” The alarm around this particular strain [A-H1N1] has a couple of roots. First is, it’s new… it’s novel. And new is always cause for some amount of concern. Second, it does appear to have just recently jumped from one species, pigs, to another, humans. And very commonly, in the whole world of viruses – not just influenzas – when they first make the jump from one species to another is when they’re really hot viruses, dangerous viruses. That certainly was the case with SARS, which had just made the jump from bats to civets, civets to humans. So we always worry when we see a recent jump. ”
A quote from Laurie Garrett, during an interview with the Online News Hour (transcript link here) on May 1 2009.
Ms. Garrett, author of The Coming Plague: Newly Emerging Diseases in a World Out of Balance (1994), and The Betrayal of Trust: The Collapse of Global Public Health (2000), is currently a senior fellow for global health at the Council on Foreign Relations.
How A/H1N1 influenza – identified in Mexico in March 2009 – continues to develop in human populations is still uncertain, as the virus spreads to every continent. The good news is that clinicians seem to think it is not as virulent as first feared; the bad news is that over time, the possibility still exists that we are witnessing a phenomena that every epidemiologist dreads in his or her lifetime: the emergence of an uncontainable virus in a human population who have little or no immunity against it.
While many people thought the media hype over this emerging virus was of hysterical proportions, and discounted the severity of the strain, a different way to view these events is as a sort of dress rehearsal which demonstrated that world-wide networks of disease surveillance, data-collection and cooperative intelligence sharing are functioning reasonably well. (But I’m not a virologist so maybe I know no more than the next guy on the street.)
If nothing else, it shows that swarm-intelligence and citizen-journalism is alive and well!
You could say that some of my reactions to public health crises have been shaped in part by having lived in city of San Francisco in the early 1980’s, when a different public health crisis unfolded with the identification of a novel viral infection which came to be known as human immunodeficiency virus. If you haven’t already read And The Band Played On by Randy Shilts, who was a reporter at the time for the San Francisco Chronicle, it is truly worth the time. *
Let’s hear it for more dress rehearsals, and fewer real-life epidemics.
Following are a few books or online resources for background information on epidemiological investigations, medical detective work and emerging infectious diseases, for your consideration:
- “The Threat of Pandemic Influenza: Are We Ready?” A Workshop Summary, 2005 (free online full-text from National Academies Press site – link to PDF here).
- Book: The Great Influenza: The Epic Story of the Deadliest Plague in History by John Barry (Viking, 2004).
- Book: When Germs Travel: Six major epidemics that have invaded America since 1900 and the fears they have unleashed by Howard Markel (Pantheon Books, 2004).
- Book: Microbial Threats to Health: Emergence, Detection and Response by Mark Smolinski, Margaret Hamburg, Joshua Lederberg (National Academies Press, 2003).
- Book: The Molecular Epidemiology of Human Viruses, by Thomas Leitner (Kluwer, 2002).
- Book: The Invisible Enemy: A Nature History of Viruses, by Dorothy Crawford (Oxford University Press, 2000).
- Online Book: Bird Flu: A Virus of Our Own Hatching by Dr. Michael Greger (Human Society Press, 2006). Free fulltext book at this link.
- Book: Man and Microbes: Diseases & Plagues in History and Modern Times, by Arlo Karlen (Putnam Books, 1994).
- Robert Preston is the author of two popular works, The Demon in the Freezer: A True Story (Random House, 2o02) and The Hot Zone: A terrifying true story (Random House, 1995).
- Book: Emerging Viruses in Human Populations by Edward Tabor (Volume 17 of Perspectives in Medical Virology, Elsevier, 2007).
- Book: Seasonal Patterns of Stress, Immune Function, and Disease by Randy Nelson (Cambridge University Press, 2002).
- Book: Human Virology: A Text for Students of Medicine, Dentistry and Microbiology by Leslie Collier (Oxford University Press, 2006).
- A professor of virology from Columbia University blogs at the Virology Blog.
* Randy Shilts, who was a great journalist and a brave activist for gay rights, died of AIDS in 1994 at age 42.