The plague is an old microbial foe that has haunted our cities and our ports for millennia, killing millions of people in waves of pandemics since antiquity. But Yersinia pestis no longer has the same presence, or stranglehold, in our society and seems negligible when we consider the current state of microbial affairs – increasing levels of antibiotic resistance and novel and emerging viral pathogens, just to name a couple of today’s most pressing issues. Even its moniker, “the plague,” has been appropriated for more contemporary microorganisms that appear to come from nowhere and quickly, fatally sweep through a population – SARS and HIV are prime examples of two new “plagues.”
Vaccines were once thought of as an axiomatic good, a longed-for salvation in the form of a syringe, banishing crippling and deadly infections like polio, smallpox and tetanus. But within the past few decades we have seen the emergence of anti-vaccination movements and a rise in cases of childhood diseases that are entirely preventable with a quick jab to the arm.
The Democratic Republic of Congo is home to one of the largest and most biologically diverse rain forests in the world, featuring an incredible variety of animals including bonobos, forest elephants, and mountain gorillas. The country is also the stomping ground of a staggering array of microbial organisms and the region is well known as a wellspring of novel human pathogens, some with big household names and others little known. Some of these diseases, such as HIV/AIDS, have emerged as recognizably major pandemics; others, such as Ebola virus, have been limited to small, localized outbreaks; others still, such as the mosquito-borne Chikungunya virus, pose the risk of becoming new threats to global health.
Rabies is one of mankind’s long-feared diseases. And rightfully so: for centuries, a bite from a crazed, slavering animal was almost always a guarantee of a slow warping of the mind and a pained, gruesome demise. A death sentence.
This past May I had the pleasure to chat with Desiree Schell of the radio and podcast show Skeptically Speaking about how infectious diseases and parasites can shape society for an episode examining the impact of science and medicine on specific communities. Over at their website, you can download the hour-long episode “Community Specific Science” featuring myself, Danielle Lee and Dr. Joe Henrich and hear more about how science journalism and the social sciences are investigating the ways in which the livelihoods and health of certain groups - delineated by ethnicity, culture or religion - are affected by scientific research and medicine. Lee speaks for the first third of the episode on the state of science coverage in media that serves minority audiences, while Henrich finishes the show with his research on cultural outliers, those societies not generally considered Western, Educated, Industrialized, Rich, or Democratic – what Dr. Henrich refers to as WEIRD – and the state of behavioral research.
Today in The New York Times coverage of a report published yesterday on a Saudi hospital-borne outbreak of Middle East respiratory syndrome released by The New England Journal of Medicine, a potential epidemiological phenomenon was briefly addressed: men have made up the majority of infected cases and the low rates of infection among women may be due to an emphasis on the wearing of the face veil, known as the “niqab,” in Arab culture.
Spears. Bows and arrows. Swords. Guns. Bombs. Drones. Microbes. The evolution of weapons and forms of warfare shadows our technological advancements, from the field of metallurgy to that of microbiology.
Parasites and viruses once thought to make their homes exclusively in exotic locales beyond America’s borders are now gaining a foothold in the country and they are exacting significant economic tolls and placing heavy burdens on health care systems. Neglected tropical diseases such as cysticercosis, echinococcus, toxocariasis, dengue, West Nile virus and Chagas have found their way into the country due to a synergistic combination of factors, including globalization, migration, trade and climate change.
A recently published paper in Scientific Reports has found that climate variability in the form of the North Atlantic Oscillation (NAO) has had a significant impact on the occurrence of disease outbreaks in Europe over the past fifty years. Researchers in France and the United Kingdom studied 2,058 outbreaks occurring in 36 countries from 114 infectious diseases from 1950 to 2009 and found that climatic variations and seasonal changes in air pressure across the continent attributed to the NAO influenced the outbreak occurrences of eleven diseases. Every conceivable route of transmission – by air, food, water and vector – was influenced by NAO conditions.
One of the hardest questions to answer in an infectious disease outbreak investigation is “Why?”
Why then? Why there? These questions can be almost impossible to answer – not only because of their heady metaphysical nature but also because of the difficulty of assessing the minute interactions between microbe, environment and human host. Public health officials are often left shrugging their shoulders, half-heartedly admitting to an unsatisfied public that they just don’t know and indeed may never know, later drowning their sorrows in dark and smoky bars with cup after cup of the metabolic waste products of unicellular fungi.