2010. Oldstone, M.B.A. Oxford, 383 pp.
a book review by Wm Olkowski, PhD
Viral information is critical in today’s world of rapid transport. The first epidemic of the 21st century was SARS (Severe Acute Respiratory Syndrome), which originated in south China and jumped to Canada days after the first index case. With SARS we were lucky. But SARS demonstrates how viruses can move rapidly around the globe, threatening people who know virtually nothing about it, where it came from nor what to do about it. This, with the potential to overwhelm all local medical services means potential catastrophe.
Viruses are big killers even if one leaves out HIV/AIDs, the biggest killer in the world today (in the U.S. 40,000 new cases per year, most infected people do not know they are infected). Mandatory assays at ER’s around the country have been denied funding from insurance companies. How short sighted. A public supported health care system would not be so stupid, maybe.
Funny how disease gets a back burner, mostly to military activities, yet causes more harm than all the military destruction combined. And the military gets the bulk of the money. Yet, most people are unaware of how these diseases caused historical changes and raised current costs in pain and suffering as well as financial losses from disabled people and disease treatments. An AIDS case detected early will stand to cost $600,000 over the lifetime remaining only for treatment, no cure (estimate based on $25k/yr for 25 years).
This book can update and educate about the biggest threats to humanity and civilization today, AIDS is covered in detail, including the one time controversy over its causal agent, now widely acknowledged to be a virus that jumped from monkeys to humans. Such threats will remain with an increasing number of viruses as our population continues to push into new undeveloped areas and continues to eat bush meat, for example.
Recent advances in knowledge concerning viruses and past learnings from previous epidemics are covered. But many don’t know that a consensus is developing that viruses are involved with about 20% of cancer cases. Consider that about 25% of the known 600 viruses causing diseases in animals are cancer producers. Makes you think, maybe.
With the current ignorant antivaccine popular push will come some consequences that nobody who is antivaccine is covering. This antivaccine trend seems set up by the rather excessive demands on simultaneous vaccinations of preschool children as a prerequisite for kindergarten. Too many vaccines at the same time maybe a problem but a more serious breakdown between scientists and the public is an even greater threat. Without the science we have only prayer and we all know how well that works. More involvement from the public is needed in scientific programs.
What Causes Disease?
The first part of the book is a brief overview of human history from the standpoint of our beliefs about causation and how science brought clarity and knowledge where god’s vengeance and terror were taught by religious authorities (with threats of death and torture). Going over the steady but significant discoveries in disease causation starting in the late 1800s tells the story of science like no other. There is an inserted 22-page summary of the important events and discoveries starting with Hippocrates in 400 BC going up to the planned eradication of polio by 2015. This table of events presents the details of a worldwide process of medical research and investigation of great importance to humanity and represents some of the fruits of the enlightenment, now being eroded by ignorant religious teachers.
Will rationalism prevail today? I have hopes but knowledge and education is what is needed and has always been needed. But it has always been in limited supply.
Knowledge in Place of Fear?
Who knows? But putting some attention on the facts could help displace fear. Hey there’s a good slogan, Knowledge in Place of Fear. Reading how the world cooperated in four world-wide campaigns mostly based on vaccines has virtually eliminated smallpox, poliomyelitis, measles and yellow fever from the planet. More remains to be done, however. But all these remain in the background ready to flare up again, unfortunately.
The Russian Experience
All of these maladies could be eliminated from the planet if we could agree to do so. But the lessons from our agreement with Russia concerning biowarfare must not be forgotten. Russia said it was reducing its commitments in biowarfare yet was very busy building microbial agents for dissemination via rocket while we were disbanding our biowarfare research units. While we were doing this good thing Russia had weaponized smallpox so cultures were ready to fly with the outbreak of war. Weaponizing means creating high virulence and dispersal capabilities so only one viral colony (or bacterial colony) needs to be delivered to each metropolitan area. I just wondered how really close we came to destroying ourselves.
And we are still tempting the fates, now with rogue nations who are probably developing microbial warfare capabilities with the residue from the now disbanded microbial research units in Russia.
The first part of the book also covers a short intro to virology and immunology. Both are difficult subjects but are presented so someone without special training can follow the ideas.
Part two covers the big four: smallpox, measles, polio, and yellow fever. Measles remains the biggest threat because new cases are introduced into previously vaccinated and protected populations. So without threat of disease vaccination is abandoned. Introducing a new agent into a population without protection can be devastating. Measles is a different most serious disease for an adult. Most people now are protected from previous vaccinations. And these people are now not realizing they should continue getting vaccinated, especially as adult measles can kill and certainly maim.
All the other virus diseases are covered in the next 9 chapters: haemorrhagic fevers, Lassa Fever, Ebola, Hantavirus, SARS, West Nile Virus, HIV/AIDS, Mad Cow, and Influenza. The last chapter talks about the future.
Close, constant and rigorous surveillance will be needed by all the countries of the world. Disease knows no political barriers. Viruses can be expected to jump from animal reservoirs to other wildlife (like West Nile Viruses killing North American birds) and to humans like influenza viruses that go from birds to pigs and to humans. Yellow fever may be reintroduced to North America as measles does now periodically. Climate warming and zone shifting will cause movement of vectors north. Infections, however small, represent emergencies as the faster the response the smaller potential outbreak. China delayed notice about SARS and all the contact cases from the only index case were found quickly and quarantined for treatment in Canada, mostly. That was a close one.
The whole subject of slow viruses, i.e., mad cow, BSE, scrapie, CJD is another frightening threat. Mad cow disease has been found in the US, for example, but only in one cow. But unlike England and Europe we are not testing all beef being reared in the US because of the cost. So just how bad the situation is in the US is unknown as nobody is looking. There is no required surveillance. England, where the most recent outbreaks were discover did the testing and killed thousands of infected cattle with great loss, but they contained the spread in humans.
Also, estimates place a 50-year incubation period on the mad cow infection, believed to be a miss folded infectious protein called a prion. Younger people have been found with the prion but still the beef industry fights back. Their attitude is prevention is too costly, wait for the disease, then sample and treat. I eat grass fed organic beef, just in case. I think it’s a matter of time before mad cow is acknowledged as being here in the US. And since virology is still rather a young science one may expect some surprises yet from this frontier in public health.