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URL: http://www.avianflutalk.com/forum_posts.asp?TID=34564 Printed Date: May 01 2024 at 10:49am
Topic: Global Health ThreatsPosted By: jacksdad
Subject: Global Health Threats
Date Posted: June 27 2015 at 2:38am
Interesting article, if a little optimistic when it comes to an adequate global response to something like a novel influenza virus.
The Good News About Our Battle With Global Heath Threats From MERS, SARS, Ebola And The Flu
http://www.forbes.com/sites/robertpearl/2015/06/25/the-good-news-about-our-battle-with-global-heath-threats-from-mers-sars-ebola-and-the-flu/#comment_reply - Comment Now
In
recent weeks, the threat to South Korea from Middle East Respiratory
Syndrome, better known as MERS, has exploded. Over the last 18 months or
so, Ebola has hit West Africa hard and penetrated the borders of the
United States and Europe. During the previous decade, H1N1 Flu and
Severe Acute Respiratory Syndrome (SARS) infected people around the
globe.
What is going on in the world and what does it bode for the future?
Clearly these infectious diseases are cause for alarm. Each of these
virus-induced illnesses damages the lungs and poses a major health
threat. But interestingly, even those caused by similar viruses vary in
origin, ease of spread and the danger posed to human life.
And unlike the antibiotics available to fight bacterial infections,
we have few medical treatments for viruses. Rather, we depend on our
immune systems to produce antibodies, proteins capable of fighting
diseases like the flu.
Most troubling about the emergence of these viral infections is no
one can predict where and when the next epidemic will hit. All we know
with certainty is that it will occur. If one known virus mutates, or a
new virus emerges, a pandemic could result with devastating
consequences.
The good news is that even though we face a problem of epic
dimensions, we also have powerful new tools to prevent or fight the next
outbreak. Already, advances in our understanding and treatment of these
types of infectious disease have enabled us to limit the spread of
these newer viruses. Medical researchers are figuring out how emerging
diseases like MERS are transmitted. And, as a result, we’re better
prepared for the future than at any time in the past.
Even
so, we’re hardly in the clear. As each new viral disease develops, we
need to rapidly identify the virus, develop an effective vaccine, ensure
that we achieve strict quarantine and gain world-wide collaboration to
contain these dangerous threats to global health.
Let’s look at these viruses to understand their biology and how we might best respond to a new threat in the future.
https://www.flickr.com/photos/dfid/15650293350/in/photolist-pQXQXY-pQTq2G-pCYRsM-pCUpCu-q8hfKa-pCEgPv-qU3kBj-pms8TM-pCWrGt-dVcFac-pu4cpB-q9dmhB-q6bRs1-pbJCnW-q6qnjj-pQTLS9-q8pUhh-rMR6f3-rph1tR-pRbrUs-pSaMep - Photo by https://www.flickr.com/photos/dfid/ - Simon Davis, DFID / https://creativecommons.org/licenses/by/2.0/ - CC BY-2.0
The Virus Briefly Explained
A virus is a tiny infectious agent, too small to see through a
traditional light microscope. They can replicate only inside the living
cells of other organisms such as humans, birds, and pigs. Viruses
contain small amounts of DNA or RNA in a thin protein and lipid shell.
Because of their simple form, they’re unable to survive outside of
animal or plant hosts, but can change quickly and go from innocent to
lethal.
Some viruses are easily transmitted from person to person, but others
are not. Transmission can occur through a variety of body fluids,
including sputum, blood, genital secretions, or fecal material. Of
course, when a virus is easily passed between people, the risk of spread
across borders increases, and the threat of a pandemic grows.
Why MERS Is Distinctive
Although the current outbreak in South Korea has infected more than
100 patients and led to a handful of deaths, MERS appears relatively
difficult to transmit. It requires both close physical contact and an
underlying medical vulnerability. To date, almost all victims have been
elderly patients in hospitals. The likelihood of healthy, young people
developing it appears low. To date, only one child has been infected.
But were it more contagious, containing the spread would have been
far more difficult. In spite of quarantine, one infected individual from
Korea was able to get on an airplane, fly to Hong Kong and take a bus
to China, where he ultimately was hospitalized. Fortunately, it does not
seem he infected anyone along the way.
We know that the first individual diagnosed with MERS during the
current breakout had visited Saudi Arabia. No surprise there; most
outbreaks have occurred in Middle Eastern countries. MERS was first
reported in 2012 in Jordan – hence the “Middle East” in its name –
according to the http://www.cdc.gov/coronavirus/mers/about/index.html - Centers for Disease Control and Prevention (CDC). And similarly, the two patients identified in the United States also were returning from Saudi Arabia.
MERS is caused by a coronavirus, but genetically distinct from other
human diseases caused by that particular family of viruses. Like many
viral illnesses, it began as an animal virus, in this case one common in
camels. And similar to many viral diseases, MERS-related symptoms
usually consist of fever, cough and shortness of breath.
Still, once a patient is infected, the chances of dying are high. No specific treatment is currently available.
The Subtext On Ebola
Ebola dominated the headlines a year ago, as it decimated villages in
Africa and infected people in the United States. The virus that causes
the disease is an equal-opportunity killer, affecting healthy people as
often as it does those with chronic disease. The fatality rate varies by
geography, but in most cases exceeds 50%. The first symptoms are fever,
muscle pain and sore throat, frequently followed by nausea, vomiting,
and diarrhea. Some individuals will also develop internal and external
bleeding, often through the gums or the intestines.
The best defense is good infection control practices and avoiding
contact with infected blood and body fluids. Quarantine to minimize
human-to-human spread is essential. Because transmission doesn’t happen
until a patient becomes sick and feverish, limiting exposure is easier
than with the other viral diseases. All staff caring for infected
patients should wear protective coverings and respiratory devices. A few
experimental medications are being studied to determine effectiveness.
Researchers believe this virus began with wild animals and spread to
humans. The current Ebola virus can be traced back to the first
outbreak, in 1976, near the Ebola River in the Democratic Republic of
Congo, from which the disease gets its name. Scientists know Ebola
persists in fruit bats and infects people through contact with the blood
of ill or dead animals, including chimpanzees, antelope or the bats
themselves. Transmission from animals to humans happens only by direct
contact through broken skin or mucous membranes. Human-to-human
transmission can occur through direct exposure to the bodies of Ebola
victims during burial practices, and contributed to the recent spread
through the West African countries of Liberia, Guinea, and Sierra Leone.
But much of the spread can also be traced to travelers carrying the
virus, crossing borders into adjacent nations and infecting others.
The SARS Conundrum
SARS filled headlines a decade ago, but has gone quiet since then.
But before SARS was ultimately controlled through quarantine in 2003, it
infected 8,000 people and killed nearly 10 % of those affected. First
reported in Asia in 2002, it spread through travelers to other
countries.
SARS starts with fever and cough, then progresses to pneumonia, often
with a high fever and severe body aches. It, too, is a coronavirus, but
unlike MERS, no major underlying illness is needed to catch it. Close
person-to-person contact, via coughing or sneezing – usually within
three feet of another individual – is sufficient for transmission. It
can also be conveyed when a healthy person touches a surface or object
contaminated with mucus and then touches his own mouth, nose or eye with
his hand.
The mainstay of treatment is supportive care, often in an intensive
care unit, until the patient’s immune system has had enough time to
respond. No specific medication is currently available.
Influenza: A Cautionary Tale
Influenza – or more commonly “the flu” – infects people around the
globe each year, and on occasion has erupted into an epidemic, killing
millions. Effective vaccines have recently reduced the dangers from
influenza, but history offers a harrowing warning about the prospects of
recurrence.
In 1918, a new strain arose, infecting one-fifth of the world’s
population and killing an estimated 50 million people. The first wave,
referred to as the “three-day fever,” was relatively benign. But when it
returned six months later, it was lethal. People died hours or days
after the first symptoms appeared. Those most affected were young and
healthy.
How do we explain this epidemic? We now understand that the influenza
virus is “sloppy” – it replicates and creates frequent new mutations.
Most of these changes are minor and the severity of disease and spread
are limited.
But big changes in the viral genome can bring about pandemics like
the one that struck in 1918. And the more the genetic material mutates,
the greater the risk for everyone. Under such circumstances, even now,
we would have no way to prevent a pandemic.
Next Steps For The Next Generation Of Viruses
Why is all this happening? The increase in international travel in
recent decades has dramatically shrunk the time a virus takes to spread
from here to there around the globe. And, in the process, drastically
elevates the risk of infection spreading from the first victim to
unsuspecting strangers thousands of miles away.
Case in point: the virus in the 1918 influenza pandemic took months to span the world. The 2009-2010 pandemic needed just days.
Even in light of such realities, hopes today run high. Scientists can
now identify new viruses quickly. It took four years to identify the
virus that causes HIV/AIDS, but only a few weeks to identify the ones
that led to SARS and MERS. Through public health advances, we have
learned how techniques such as quarantine, masks, protective clothing
and hand washing can limit the spread of new viral illnesses.
We now have effective vaccines against some of these viruses. We have
new tests to rapidly diagnose many diseases when they occur. And in
laboratories around the globe, researchers are developing potential
vaccines and treatments for diseases like Ebola. In addition, physicians
now can prescribe the latest antiviral medications to lessen the
symptoms of milder forms of disease.
In the future, we will need worldwide collaboration on programs to
identify new outbreaks immediately and thereby limit transmission. We
will need governments and research institutes to invest in developing
effective, low-cost and easily administered immunizations and antiviral
treatments. And when we have effective vaccines, everyone will need to
be vaccinated.
At one time, protecting
the public’s health was considered a local community responsibility. But
in this new world that’s no longer so. With people and goods now moving
so freely across borders, we are all now citizens of a global
community. We must now undertake a collaborative world-wide enterprise.
Nothing less will do.
Dr. Robert
Pearl is the CEO of The Permanente Medical Group, a certified plastic
and reconstructive surgeon, and Stanford University professor. Follow
him on Twitter: https://twitter.com/robertpearlmd - @RobertPearlMD .
------------- "Buy it cheap. Stack it deep" "Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary.
Replies: Posted By: Jen147
Date Posted: July 01 2015 at 12:41pm
Really good read!
Man I like that guys helmet.
Posted By: jacksdad
Date Posted: July 01 2015 at 3:17pm
I spotted that too, Jen. It is pretty cool
------------- "Buy it cheap. Stack it deep" "Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary.
Posted By: Jen147
Date Posted: July 01 2015 at 4:14pm
The other guy has helmet envy.
Posted By: jacksdad
Date Posted: July 01 2015 at 8:50pm
------------- "Buy it cheap. Stack it deep" "Any community that fails to prepare, with the expectation that the federal government will come to the rescue, will be tragically wrong." Michael Leavitt, HHS Secretary.
Posted By: onefluover
Date Posted: July 01 2015 at 10:20pm