Wednesday, February 04, 2009

Pandemic, Drug Resistance and Natural Selection

Massive overuse of antibiotics, overcrowded mega-slums, increasing hunger and global travel are the necessary "initial state" conditions for global pandemic.

Correspondent Albert T. recently called my attention to several news stories which support the sobering conclusion that conditions are, if not perfect, then certainly ripe, for a global pandemic of the sort which depopulated Europe in the 14th century.

Here are the necessary "initial states" for any pandemic to become virulent and deadly:

1. the bug (virus, bacteria or parasite) must be resistant to all widely available drug-based countermeasures/pharmaceutical cures
2. it must spread easily via contaminated water, surfaces or air (be contagious) much like rhinoviruses (colds and flu)
3. it has to not kill its host until the host has had time to spread it to others
4. the host populations (domesticated birds and humanity) must be packed together in dense groups
5. the host populations (wild birds and humanity) must be mobile so existing trade and traffic will provide vectors for the disease to spread quickly
6. public health officials and governments must be unable to effectively quarantine those initially infected

Strangely, all talk of a bird-flu pandemic has ceased. It seems that because no such contagious mutation has appeared yet, concern has dropped to near-zero. But the very size of the human population--stupendous, at 6.5 billion individuals and rising--and the constant passing of microbes between domesticated birds, their wild brethren and human handlers provide nearly ideal conditions for the eventual emergence of a bird-flu variation which acquires virulence and contagion.

Due to overuse, incomplete treatment protocols and situations like the story below, the arsenal of pharmaceutical countermeasures/cures humanity has to deploy against viruses and super-bacteria (resistant to most antibiotics) is shrinking to near-zero.

Here are the stories, and Albert's comments:

World's highest drug levels entering India stream
PATANCHERU, India – When researchers analyzed vials of treated wastewater taken from a plant where about 90 Indian drug factories dump their residues, they were shocked. Enough of a single, powerful antibiotic was being spewed into one stream each day to treat every person in a city of 90,000.

Last year, The Associated Press reported that trace concentrations of pharmaceuticals had been found in drinking water provided to at least 46 million Americans. But the wastewater downstream from the Indian plants contained 150 times the highest levels detected in the U.S."

Albert's comment: It does seem like we humans are in a race for natural selection, and since it's too slow we try to hurry it along by exposing ourselves to toxic chemicals here and there. This almost begins to sound like a comic book where a hero was exposed to toxic slime to get super powers although I doubt it would be as positive in real life.

"We don't have any other source, so we're drinking it," said R. Durgamma, a mother of four, sitting on the steps of her crude mud home in a bright flowered sari a few miles downstream from the treatment plant. High drug concentrations were recently found in her well water. "When the local leaders come, we offer them water and they won't take it."
Pharmaceutical contamination is an emerging concern worldwide.

Plague Reappearance in Algeria after 50 Years (
Deadliest weapon so far... the plague (The Sun)
Anti-terror bosses last night hailed their latest ally in the war on terror — the BLACK DEATH. "At least 40 al-Qaeda fanatics died horribly after being struck down with the disease that devastated Europe in the Middle Ages. The killer bug, also known as the plague, swept through insurgents training at a forest camp in Algeria, North Africa. It came to light when security forces found a body by a roadside."

Albert's comments:
This is very upsetting. My firm belief is that this time around the only way we come out of the depression is through a cataclysmic event, ergo plague or something close. We haven't had one in a while. The concentration of humans on the planet is really a bit high so we are due for a wave of mother nature doing a selection number on us. The most likely outbreak is probably a strong strain of a flu pandemic not receptive to drug treatment.

Thank you, Albert, for this report. History is certainly replete with examples in which the stresses of deteriorating finances, warfare and drought lead to famine/hunger which then weakens the populace to the point it is susceptible to new diseases or new mutations of old diseases.

Indeed, many scholars point to the plague as the key nail in the coffin of the Roman Empire. Even without plague, the depletion of soils and the rural populace via high taxation and forced recruitment created a rural labor shortage in the Western Empire; once the food surpluses from North Africa ceased to arrive, then Rome was depopulated in a mere generation.

Scientists have decoded the genetic structure of the deadly 1918 virus: Why Revive a Deadly Flu Virus? (New York Times)
Among the chain of some 4,000 amino acids that made up (the 1981 virus') proteins, only 25 or 30 distinguished it from a common, nonvirulent avian flu. Rather than originating from a reassortment of genes from both an avian and mammalian source, like the viruses that caused the later pandemics, the 1918 flu most likely began as a bird-adapted strain that, with just a handful of mutations, made itself at home in human beings.

To flu researchers and public-health officials, the resemblance of the 1918 sequence to those of common avian flus underscores the stark fact that there is more than one way for a virulent strain like H5N1 to make the jump and become transmissible person to person.

He had conducted experiments showing that mice were protected from the virus by the current human flu vaccine and by Tamiflu, the antiviral drug. In any case, because a virus descended from the 1918 one has been circulating in the population since 1977, Tumpey is confident that everyone carries at least partial immunity to the 1918 virus itself.

Earlier this month (January 2006, the date of this article's publication), the H5N1 virus recorded an extraordinary rash of cases, including four fatalities in Turkey, the first outside East Asia. All the victims appear to have caught the virus from eating or handling infected poultry.

But most flu researchers worry that as the virus's range increases, so does the likelihood that somewhere, sometime, some random set of mutations will send it over the edge into transmissibility, unleashing a pandemic.

Everyone agrees that at some point, another pandemic will come - if not from this strain, then from some other one perhaps not even yet under surveillance."

If all of that isn't sobering enough, please read Planet of Slums by Mike Davis, which reports on the staggering overcrowding of the many mega-slums which hold much of the current human population.

The idea that public health authorities could rein in a virulent bug via quarantine in "cities" where millions of people are crowded into shanties is absurd.

The Great Wave: Price Revolutions and the Rhythm of History by David Hackett Fischer shows how the rising prices and poor weather of the late 13th century created ideal conditions for the Plague to sweep through a stressed Europe. He also suggests that famine and pandemic contributed mightily to China's decline in the 16th century.

Last but not least, there's The Blue Death: Disease, Disaster, and the Water We Drink .
We may yet look back on the days of mere financial duress as "the good old days."

What's for dinner at your house? has been updated with two new recipes: Quick Easy Vegetable Soup and Pork Butt Stew.

New Operation SERF Installment:
Operation SERF, Part 9
Chris Sullins' "Strategic Action Thriller" is fiction, and on occasion contains graphic combat scenes.

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Thank you, Morris P. ($25) for your much-appreciated generous donation to this site. I am greatly honored by your support and readership.

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