Those words were ringing in my ears when the first reports of the Mexican swine flu outbreak began trickling in few days ago. Dozens of young, otherwise healthy men were dying. Was this an encore of the infamous 1918 pandemic? Another SARS? Patients killed by their own overzealous immune systems (“cytokine storms”)? Or poor patients who came to the hospital too late to be saved? Then came lab reports of an unusually cosmopolitan swine/avian/human virus, with genetic links to two continents. This sort of thing doesn’t just happen. An awful lot of things have to happen first to make it possible.
Since TrackerNews is both an aggregator and a resource (searchable dabase of vetted links), I looked for research that might provide some clues. Fairly quickly, I found two:
- A 2004 article from Porkmagazine: SIV Gets More Complicated (Herd Health), which noted a spike in the number of swine flu strains. There are now so many that a single herd can harbor more than one strain. Instead of a seasonal problem, swine flu has morphed into a year-round plague. Even more vexing, there are too many strains for a single vaccine to cover. “Since 1998, SIV has moved from a single, stable virus to a virus with the ability to reconfigure itself to the point where it may avoid control by existing vaccines.”
- A 2008 article from National Hog Farmer: Researchers Identify New Swine Flu Strain - a strain with a “molecular twist” that merged avian and swine components. Not only did it infect pigs, but mice and ferrets in the lab so was well adapted for mammals. This particular strain, which was found in 2006 in two separate herds that, notably, both drank from ponds frequented by migrating waterfowl, hasn’t been seen again and likely presents little threat to humans. But the point is they saw the mix. It happens. And, given all the range of swine strains—some of which have passed from humans to pigs—the opportunity to hit the pandemic jackpot has been steadily ratcheting up.
The next clue came from a swine flu outbreak timeline compiled by Dr. James Wilson, CTO and Chief Scientist of Veratect, a biosurveillance service:
Veratect reported local health officials declared a health alert due to a respiratory disease outbreak in La Gloria, Perote Municipality, Veracruz State, Mexico. Sources characterized the event as a “strange” outbreak of acute respiratory infection, which led to bronchial pneumonia in some pediatric cases. According to a local resident, symptoms included fever, severe cough, and large amounts of phlegm. Health officials recorded 400 cases that sought medical treatment in the last week in La Gloria, which has a population of 3,000; officials indicated that 60% of the town’s population (approximately 1,800 cases) has been affected. No precise timeframe was provided, but sources reported that a local official had been seeking health assistance for the town since February….
…Residents believed the outbreak had been caused by contamination from pig breeding farms located in the area. They believed that the farms, operated by Granjas Carroll, polluted the atmosphere and local water bodies, which in turn led to the disease outbreak. According to residents, the company denied responsibility for the outbreak and attributed the cases to “flu.” However, a municipal health official stated that preliminary investigations indicated that the disease vector was a type of fly that reproduces in pig waste and that the outbreak was linked to the pig farms. It was unclear whether health officials had identified a suspected pathogen responsible for this outbreak….
Confined Animal Feeding Operations, a.k.a CAFOs, a.k.a factory farms have revolutionized agriculture over the past 20 years. This is agriculture on steroids. Sometimes literally. Poultry, cattle and pigs are raised in such ferocious, relentless quantity, the animals require a battery of drugs and chemicals simply to live long enough to be slaughtered. The waste streams and accompanying stench are a nightmare for anyone and anything down wind or down stream. Stats defy comprehension.
According to a 2006 Rolling Stone‘s Jeff Tietz’ tour de force expose on hog CAFO king, Smithfield Farms (of which Granjas Caroll, the CAFO in Vera Cruz, is a subsidiary):
- “Hogs produce three times more excrement than human beings do. The 500,000 pigs at a single Smithfield subsidiary in Utah generate more fecal matter each year than the 1.5 million inhabitants of Manhattan.” (Granjas Caroll processes nearly a million pigs annually)
- “The immobility, poisonous air and terror of confinement badly damage the pigs’ immune systems. They become susceptible to infection, and in such dense quarters microbes or parasites or fungi, once established in one pig, will rush spritelike through the whole population. Accordingly, factory pigs are infused with a huge range of antibiotics and vaccines, and are doused with insecticides. Without these compounds — oxytetracycline, draxxin, ceftiofur, tiamulin — diseases would likely kill them. Thus factory-farm pigs remain in a state of dying until they’re slaughtered. When a pig nearly ready to be slaughtered grows ill, workers sometimes shoot it up with as many drugs as necessary to get it to the slaughterhouse under its own power. As long as the pig remains ambulatory, it can be legally killed and sold as meat.”
- “Industrial pig waste also contains a host of other toxic substances: ammonia, methane, hydrogen sulfide, carbon monoxide, cyanide, phosphorous, nitrates and heavy metals. In addition, the waste nurses more than 100 microbial pathogens that can cause illness in humans, including salmonella, cryptosporidium, streptocolli and girardia. Each gram of hog shit can contain as much as 100 million fecal coliform bacteria.”
A report from the Pew Commission on Industrial Farm Animal Production goes into more microbiological detail. CAFO’s are a major source for the development of antibiotic resistance and water and air pollution disaster. Pig and poultry CAFOs are cauldrons for dangerous flu strains.
David Kirby’s Huffington Post article, Swine Flu Outbreak — Nature Biting Back at Industrial Animal Production? ties it all in a bow:
… Dr. (Ellen) Silbergeld thinks the genetic swimming pool that is found in modern swine – or poultry – production is probably the place from whence this killer bug evolved.
“CAFOs are not biosecure,” she told me. “They have high rates of ventilation and enormous number of animals that would die of heat stress unless the building was ventilated. We and others have measured bacteria and viruses in the environment around poultry and swine houses. They are carried by flies, too. These places are not bio-secure going in – or going out.”
“These mixing bowls of intensive operations of chickens and pigs are contributing to speeding up viral evolution,” Dr. Silbergeld added. “I think CAFOs are contributing.”
But, what about traditional outdoor farms? Aren’t those animals even more susceptible to wild type viruses than animals kept indoors, as industry claims? “Well, let’s say that animals in confinement are ten times less likely to be infected by wild animals,” she said, “But there are 100 times as many of them. You do the math.”
Only time will tell whether the ongoing swine flu outbreak peters out as a local tragedy or develops into a full-blown global catastrophe. Only diligent epidemiological investigation will prove if there is indeed a CAFO link. But we would be foolish not to see this as a last ditch wake up call for stricter controls over CAFOs. The risks are simply too great, too inevitable.
So, as maps are developed charting the progress of the outbreak, I hope they are layered with the kinds of information that explain not only how this happened, but also to help visualize vulnerabilities.
- CAFO location: Where are they in relation to human cases?
- Hog shipping routes: Contaminated trucks have been implicated in other animal disease incidents
- Data on swine/avian strains documented in pigs – even those that don’t cause clinical illness
- Data on swine flu outbreaks at pig operations: In many areas, including the Vera Cruz region in Mexico, the disease is considered endemic. Were pigs vaccinated? Would the vaccine have protected against this strain?
- Bird migrations, especially of waterfowl
- Human vaccine status: Have cases diagnosed in the U.S. been milder because the patients had been vaccinated while patients in Mexico had not? Although the vaccine targeted different strains, was their any cross protection?
- State of patients at time of first doctor visit: Do poor patients wait longer to seek medical help?
The last point raises some inconvenient truths for public health. Here in the U.S. where over 40 million are uninsured and probably an equal number are under-insured, it is unrealistic to tell people to see a doctor (they may not have one). Likewise, skipping work is a tough choice for families living paycheck to paycheck. According to a new study published by the Kaiser Family Foundation, nearly 60% of Americans delayed or deferred health care over the last year. Prescriptions went unfilled and treatments skipped.
Public health goals and private realities simply aren’t meshing .
Advising residents of Mexico City to keep 6 feet away from one another is equally unrealistic.
For that matter, if flu protection is a national – an international - priority, why not make flu shots free for everyone?
- Swine-flu outbreak linked to Smithfield factory farms (Grist/Tom Philpott)
- Fast Food Nation: The Dark Side of the All-American Meal (Eric Schlosser)
- The Omnivore’s Dilemma (Michael Pollan)