Friday, 29 August 2014

Ebola set to worsen, author says difficult to contain


Humans are strange animals. When it comes to mass-infections we’ll throw our hands up in panic if the sickness is sudden, unpredictable and mysterious. Much of the time that pandemic passes, although its speed and ferocity can be frightening.

On the other hand, if the infection is HIV or Lyme disease, plenty of people end up dead, but the timescale is extended and the deaths are withering, not sudden. The initial panic quickly subsides but these epidemics can be far more widespread and murderous.

Our reaction to speed is expected considering our evolutionary history. For almost all of our species’ existence, humans needed to respond accurately to threats on very short timescales. It was that or we turn into worm food.

Take Ebola for instance, because it’s in the news cycle. The virus doesn’t necessarily act as rapidly as other viruses but it moves super fast through the body and according to current statistics kills well over 60% of infected people. This mortality rate is extremely high among the flora of animal infections.

Shortly after the latest outbreak of Ebola in Western Africa a colleague suggested I read Spillover by David Quammen to better understand animal transitions of viruses, bacteria, microbes or parasites onto human populations. These infections are affectionately called “zoonoses”.

Considering how dry microbiology and virology can be (I remember going through the basics at school…yawn), this book is both informative and bizarrely entertaining. Mr Quammen, a science writer, adds only a dash of important medical and scientific terms to his narrative. He has to, because it’s important to know about an R0 (pronounced “R naught”), reservoir, hosts, incubation, BSL, vectors, and iatrogenic infections.

Sounds tough, I know, but the book has a wonderful narrative flow. The author really threw himself into the task by travelling to every hotspot harbouring the worst zoonoses.

Mr Quammen tramped the jungles of Central Africa, stalked the temples of Asia and the wandered the suburbs of middle America looking for signs of infection. He writes about them as if he’s living a mystery novel.

Ebola, for instance, is a cryptic beast because no one knows how it gets around. It just appears out of the bush one day, infects more than 2,600 individuals (killing 1,400 so far in 2014) before disappearing back into the wild like a ghost. Mr Quammen characterises dozens of other deadly infections like Hendra, Marburg, SARS, avian influenza, and AIDS all while looking for signs of the NBO or ‘Next Big One’.

This is the infection, which, according to worried scientists, threatens to marry in an unholy union the worse characteristics of its parent infection, with new traits our medicines can’t yet treat. Thriller movies have been made about this event, and the World Health Organisation knows how unprepared we all are for the expected pandemic.

The worst part about the book is how shockingly ignorant science is about where many infections come from, how they work and how best to fight them. Mostly the solution a tenuous series of treatments before simply letting the infection die through its inability to spread outside the quarantine zone.

What’s happening now with Ebola is simply a microcosm of the coming NBO. Not only does no one know where Ebola comes from, there’s no effective treatment for the virus if it isn’t noticed early. And even if it is caught early, there’s only a small chance of survival.

Mr Quammen’s advice for treating Ebola victims is hauntingly frank.

“If your husband catches an ebolavirus, give him food and water and love and maybe prayers but keep your distance, wait patiently, hope for the best - and, if he dies, don’t clean out his bowls by hand. Better to step back, blow a kiss, and burn the hut.”

Again, this is seriously our only real response to bad viruses, and we know a damn sight more about this virus than the approaching Next Big One.

This intense book is difficult to put down for its high readability. Then again, learning about how quickly small life forms might crush human civilisation made me wish for a happier ending. Unfortunately, there might not be one.

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