The other day my friend Adam, a fellow BusinessWeek alum, posted a question on Facebook about whether a bout of Ebola conferred immunity on survivors. In other words, if it didn’t kill them, did it make them stronger, more resistant? The short answer is yes, but just like cold and flu viruses, there are several strains and immunity to one does not readily translate to others. In fact, it turns out that Ebola’s deadly trick involves disabling a key component of a victim’s immune system. The survivors are the ones who somehow manage to hang on long enough to mount a workaround defense that itself doesn’t prove fatal.
My big splash at the magazine was a special report (“Bioinvasion”) on emerging zoonotic diseases, which are illnesses that affect several species, humans among them. Not only are the majority of diseases zoonotic, but also almost all the headline plagues to emerge in the last few decades, including Ebola, are as well. The article received a lot of attention at the time, including receiving an award from the American Society for Microbiology, which led to an address book full of “-ologists” of every description. My favorites were—and are—veterinary epidemiologists who always seem to be at least a half step ahead of anyone in public health.
Tracey McNamara was head of pathology for the Bronx Zoo during the early days of the first West Nile outbreak. She boldly challenged the CDC’s initial diagnosis of another virus by making the link to dead crows (her necropsy freezer was full of birds that had perished on zoo grounds). "If you wait for the first human index case, you’re too late," she told me during an interview. Those words stuck with me, yet over and over and over again, divisions between public health, livestock health and wildlife health agencies make it difficult to get ahead of the curve.
The first human case in the West African Ebola epidemic was traced to a young child in Guinea where, it turns out, roasted bat and bat soup are menu staples. That is significant because migrating fruit bats turn out to be the key reservoir hosts: species that carry and can transmit the virus but aren’t devastated by it. Health officials suspected a link early on and put a ban on bat dining in March, yet in the chaos that has unfolded, food shortages could make that a challenge to enforce. In any case, it still doesn’t address why, after presumably centuries of bat cuisine, it is now such a dangerous choice. Earlier the investigation another all too plausible explanation was put forth: the exotic animal and bush meat trade literally smuggled the virus into West Africa. The answer might yet turn out to be a combination of both where a disease-carrying animal shipped into the area managed to infect some bats and it was off to the viral races.
Ebola is not the only bat-transmitted scourge to make headlines in recent years. Nipah, Marburg and Hendra viruses all have a bat connection as, of course, does rabies. Curiously, one the most promising Ebola vaccines is based on one for rabies and provides protection against both.
These are viruses that long been circulating in bats and to which humans have largely been blissfully oblivious. So what has changed? It is going to come down to habitat loss,climate change, increased trade and faster travel, none of which are easily addressed by public health efforts. There is no end in sight for the crisis in West Africa and a real threat to the rest of the world. When a deadly virus can travel first at the speed of a migrating bat and then by plane, train and automobile, no place and no one is truly safe.
Every few years, generally in the immediate aftermath of a new or particularly deadly zoonotic disease, the push is on for a “one health” approach to medicine that connects the dots between human and animal health. It never seems to last very long. The wildlife surveillance component is usually the first to fall from lack of funding, while monitoring livestock and poultry becomes mired in the politics of regulation. Public health infrastructures in places such as Guinea, Liberia and Sierra Leone that have been wracked by decades of war and poverty have never been high priority. By the time the World Health Organization is brought into the picture, the virus has a substantial head start.
Data science can help. Healthmap, a very clever and comprehensive data aggregator, pointed to the possibility of a hemorrhagic fever cluster over a week before the WHO declared an Ebola outbreak. Likewise, cell phone data can be used to map possible routes of spread, potentially in real time, though the balance between potential threat and privacy concerns have yet to be thrashed out. Still, almost all the data feeds are focused on human actions. Until there is a better handle on wildlife health, the response is still going to be about playing catch up.
There is a real opportunity for citizen science to fill in some the blanks, providing field reports of sick and dead wildlife and ailing livestock and pets. It wouldn’t be that hard to set up. It could follow the template—or perhaps become part the database—of Project Noah, a brilliant, massive crowdsourced web-based wildlife field guide.
Beyond our narrow species-specific enlightened self interest, this is yet another wake up call on the importance of doing right by the environment. Deforestation, chemical contamination, carbon pollution—there is a perfect storm besetting our planet, threatening everything that calls it home.
— J. A. Ginsburg
Dot to Dot grew out of the TrackerNews Project, a demo news aggregator developed for InSTEDD, an independent spin-off of Google.org's humanitarian practice that focused on health issues, humanitarian response and technology.
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