Sunday, January 07, 2007

What We Cannot See Threatens More

So many people talk about terrorism with an idea of people in mind. We seem to concentrate on nuclear threats and how it will bring the demise of our human race. Since I am not able to foresee the future, I cannot eliminate this possible threat in the future...but in my view...I do not believe this to be the most imminent threat to our race. That is not what scares me....

With each piece of knowledge that I acquire, I am scared of the terrorists that I cannot see. The silent killers. The millions of microbes that have the potential to do more harm, in more places, at the same time, than any nuclear bomb. We live in a time when travel and international business is the way of the world. We move around so often and so quickly, businessmen often forget where they have been on a given trip. I applaud progress and fair business, but I also am afraid of what else travels along on these trips with any given person from place to place. People come into contact with organisms in new environments in which they have never been exposed and then in turn infect 10's if not 100's of people in a single afternoon.

Imagine the number of people you are near at the O'Hare airport in Chicago or Grand Central Station in NYC. Try to quantify the trail of contact of each person you are near...and ultimately where they go. The numbers are astounding and you feel as if you can't possibly tackle something this big. So, why do I call these microbes terrorists? That is simple. These microbes or whatever the latest attack is, is invisible to the naked eye, it evolves faster than we can sequence it, symptoms may seem like the common cold and does not have the ability to rationalize. We cannot sit in a room with these invaders, sign a treaty no one has any intention of keeping and walk away feeling like we have control. We are at the mercy of these invaders.

You may be wondering why this is a problem now more than ever in the past. Research and reports have been published explaining why we are at a greater risk now of new pathogens emerging. First and foremost, we are dealing with microbes that have "tremendous evolutionary potential". We are also faced with so many other things such as "changing climate, altered ecosystems, increased human contact with animals, new medical technologies that have created novel pathways for the spread of infections, and 'the rapid and virtually unrestricted transport of humans, animals, foods and other goods, which can lead to the broad dissemination of pathogens and their vectors throughout the world'". We are sharing and trading microbes into new environments not previous occupied. This is and will be an action that carries harsh consequences.

"Any of these factors alone can trigger problems, but their convergence creates especially high-risk environments where infectious diseases may readily emerge, or re-emerge...It is conceivable, in fact, that in certain places microbial 'perfect storms' could occur, and unlike meteorological 'perfect storms,' the events would not be on the order of once in a century, but frequent." We have in recent years experienced such occurrences that could have been much worse than they were, (i.e., SARS, avian bird flu, west nile). As we learn more with each passing day and from past epidemics, we must work together not as a country or countries, but as a race, to face such obstacles.

In the example of SARS, the result could have been devastating. One country, China, hid the outbreak for many weeks if not closer to months. Politics and tourism blinded what was truly important...its' people. Once the knowledge of a new epidemic hit the WHO, global cooperation began the process to stop the impending devastation. It is only due to laboratories around the world, working tirelessly for a common cause, that we are not writing about entire countries being wiped out. By May 17, 2003, the WHO reported 7,761 cases of SARS around the world with a death toll of 623. This was spread across 28 countries on 5 continents. Of those, 66 cases were in the US (no deaths), 5209 cases in mainland China with 282 deaths and 1710 cases in Hong Kong with 243 deaths. Although the number of cases seem high, the low number of deaths is due to a few dedicated and active people that rallied early to stop this from spreading even more. They were successful in their efforts of containing the cases early. However, an expert in human diseases caused by parasitic worms and a tireless foe of infectious diseases, a doctor once part of the doctors without borders and one of the doctors that preached, "stay close to the victims", did just that.

Carlo Urbani stayed close to the first victims of SARS. He monitored them himself and rid the area of unnecessary people that could be at risk. Urbani also was the first to act and begin to gather the people necessary to alert the world. Unfortunately, it was only a matter of time before he too fell victim to this outbreak. Urbani died with his wife and 3 sons following behind his casket. The SARS virus was so infectious that even another week's delay in recognizing the problem would have spread the germ to hundreds if not thousands more people before control measures were put into place, one nation at a time. This is what Urbani did for all of us. His quick action had limited the number of cases and his doctors said he had probably inhaled so much virus as he tried to treat so many people that he was doomed from the start.

I write this as an introduction to the continuing story of what really threatens us. We do not have any idea of what or where the next big terrorist will come from, or even the ability of science knowledge to combat it. I do not fear other nations and the weapons they hold as much as I fear microbes that can appear and evolve faster that we can identify common links. Researchers wait with dread of that never previously seen microbe that has the ability to jump across the animal-human line. This threat, in addition to combining with common viruses that we cannot control now, is what scares me!


M. Enserink, "A second suspect in global mystery outbreak". Science 299 (March 28, 2003)

M. Hamburg, J. Lederberg, B. Beatty, et al. "Microbial threats to health: Emergence, detection, and response" Institute of Medicine National Academy of Sciences. Namtional Academies Press, March 2003.


Sakshi said...

A topic close to my heart. If I was not so averse to killing primates, I would really love to work with class IV pathogens - Marburg, Ebola and the like.
It is striking to see the rapid evolution and jumping species barriers by these viruses. In case of the ape viruses, I wonder if it is because we have infringed on their territory so much that we are more exposed to them or if the viruses are jumping hosts becuase they are finding lesser apes to inhabit in. Either way it is a dangerous situation. We are close enough to these apes that the viruses does not have to mutate a whole lot to find the key to open our immunological locks. At the same time, we do not know how to block these viruses - result is the almost 100% lethal effect of viruses like Ebola.
Free trade has meant that we can not effectively shut down and control infections. Most viruses we know have incubation time of atleast 7-15 days.. without symptoms.. imagine how many people can be exposed to the pathogen. We can potentially infect most of the world!! A real threat lies near us.. and we don't even see them .......

Revealed said...

Scarier still a hybrid. Think about that. HIV and a cold virus.

Sakshi said...

@ Revealed- Yeah,that is scary. But a moe possible situationis human engineering these bugs for warfare.
When the small pox strain was taken out of the freezer to be studied again, I was aghast (right after the anthrax scare here .. after 9/11). I thought we eradicated smallpox - but human distrust has meant that we never got rid of it.. Sadly there are super strains of this bug already made :(
Mankind is its own enemy.

Revealed said...

@sakshi: heard about the small pox thing too. till then thought we had destroyed every last one. humans. bah!