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Thursday, 29 March 2012

Contagion

Yesterday I boarded a plane to Hong Kong along with my lovely family. A long journey to say the least - 11 hours (not helped by an hour delay at Heathrow!) Scouring through the BA inflight entertainment, I have to say, only one movie really appealed to me - Contagion.

Without spoiling the plot (although to be honest, the film was so bad I strongly advise you don't see it), Contagion concerns a deadly pandemic of the fictional disease Meningoencephalitis Virus One (MEV-1). MEV-1 is a retrovirus that infects both the lungs and the brain,  causing severe cough, fever and headache, before culminating in seizure, brain haemorrhage and death. By the end of the film, 26 million people in the world die and it seems everywhere there is chaos and suffering. For those of you keen to see what I'm talking about, the trailer can be found here. Now, as I said, the film was beyond dreadful - horrific, I could have probably have done a better acting job (that's saying something!) However, the film first captured my attention because it concerns the outbreak of a deadly, global pandemic. This is an issue that really fascinates me.

The world has experienced its fair share of epidemics and pandemics. We've had the Black Death, Spanish Flu, Smallpox, Malaria and more recently SARS, MRSA, Bird Flu, Swine Flu and of course, HIV and AIDS. The topic of end-of-the-world situations has always fascinated me for some reason, and simulating such an event through a sudden outbreak of disease is something I take an even greater interest in. The aim of this particular blog entry is to assess (albeit with very limited knowledge) what we can expect to see pandemic-wise in the future.

Bird Flu, or H5N1, sent the world into shock in 2004, killing around 60% of the people it infected, which was only 565 people with 331 known deaths. There was great danger especially in China and Asia. However, despite the initial large shock, H5N1 died down because not that many actually caught the disease. A 60% mortality rate is high, but what stopped H5N1 from becoming a Contagion-esque pandemic was the virus' inability to effectively spread between humans. This all changed, however, when in September last year, scientists in America introduced 5 gene mutations to the H5N1 virus genome. These mutations enabled the virus to spread a lot more effectively between ferrets in a lab, yet the virus was still just as deadly. If H5N1 were to mutate in this way, the world would definitely have a serious problem on its hand. There is even a big dispute Stateside at the moment regarding as to whether it would be safe to publish a scientific report on these findings - bioterrorists could easily access the information and use it to their advantage. David Nabarro, UN coordinator for avian and human influenza, predicted Bird Flu could kill up to 150 million people around the globe. That, folks, would be a big problem indeed.

MRSA stands for Methicillin-Resistant Staphylococcus Aureus; it is a selection of strains from the bacterium species Staphylococcus Aureus. A decent proportion of us find S.Aureus on our skin and in our nasal passages - it is generally harmless. However, once it gets under our skin (through open wounds for example), S.Aureus can be a real pain. It can cause conditions from pimples, impetigo (skin condition) and boils to life-threatening conditions such as pneumonia, meningitis, septicaemia and toxic shock syndrome. My late grandmother suffered from MRSA - it was particularly unpleasant. MRSA and more 'normal' strands of S.Aureus do not tend to differ in how aggressive they each are, they differ in how they can be treated. Simply put, MRSA are strands of S.Aureus that have survived antibiotic treatment (somebody forgot to finish their course..) and through a few natural genetic mutations. They have evolved (natural selection etc.) to become resistant to that particular antibiotic. Over time, hospitals have resorted to using a range of antibiotics to treat MRSA, and over time MRSA had indeed become resistant to this variety of antibiotics too. Thus MRSA appears, theoretically, to be unstoppable over time - it will always win. Maybe so, maybe not. Maybe other bacteria will become antibiotic-resistant too? Multidrug-Resistant Tuberculosis and then Extensively Drug-Resistant Tuberculosis have already been identified. What's next? We'll have to wait and see.

My final scenario revolves around a disease like Smallpox. Smallpox was the first ever disease to be eradicated from the world in 1977 through a lengthy, but effective, vaccination campaign. Smallpox was both extremely deadly (mortality rate of 62%) and could easily spread - in the 20th century alone, it was estimated there were between 300 and 500 million deaths worldwide. Two phials of Smallpox were kept safely stored in US and Russian laboratories, however there are (and always will be) conspiracy theories that the phials were removed for whatever reason (robbery, experiments etc.) and thus there is a definite chance that Smallpox could once again invade the planet. The incubation period (time elapsed between primary infection and appearance of symptoms) is 12 to 24 days. This long period of time would allow infected individuals to spread the virus all over the world (particularly through the recent boom in aviation travel) before any symptoms were detected. Besides, we eradicated Smallpox years ago - how many people are actively looking for symptoms and incidences? Since the virus was completely eliminated back in 1977, no one was vaccinated for it afterwards, as there was no need - people born within the last 35 years would be very vulnerable to it. Governments do stockpile vaccines but they would have to act extraordinarily quickly to prevent significant fatalities. This could very well become a Contagion-esque situation, although fortunately we do know how to treat Smallpox. There's no doubt in my mind, however, that Smallpox would absolutely storm the planet if let loose.

Am I scaremongering? Any other pandemics you reckon could erupt? Let me know!
AJ


2 comments:

  1. I enjoyed Contagion, also because I'm a med-nerd and it's just a hectic concept. You should read "The Way We Fall" by Megan Crewe - it's excellent and pulls the whole thing off way better than Contagion does.
    Enjoy Hong Kong, by the way!

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  2. Ahhh I really like the concept of Contagion, just didn't think the film really tied it together nicely. That sounds like a good read then, I shall investigate! Thanks! And it was brilliant thank you, just on the way home now sadly.

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