say, is influenza - that complaint commonly shrugged off as "just a dose of flu" - which kills hundreds of thousands of people around the world each year and is one of the most unpredictable and highly contagious diseases.
Figures from the Australian Institute of Health and Welfare show that in 2000, 2937 Australians died from influenza or pneumonia, with the two so closely related they tend to be spoken of together. In Victoria, flu and pneumonia claim about 400 lives each year, and cause thousands more hospitalisations.
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Vaccines are available and, as long as the flu does not mutate too far from the known strains, scientists can mix appropriate seasonal strains into the vaccine.
But what really worries them is the potential that a virus will change so radically - perhaps finding its way from birds to humans - that our systems have never seen its like before and will be powerless to fight it. This is the recipe for what experts anticipate is an inevitable flu pandemic, and the resulting infection and death rate would be catastrophic.
"If SARS were an influenza pandemic," says Melbourne University professor of virology, Ian Gust, "and the mortality rate was similar to what it is now (about 3.5per cent), we would have tens of thousands of people dead, rather than less than 100." And that is not because the virus would be any more potent, but because it would be much more contagious.
An unassuming collection of labs in Parkville form the home of the WHO's Collaborating Centre for Influenza, one of four such centres around the world. It is the centre's job to collect samples of viral strains and keep a hawkish eye on any developments in the region.
Its deputy director, Alan Hampson, is a softly spoken virologist who does not appear given to hyperbole. When asked about the likelihood of another flu pandemic, the answer is blunt: "it's not a matter of whether it will happen, it's when it will happen."
An illustration of just how edgy scientists are about the potential for a pandemic can be found in the SARS story. Last month, a Hong Kong family returned home from a visit to southern China, a region from which many viruses appear to spring. The young daughter had recently died from a mysterious flu-like virus, which the son had also contracted. Soon after, the father also died from the virus.
"(Health authorities) immediately thought, 'right, what we've got in southern China is the chicken flu," Hampson explains, and the WHO started preparing for a flu pandemic.
This family did have the chicken flu, but it did not take off because it was not transferable from human to human.
But what WHO soon discovered was another virus emerging in southern China: SARS. At this stage, SARS is believed to be a coronavirus - a major cause of common colds and not usually associated with severe illness.
"When it became clear it wasn't influenza, but doing the same things associated with a pandemic, WHO rang all the same alarm bells," Hampson says. But SARS, at this stage at least, is not a pandemic.
Last century, three influenza pandemics swept the globe, killing millions of people. By far the worst was the so-called Spanish flu of 1918-1919, which caused the deaths of between 20 million and 40 million people. Alarmingly, most of those who died were young and otherwise healthy. The Federal Government's influenza pandemic plan of 1999 reports that by the end of 1919, 11,500 Australians had died of influenza, with 60per cent of those deaths in the 20 to 45 age group. The Royal Exhibition Building in Carlton was turned into a makeshift hospital to cope with the scale of the disease.
In 1957 and 1958, the Asian flu hit, and in 1968 the Hong Kong flu took hold. Both pandemics caused a two to five-times-greater death rate from influenza in Australia than in non-pandemic years, although neither were anywhere near the scale of the earlier disaster.
According to the WHO's website, the next influenza pandemic is likely to throw up the following grim figures: 280,000 to 650,000 deaths in less than two years in industrial countries alone, as well as 1million to 2.3 million hospitalisations.
The reason influenzas are so difficult to predict and contain is that they can jump species, presenting humans with a previously unknown virus against which we do not have any immunity.
Hampson explains what happens in the following way. There are three types of influenza - A, B, and C. A and B are the dangerous ones associated with annual outbreaks. Of those, the A group is the deadliest, and the only one that can cause pandemics.
Within the A group there are 15 different types of flu, only two of which are currently found in humans. However, all of them are found in birds, and most commonly in ducks. Sometimes, the duck viruses can be passed on to other animals - pigs and chickens are among the likeliest suspects - and, if the same cells it infects in the animal are also infected by a human virus, a hybrid virus can result.
"So then you can get a virus that's a genetic mix of the two others," Hampson explains. "Suddenly, you have got a bird virus that has the ability to grow and spread in humans." Once that happens, it can storm through populations, and is likely to cause many deaths before science can catch up with it.
How does influenza kill? The danger occurs if the infection, which starts in the nose and throat, moves down into the chest, causing pneumonia. The body sends white blood cells to combat the invader, and the lungs fill with liquid and become so heavy they can no longer function.
Associate Professor Lou Irving, director of respiratory medicine at the Royal Melbourne Hospital, says an influenza pandemic would cause chaos. "We would be looking at a significant number of the population infected, say, 40 per cent or maybe more," he says. "That would mean schools would close, businesses would close, our hospitals would be overwhelmed by people."
More than that, says Ian Gust, there simply would not be enough vaccine in the world to cope with demand.
Potential pandemics aside, doctors remain concerned about the regular flu season that arrives every winter and inevitably claims lives. Lou Irving expects to be treating people with chronic illnesses - lung disease, heart disease, kidney disease - who have contracted the flu and become very sick. At the Royal Children's Hospital, infectious diseases physician Dr Jim Buttery also expects to see the flu strike the very young. "It's thought that each year up to 30per cent of children will have symptoms from influenza," he says. Last year, the hospital admitted 130 children for the flu.
However, he makes the same recommendations for vaccinating children as for adults - they should have the vaccine if they have an underlying condition that places them at higher risk.
As usual, governments and health authorities are urging people to have flu shots now. This winter they expect an A/Moscow-like strain, an A/New Caledonia-like strain and a B/Hong Kong-like strain.
Despite the popular wisdom that flu shots can make you sick, Hampson insists that is just not possible. The vaccines are made by growing the viruses in eggs, and then killing them and breaking them apart. Once the vaccine is injected, the body thinks it has been invaded and produces an immune response.
Still, people appear to be more relaxed about influenza and its potential risk than a new disease like SARS. Perhaps, doctors say, it is a case of better the devil you know.
And what of SARS? For the moment, the disease is still spreading in Hong Kong and China, and the death toll continues to climb. Gust suspects it will eventually run its course.
It is probably too early to say for sure, he says, but "I think probably it will burn itself out, and with early identification and quarantining of individuals, then the virus will disappear." In Vietnam, for example, authorities appear to have thwarted the spread of the disease.
In the meantime, experts watch and wait for new viruses to show themselves, especially one that might spark a pandemic. When that might be is impossible to predict, but "based on the history of the way influenza has behaved," says Jim Buttery, "most people believe we're overdue for one".
Amanda Dunn is The Age health reporter.
The Ebola Virus
?He becomes dizzy and utterly weak, and his spine goes limp and nerveless and he loses all sense of balance. The room is turning around and around. He is going into shock. He leans over, head on his knees, and brings up an incredible quantity of blood from his stomach and spills it onto the floor with a gasping groan. He loses consciousness and pitches forward onto the floor. The only sound is a choking in his throat as he continues to vomit blood and black matter while unconscious. Then comes a sound like a bedsheet being torn in half, which is the sound of his bowels opening and venting blood from the anus. The blood is mixed with intestinal lining. He has sloughed his gut. The linings of his intestines have come off and are being expelled along with huge amounts of blood. Monet has crashed and bled out (Preston, 23-24).?
The preceding paragraph is from Richard Preston?s nonfiction bestseller, The Hot Zone, and it gives a graphic account of a person in the final stages of infection by the Marburg virus, which belongs to the same family of viruses as Ebola. Marburg is the milder of the two. Ebola has almost identical symptoms and a higher rate of fatality. Hundreds have already died from Ebola and the threat of an Ebola pandemic is greater than many realize. Researchers are just beginning to understand how this mysterious virus works.
Part One: History : Ebola Sudan
The first modern major outbreaks of Ebola occurred almost simultaneously in the African countries of Sudan and Zaire (now known as the Democratic Republic of the Congo) in 1976 (Klenk, Slenczka, and Feldman, 1).
The outbreak in Sudan began in the town of Nzara on July 6, 1976 when a man known as Yu.G. (referred to by his initials) went into shock and died with blood leaking from all his body orifices. Soon two of his coworkers from a local cotton factory became ill and died of massive hemorrhaging. From them the disease spread throughout Nzara, killing many of those infected. Then illness broke out in a hospital in neighboring Maridi, infecting patients and staff. The repeated use of unsterilized needles helped facilitate the spread of the disease. Doctors noticed that some victims showed mental symptoms such as derangement or depersonalization (loss of personality) (Preston, 95-98; 19).
The virus in Sudan had a fifty percent mortality rate. Half of those infected died. If the virus had mad it out of central Africa it would have likely spread over the globe. Fortunately the outbreak died out before it could spread further, possibly because it killed its hosts faster than it spread to new ones (Preston, 99). All told, about 284 people were infected (Chris?s Ebola Site).
Part 1: History: Ebola Zaire
Two months after the mysterious outbreak in Sudan, a more lethal outbreak occurred five hundred miles to the west in Zaire. The outbreak occurred in a region known as the Bumba Zone, which contains scattered villages and is drained by the Ebola River (Preston, 101).
It started around August 28, 1976, when an unknown patient came into the Yambuku Mission hospital complaining of diarrhea. The Belgian nuns who staffed the hospital had trouble diagnosing his illness, which consisted of diarrhea and a nosebleed, and after two days the man left against the Sister?s wishes. On September 5, a man named Mabalo ?Antoine? Lokela, who worked at the mission?s school and who had received a quinine injection at the hospital a week previous, came back seriously ill. He had a fever, vomiting, severe diarrhea, and was bleeding from the gums and nose. There was also blood in his diarrhea and vomit. Though the hospital staff did not know it, several other patients who had recently been released were also suffering from the same disease. And those in their families who tended to them were beginning to develop symptoms. Despite the best efforts of the Sisters, Antoine Lokela died on September 8. His body was prepared for burial by his mother and sister, assisted by his mother-in-law. In a matter of days they too were suffering from the strange illness. His sister survived (though the illness caused a miscarriage), but his mother and mother-in-law both died on September 20. Before long eighteen of Antoine?s friends and family would die of the mysterious bleeding illness (Garret, 101-103).
Soon the mission hospital was filled with people bleeding to death from the strange disease. Some were showing mental symptoms. The Sisters were helpless to stop it, and on September 12, one of their own, Sister Beata, came down with the sudden fever and hemorrhaging that was killing her patients (Garret, 104).
Responding to a radioed message asking for assistance, Dr. Ngoi Mushola left the city of Bumba for Yambuku on September 15. He arrived to witness firsthand the horrible disease, which he too was unable to treat. Two days later he hurried back to Bumba to send a report to authorities in Kinshasa. Ngoi?s report is the first description of this new disease. In it, he stated that the Yambuku hospital had used all of its antibiotic supplies with no success (Garret, 104-105).
On September 19, the same day Sister Beata died, there came reports of the disease in over forty villages. The villagers were beginning to panic. Two professors, microbiologist Muyembe Tamfum Lintak and epidemiologist Omombo, were dispatched from the National University of Zaire to Yambuku. They arrived on September 23, just after Zairian nurse Amane Ehumba died from the disease. Shortly afterward Sister Myriam, who had tended to the dying Sister Beata, became sick. The professors had not taken Ngoi?s report seriously, but the reality of the situation soon sank in as patients died before their eyes as they discussed possible treatment. The two had not brought protective equipment (gloves, masks, etc.) but worked diligently collecting and examining blood samples and performing autopsies. The professors then agreed to take the seriously ill Sister Myriam, Father Augustin (who had a high fever), and accompanying nurse Sister Edmonda to Bumba. From there the three flew to Kinshasa. Sister Myriam died in Ngaliema hospital on September 30 (Garret, 105-106). After her death the walls and furniture in the nun?s hospital room were stained with blood. Doctors at the hospital began to fear that the disease was Marburg virus (Preston, 109-110).
Marburg is a virus that causes the same kinds of symptoms that the infected people in Zaire and Sudan showed. It is named for a town in Germany where it was first discovered during an outbreak in 1967 (Duchene, 3). The outbreak began in factory that housed monkeys for research. Thirty-one people were infected, and seven died. The virus originated in the monkeys, which were shipped from Africa (Duchene, 3).
The nun who had traveled with Sister Myriam soon developed the disease and was place in a private room. Nurse Mayinga, who had tended to Sister Myriam as she lay dying, also became ill. Mayinga did not report her illness to the doctors at Ngaliema and instead went into the city. There she came into contact with many people before finally becoming so sick that she had no choice but to go back to Ngaliema (Preston, 110-112).
Meanwhile, at the mission, only seven of the seventeen employees were well enough to tend patients. The others were all dead or dying. Sister Genoveva closed the hospital to all but the current patients. She then used rolls of bandage gauze to cordon off the mission (Garret, 107).
Zaire?s Minister of Health called Dr. William Close, an American who was President Mobutu Sese Seko?s personal physician, asking him to request assistance from American authorities. Close contacted the Centers for Disease Control (CDC) in Atlanta, Georgia, and explained the situation to President Mobutu. The President placed the Bumba zone under isolation and lent his private airplane to the medical effort. Medical supplies and lab equipment were placed on his jet and flown to Bumba. About that time virus experts from the World Health Organization (WHO) began to notice similarities between the outbreak in Yumbuku and the one that had started earlier in Maridi, Sudan. They feared that the two were actually one outbreak. They sent for blood samples from Sudan. When they received them, they sent them for analysis at labs in the US and UK (Garret, 107-109). Blood from Yambuku was sent to the CDC where it was analyzed by virologists Patricia Webb and Frederick Murphy (who was one of Marburg?s discoverers). It was on October 13, 1976 that Murphy first viewed the virus through an electron microscope. The sample was full of a virus that bore a strong resemblance to Marburg. He and Webb notified virus hunter Karl Johnson. Webb then ran tests to identify the virus. It was not Marburg, and did not resemble any other virus, therefore it was concluded to be a new virus. Johnson named it Ebola, after the Ebola river (Preston, 115-117).
Medical teams began arriving in Zaire, but the epidemic was already winding down. Nurse Mayinga died on October 20. Fortunately, none of the people she came into contact with caught the virus (Garret,124). By the end of the epidemic there were 318 cases reported, with a frightening 90% fatality rate (Patni).
Part One: History: Other Major Outbreaks in Africa
A second major outbreak occurred in Sudan in 1979, of the thirty-four people infected, twenty-two died. The outbreak started at the same cotton factory in Nzara where the first one occurred (Patni).
A second outbreak in Zaire in 1995 left 245 dead, while the most recent major outbreak in Northern Gabon killed forty-four between 1996 and 1997 (Glausiusz, 24). The Gabon epidemic was probably started when two children from Mayibout, Gabon, found a dead chimp and brought it home to eat. Soon all who had eaten or helped prepare the chimp fell ill. Luckily, WHO arrived to contain the outbreak (Purvis, 59).
Part One: History: Plague of Athens
For centuries scholars have debated what disease caused the plague of Athens. The plague, which occurred around 425 BC was called ?The Thucydides Syndrome? (Sinha and Powell ). It was described by the Greek historian Thucydides, who contracted and survived the disease. The symptoms he described sound very similar to those of Ebola. He wrote that the disease started ?...in Ethiopia beyond Egypt, it next descended into Egypt and Libya (Olson).? The disease devastated the population of Athens, and may have brought about the end of the Golden Age of Greece (0lson).
Part One: History: Ebola Reston
In 1989, there came a wake-up call to those who thought that a virus from another continent is no threat to them. Located in the town of Reston, Virginia, about ten miles from Washington DC, was a company called Hazleton Research Products. On October 4, the company received a shipment of one hundred monkeys from the Philippines. The monkeys were macaques that had been shipped from Manilla via Amsterdam and New York City. Soon after their arrival at the Reston monkey house an unusual number of them began dying. By November 1, the colony manger had become alarmed. Twenty-nine out of the one hundred monkeys had died. He had consulting veterinarian Dan Dalgard take a look at the monkeys. While performing an autopsy on a dead monkey, Dalgard noticed blood inside the intestines. He began to worry that they were suffering from simian hemorrhagic fever, which is harmless to humans but lethal to monkeys (Preston, 157-168).
On November 13, Dalgard contacted the United States Army Medical Research Institute of Infectious Diseases (USAMRIID), at Fort Detrick in Frederick, Maryland. He thought that they could help identify the virus killing the monkeys (Preston, 173). On November 17, intern Thomas Geisbert looked at a sample from an infected monkey through an electron microscope. What he saw frightened him. He saw cells that were destroyed by a virus that resembled Marburg?s characteristic, rope-like shape. The sample was the same one that had come from a flask that he and virologist Peter Jahrling had sniffed while looking for signs of bacterial infection (Preston, 291-297). Jahrling at first thought that Geisbert was joking when he was told about the possible Marburg infection, but soon was convinced enough to notify Colonel C.J. Peters, chief of the disease-assessment division at USAMRIID. Peters was worried but skeptical, saying he wanted more evidence before taking action. Jahrling agreed to conduct a test for Marburg and Ebola on the sample. Neither Jahrling nor Geisbert mentioned their possible exposure to the virus (Preston, 201-209).
Jahrling performed a test that involved reacting the sample with blood serum from victims of Ebola and Marburg. If the virus was the same as the one the victim had been exposed to, the blood would glow. He tested for Marburg with the blood of Dr. Shem Musoke, who had survived the virus after catching it while treating a victim in Nairobi Hospital. The blood did not react. He tested for Ebola Sudan with the blood of a man named Boniface who had died in the Sudan outbreak. The blood glowed weakly. He tested for Ebola Zaire with the blood of nurse Mayinga. The blood glowed brightly. Whatever the virus was, it was very closely related to the virus that had killed ninety percent of those infected in Zaire (Preston, 215-217).
USAMRIID soon launched an operation to quarantine the monkey house and euthanize all the monkeys. This operation was conducted under strict safety procedures, meaning that those involved had to wear space suits and go though chemical showers to decontaminate themselves. Several times during the operation there were mishaps that exposed people to the virus. Fortunately, this strain of Ebola wasn?t fatal to humans. Unfortunately, this strain was airborne. If the strain had mutated and become lethal to humans, it could have spread like a grotesque flu, killing billions. Eventually all of the monkeys were killed and no humans came down with Ebola (Preston, 224-354). On December 18, the decontamination team scrubbed the building with bleach and then filled the building with formaldehyde gas, which kills even very strong microbes (Preston, 355-356).
Less than a month later, Hazleton received another shipment of monkeys. They too were infected. Since no people had died during the first outbreak, USAMRIID and the CDC decided to seal the building and let the virus work its way through the monkeys. The virus behaved like influenza, except that it caused hemorrhaging. Most of the monkeys died. Four men who worked at the facility, though they showed no symptoms, tested positive for Ebola. The Hazleton company vacated the building not long after the incident (Preston, 357-365).
Part 2: What is Ebola?: Classification
Ebola is one of several viruses that cause a condition known as Hemorrhagic Fever, a severe and often fatal disease in humans and other primates (CDC). It begins with fever and muscle pain, then swiftly develops into severe bleeding (hemorrhaging), which leads to shock due to blood loss (Chris?s Ebola Site).
Ebola belongs to the family of viruses known as Filoviridae, which have a thread-like shape (Chris?s Ebola Site). The other member of the Filovirus family is Ebola?s ?sister virus?, Marburg (Patni). There are four recognized strains of Ebola: Ebola Zaire, Ebola Sudan, Ebola Tai (name of a strain that infected a scientist in the Ivory Coast (Rodolfo)), and Ebola Reston. Reston is the only known strain not fatal to humans (Chris?s Ebola Site).
Ebola (excluding Reston) has a fatality rate of fifty to ninety percent. There is no proven cure or vaccine. This makes Ebola a Biosafety Level 4 pathogen. The containment levels at USAMRIID are numbered, 0,2,3,4 (there is no level 1). Level 0 is separated from 2 by a doorway that shine with ultraviolet light, which destroys viruses. Levels 2 to 4 are under negative air pressure, so that air flows into them if a leak develops and pathogens cannot escape. Level 4 is the highest - one must enter through an airlock and must wear a spacesuit. Level 4 pathogens, or hot agents, are extremely lethal and incurable (Preston, 59-70).
Part 2: What is Ebola?: Symptoms
The symptoms of Ebola begin four to sixteen days after exposure. They begin with a persistent headache. The headache is followed by a fever, chills, muscle aches, and loss of appetite (Chris?s Ebola Page). A flaky, non-itchy rash may appear (Rodolfo). The victim?s condition then deteriorates as they develop a sore throat, diarrhea, vomiting, abdominal pain and chest pain. The victim?s kidney and liver functions are impaired. (Chris?s Ebola Site) Massive hemorrhaging begins; the person bleeds from all orifices. Blood clots form in the brain, impairing the higher brain functions and bringing about an altered mental state. The brain damage may wipe away the person?s personality, a condition called depersonalization. As the virus continues to destroy cells, the body is partially liquefied. Finally the victim dies of shock and blood loss (Preston, 19-20).
Part 2: What is Ebola?: Transmission
Ebola is spread through direct contact with the blood, organs, or secretions of an infected person. Ebola Reston is the only airborne strain of Ebola. Ebola can be spread by the use of unsterilized needles (Chris?s Ebola Site). In third world countries, where needles are often re-used even in the best hospitals, this helps lead to nosocomial transmission. Nosocomial is the term applied to the spread of a disease through a health-care settings, such as a hospital (CDC). Nosocomial transmission is often associated with Ebola, as evidenced by the fact that most Ebola outbreaks are concentrated in hospitals. In the 1995 Zaire outbreak, 68 of the 264 cases were nurses (Rodolfo).
Part 2: What is Ebola?: How Does it Work?
After infection, the virus floods the bloodstream with a glycoprotein. This glycoprotein comes in two forms. The first is the one released into the bloodstream. The second is the one that remains on the virus. The released glycoprotein binds to the white blood cells. This may prevent them from fighting the virus or from signaling the rest of the immune system. The virus is then free to attack the blood vessels, using its remaining glycoprotein as a sort of ?key? to enter the endothelial cells (Glausiusz, 24).
Part 2: What is Ebola?: Where Does It Come From?
Unfortunately, scientists have been unable to locate the species that Ebola naturally lives in. This ?reservoir? species would be one that Ebola inhabits, but does not make sick. It has been noted that Ebola outbreaks happen at about the same time every year, like the flu. This time of year coincides with the rainy season. Cases of Ebola have been traced to contact with chimpanzees. The chimps are not the reservoir, because they die just as humans do. But the chimps may be a link between humans and the reservoir species. The rainy season, when the outbreaks occur, is the time when chimps suddenly change their diet. For unknown reasons they become carnivorous at this time of year. This may cause them to eat the reservoir species, thus introducing the virus into chimps then into the humans who come into contact with them (Neus, 7A). It is still unknown how the Philippino monkeys that were shipped to Reston became infected (Preston,).
Part 3: Treatment
As of now, there is no widely accepted or proven cure for Ebola. The best strategy remains prevention. Doctors should wear gloves, masks, and properly sterilize equipment (Chris?s Ebola Site). These simple safety procedures are difficult to follow in the African countries where Ebola frequently erupts. There is simply not enough money for medical supplies.
Treatment with anticoagulants and antibiotics have had a very limited success (Patni).
In the final days of the 1995 Zaire outbreak, eight people in grip of Ebola were given transfusions from survivors of the previous outbreak. This was an experimental treatment by doctor Jean-Jaques Muyembe Tamfum. Two were already comatose when the transfusions were given. Seven of the eight survived, strongly suggesting that the treatment was effective (Duff-Brown).
Using the discovery of Ebola?s use of glycoproteins, Dr. Gary Nabel has developed a prototype vaccine that has shown positive results in guinea pigs (Glusiusz).
Part 4: Conclusions
The fact that Ebola managed to make it to a suburb of our nation?s capital is frightening enough. The fact that the virus had mutated into an airborne form was even scarier. Those monkeys made stops in Amsterdam and New York City before arriving at their destination. If the virus had jumped species, it could have infected people at JFK airport. Those people could have traveled to London, Moscow, Tokyo, LA, and started outbreaks in those places long before the virus was identified in Reston. With modern travel the threat of a viral pandemic is very real. Ebola emerged from the rain forest, and as mankind continues destroying the rain forest and the species in it, new viruses will continue to ?jump ship? from the endangered species they inhabit into humans. Disease causing microbes are our only natural predator, and as our population grows we will encounter them more often.
Works Cited
1. Chris?s Ebola Site http://www.teenoutreach.com/Online_H...ola/ebola.html
2. Klenk, Slenczka, and Feldman. ?Marburg and Ebola Viruses? Institute for Molecular Virology http://www.bocklabs.wisc.edu/eov-ebola.html; reprinted from Encyclopedia of Virology Plus CD_ROM 1995 Academic Press Ltd.
3. Centers for Disease Control and Prevention. ?Ebola Hemorrhagic Fever? http://www.cdc.gov/ncidad/dvrd/spb/m...agesebola.html
4. Patni, Himanshu. ?Himanshu Patni?s Ebola Page? http://206.45.16.36/umc/swaweb/patni/hpebol1.html
5. Rodolfo, Jan S. ?New and Emerging Infections: Ebola? http://www.bact.wisc.edu/ScienceEd/ebolawpd.html
6. Sinha and Powell. ?Scientific American Explorations: Shaking the Ebola Tree? Scientific American 8/96 http://www.sciam.com/explorations/08...lorations.html
7. Glausiusz, Josie. ?Ebola?s Lethal Secrets? Discover July 1998 p.24
8. Neus, Elizabeth. ?Scientists Chasing Down Trail of Africa?s Lethal Ebola Virus? Idaho Statesman 18 Aug. 1996 p.7A
9. Purvis, Andrew. ?Where Does Ebola Hide?? Time 4 March 1996 p.59
10. Duff-Brown, Beth. ?Bloodswitch ?Cure? for Ebola? San Francisco Examiner 11 Aug. 1995 p.A15
11. Preston, Richard. The Hot Zone New York: Random House, 1994
12. Duchene, Paul. ?Viral Meltdown? Oregonian 26 March 1995 B1+
13. Garret, Laurie. The Coming Plague New York: Penguin, 1994
14. Olson, P.E. ?The Thucydides Syndrome: Ebola Deja Vu? (or Ebola Reemergent?)? Emerging Infectious Diseases, Volume 2, Number 2, April-June 1996. http://www.cdc.gov/ncidod/EID/vol2no2/olson.htm#refo3
http://www.atimes.com/atimes/Southea.../Fi30Ae05.html
Human transmission sends bird flu fears flying
By Marwaan Macan-Markar
http://www.sundayherald.com/46866
Bird flu is getting serious attention now.
IRT Ebola, some of your more complacent voices would probably claim that the disease's very lethality actually works in our favor - those who do contract Ebola die before they have much of a chance to spread it very far. Thus, each epidemic deadends before very long. Of course, that 'four to sixteen day' incubation period could make hash of any such calculations rather rapidly nowadays, if given half a chance. :shock:
There are only one or two small stores of smallpox left - officially. However, if some of it were to fall into the wrong hands (think Al-Qaeda)... :shock:
That's why I would classify a smallpox outbreak as being a very likely bioterrorism event - especially if it happened here, and most especially if it were widespread at the outset. :evil:
Yeah, I saw it. It bothered me more than I thought it would.Originally Posted by Wyn76
Americans have had enough of glitz and roar . . Foreboding has deepened, and spiritual currents have darkened . . .
THE FOURTH TURNING IS AT HAND.
See T4T, p. 253.
Go to Google News and put in h5n1.
Bird flu is really starting to worry me.
I wouldn't exactly say worried...but I am a tad concerned. My understanding is that the avian flu is a shifting-antigen virus like Captain Trips in Stephen King's "The Stand".
As SE Asian Farms Boom, Stage Set for a Pandemic
Conditions Ripe for Spread of Bird Flu
By Alan Sipress
Washington Post Foreign Service
Saturday, February 5, 2005; Page A01
BANGLANE, Thailand -- Prathum Buaklee stepped nimbly along the aging planks running between the cages of his chicken farm, shoveling grain with his meaty hands from a bucket into the feed trays. His feet were bare and caked with dirt. The old plaid shirt hanging on his stocky frame was soiled. And the air was rank with the smell of feathers, droppings and feed.
This soft-spoken farmer is part of an agrarian revolution in Southeast Asia and China that has more than doubled poultry production in barely a decade, bringing pickup trucks, air conditioning and other trappings of prosperity to long-destitute peasants and more protein to the diets of hundreds of millions of ordinary Asians.
But with chickens now packed into farmyards alongside other livestock, international health experts warn that conditions are set for a bird flu pandemic that could kill millions worldwide if the virus developed into a form capable of spreading among humans.
In its current form, the disease kills about three-quarters of the people who catch it from birds. Since the beginning of last year, 45 people in the region have been infected. Twelve Vietnamese and one Cambodian have died this year.
A year ago, as Thailand became the epicenter of an avian influenza outbreak, local officials descended on Prathum's farm and put his chickens to death along with tens of millions in the rest of the country. The campaign was meant to stem the spread of a disease that has struck nine Asian countries.
The mass culling, however, did not stop the virus. And now, many poultry farmers are back in business, again raising their birds in unsanitary conditions that health experts say pose a threat unprecedented in modern agriculture.
(For more, click on the link in the headline)
"Dans cette epoque cybernetique
Pleine de gents informatique."
Would a billion dead be enough for a Catalyst?
http://www.plague.info/002331.html
It's great if you are trying to peddle your product.
From the cite listed above:
But the people in the know will have long since prepared for the pandemic with their own anti-viral herbs and immune-boosting nutritional strategies.
In fact, surviving the next flu pandemic will probably be relatively easy if you have a strong immune system. The key is knowing how to make it strong (and having the discpline to actually do it before the flu strikes).
I want people to know that peace is possible even in this stupid day and age. Prem Rawat, June 8, 2008
Even the sordidly vulturine are not always wrong. :shock:It's great if you are trying to peddle your product.
From the cite listed above:
But the people in the know will have long since prepared for the pandemic with their own anti-viral herbs and immune-boosting nutritional strategies.
In fact, surviving the next flu pandemic will probably be relatively easy if you have a strong immune system. The key is knowing how to make it strong (and having the discpline to actually do it before the flu strikes).
Americans have had enough of glitz and roar . . Foreboding has deepened, and spiritual currents have darkened . . .
THE FOURTH TURNING IS AT HAND.
See T4T, p. 253.
Of course, the Russian virologist may be right and the product peddlers may be wrong. Then we will have the billion deaths and the people "boosting" their immune system will be no better off.
BTW, read up on the 1918 flu. This one upheaveled the world, and the next may be worse. I think this is a real crisis in the making...it's the only thing that now scares me worse than Peak Oil.
Pandemic
Last night here in Denver a lady on a plane developed a severe rash during the flight. The authorities quarantined the plane, keeping all the passengers on board until they could check her out. I guess it's comforting that such aggressive action was taken. But I'm not sure that most threats will show up so obviously, or soon enough.
The one that worries me most from a terrorism perspective is smallpox. Easy to vaccinate troops against, yet most civilian populations are now not vaccinated.
I'm right now reading a book titled 'Pandemic', in which a particularly nasty flu variant, with a 25% lethality rate, is being deliberately spread to the US by an Al-Qaeda splinter group.
I am almost done with it (picked it up a few days ago). Can you believe this is this guy's first time and writing a book?
Americans have had enough of glitz and roar . . Foreboding has deepened, and spiritual currents have darkened . . .
THE FOURTH TURNING IS AT HAND.
See T4T, p. 253.
Bird Flu might be a greater pandemic than swine flu was, since the species jump is greater. I read a book intitled The Great Influenza which strongly supported an argument that the swine flu may have killed 5% or even as much as 10% of the world's population, and that "official" estimates are grossly conservative. 25% fatality from bird flu, from what we have seen of it so far, is quite plausible (I have seen projections of 1 billion to 1.5 billion from several sources, which would approach this).
Sounds more like Captain Trips each month...
http://news.bbc.co.uk/1/hi/health/4270755.stm
Just to remind you, more on bird flu...
http://www.guardian.co.uk/life/news/...419083,00.html
http://www.thestandard.com.hk/stdn/s.../GB21Wd06.html
Well, at least we won't have a problem with overpopulation any more. Not if it kills nearly 3/4 of everyone who gets it. :shock:Gravest Danger of Flu Pandemic, Official Warns
By TINI TRAN, AP
HO CHI MINH CITY, Vietnam (Feb. 23) - World Health Organization officials urged governments on Wednesday to act swiftly to control the spread of the bird flu, warning that the world is in grave danger of a deadly pandemic triggered by the virus.
The bird flu has killed 45 people in Asia over the past year, in cases largely traced to contact with sick birds, and experts have warned the H5N1 virus could become far deadlier if it mutates into a form that can be easily transmitted among humans. A global pandemic could kill millions, they say.
"We at WHO believe that the world is now in the gravest possible danger of a pandemic,'' Dr. Shigeru Omi, the WHO's Western Pacific regional director, said Wednesday.
He said the world is "now overdue'' for an influenza pandemic, since mass epidemics have occurred every 20-30 years. It has been nearly 40 years since the last one.
Speaking at the opening of a three-day bird flu conference in Ho Chi Minh City, Omi said it is critical that the international community better coordinate its fight against the virus.
In recent outbreaks, bird flu has become more deadly than the strain found in 1997 in Hong Kong, making the situation more urgent, he said.
The mortality rate among identified patients who contract the disease from chickens and ducks is about 72 percent, Dr. Julie L. Gerberding, head of the U.S. Centers for Disease Control and Prevention, said on Monday. She added that her agency was preparing for a possible pandemic next year.
"If the virus becomes highly contagious among humans, the health impact in terms of deaths and sickness will be enormous, and certainly much greater than SARS,'' Omi said, referring to severe acute respiratory syndrome, which killed nearly 800 people in 2003.
"This is why we are urging all governments to work now on a pandemic preparedness plan - so that even in an emergency such as this they will be able to provide basic public services such as transport, sanitation and power,'' he said.
The disease, which devastated the region's poultry industry last year as it swept through nearly a dozen countries, has killed 32 Vietnamese, 12 Thais and one Cambodian over the past year.
Officials acknowledge that one of the biggest challenges in controlling avian flu is in altering traditional farming practices in Asia where animals live in close, often unsanitary quarters with people.
"There is an increasing risk of avian influenza spread that no poultry-keeping country can afford to ignore,'' said Dr. Samuel Jutzi, of the United Nation's Food and Agriculture Organization in the conference's opening address.
Jutzi, director of the FAO's animal health and production division, said the avian flu virus will persist in Asia for years and coordinated efforts need to focus on controlling it at its source - in animals.
"This means addressing the transmission of the virus where the disease occurs, in poultry, specifically free-range chickens and wetland dwelling ducks, and thus curbing the disease occurrence in the region before it spreads to other parts of the world,'' he said.
The challenge for many countries affected by the virus is the lack of effective diagnostic tools and surveillance systems needed for early warning and timely response, he said.
The regional conference held in southern Ho Chi Minh City near the Mekong Delta where the latest outbreaks emerged this year has brought together scientists and representatives from more than two dozen countries.
Bird flu's reemergence in Vietnam, where 12 people have died this year alone, has shown the virus is now endemic in parts of the region.
"The longer the virus is circulating in animals, including chickens and ducks, the greater the risk of human cases - and consequently, the higher the risk of a pandemic virus emerging through genetic changes in the virus,'' Omi said.
The virus has proven to be "very versatile and very resilient,'' and has even been found in animals such as tigers and cats that weren't believed to be susceptible to influenza, he added.
02/23/05 05:12 EST
Copyright 2005 The Associated Press. The information contained in the AP news report may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The Associated Press. All active hyperlinks have been inserted by AOL.
As for humanity effectively 'dealing' with the threat, I'd put my money on the virus effectively dealing with us.
Still more on the bird flu, this from the UK:
http://news.bbc.co.uk/1/hi/uk/4345079.stm
