With the Ebola virus in the news recently, you may be wondering what actions you can take to reduce the risk of contracting and spreading the deadly disease. Expert Peter C. Doherty provides valuable pointers on the best ways to stay safe and healthy in this excerpt from Pandemics: What Everyone Needs to Know answering: Is there anything that I can do personally to limit the possibility of a dangerous pandemic?
While pandemics are by their nature unpredictable, there are some things worth considering when it comes to the issue of personal safety and responsibility. The first point is to be a safe international traveler so that you don’t bring some nasty infection home with you. Protect yourself and you protect others. Though taking the available vaccines won’t prevent infection with some novel pathogen, it will contribute toward ensuring that you enjoy a successful vacation or business trip, and it should also put you in a “think bugs” mind-set. If, for instance, you are off to Africa for a wildlife safari, make an appointment at a travel clinic (or with your primary care physician) two to three months ahead of time to check your vaccine status and, if needed, receive booster shots to ensure that your antibody levels are high. Anyone who is visiting a developing country should make sure that he or she has indeed received the standard immunizations of childhood. Adolescents and young adults are much more likely to suffer severe consequences if, for instance, they contract commonplace infections like measles or mumps that have, because of herd immunity, become so unusual in Western countries that a minority of parents reject the collective responsibility of vaccinating their kids. If you’re younger and your parents are (or were) into alternative lifestyles, it may be wise to ask them very directly about your personal immunization history.
It’s also likely that, even if you were vaccinated early on, your level of immunity will have declined greatly and you will benefit from further challenge. Both possibilities will be covered if you go to a comprehensive travel clinic, as the doctors and nurses there will insist that you receive these shots (or a booster) if you don’t have a documented recent history. Any vaccination schedule should ideally be completed at least 3 to 4 weeks ahead of boarding your flight, the time needed for the full development of immunity. But this is one situation where “better late than never” applies. Should it have slipped your mind until the last minute, you should be vaccinated nevertheless. Even if you’ve never had that particular vaccine before, some level of protection could be there within 5 to 10 days, and a boosted, existing response will cut in more quickly. A travel clinic will also sell you a Gastro (gastroenteritis, not gastronomy) kit containing antibiotics to counter traveler’s diarrhea (generally a result of low-grade E. coli infection), something to decrease intestinal/gastric motility (Imodium), and sachets of salts to restore an appropriate fluid balance.
For the elderly, be aware of the decline in immunity that happens with age. You may not respond to vaccines as well as those who are younger, and you will be at greater risk from any novel infection. Depending on your proposed itinerary, it may also be essential to take anti-malarial drugs, which generally have to be started well ahead of arrival. Malaria is not the only mosquito-borne threat in tropical countries, so carry a good supply of insect repellant. In general, think about when and where you travel. Avoiding the hot, wet season in the tropics may be a good idea, both from the aspect that too much rain can limit access to interesting sites and because more standing water means more mosquitoes. Wearing long trousers, long-sleeved shirts, and shoes and socks helps to protect against being bitten (both by insects and by snakes), while also minimizing skin damage due to higher UV levels. Then, before you make your plans and again prior to embarking, check the relevant websites at the CDC, the WHO, and your own Department of Foreign Affairs (Department of State in the United States) for travel alerts. Especially if they’re off to Asia, many of my medical infectious disease colleagues travel with one or other of the antiviral drugs (Relenza and Tamiflu) that work against all known influenza strains. These require a prescription, but they’re worth having at home anyway in case there is a flu pandemic. If that happens, the word will be out that influenza is raging and stocks in the pharmacies and drugstores will disappear very quickly. But don’t rely on self-diagnosis if you took your Tamiflu with you to some exotic place; see a doctor. What you may think is flu could be malaria.
For those who may be sexually active with a previously unknown partner, carry prophylactics (condoms) and behave as responsibly as possible. Excess alcohol intake increases the likelihood that we will do something stupid. Dirty needles must be avoided, but don’t inject drugs under any circumstances. Blood-borne infections with persistently circulating viruses (HIV and hepatitis B and C) are major risks, while insect-transmitted pathogens (dengue, Chikungunya, Japanese B encephalitis) can also be in the human circulation for 5–10 days. Apart from that, being caught with illegal drugs can land you in terrible trouble, particularly in some Southeast Asian nations. No matter what passport you carry, you are subject to the laws of the country. Be aware that rabies may be endemic and that animal bites in general can be dangerous.
Can you really trust a tattooist to use sterile needles? Even if the needles are clean, what about the inks? How can they be sterilized to ensure that they are not, as has been known to occur, contaminated with Mycobacterium chelonae, the cause of a nasty skin infection? And that was in the United States, not in some exotic location where there may be much nastier bugs around.
Peter C. Doherty is Chairman of the Department of Immunology at St. Jude’s Children’s Research Hospital, and a Laureate Professor of Microbiology and Immunology at the University of Melbourne. He is the author of Pandemics: What Everyone Needs to Know, The Beginner’s Guide to Winning the Nobel Prize: Advice for Young Scientists, Their Fate is Our Fate: How Birds Foretell Threats to Our Health and Our World, and A Light History of Hot Air.
What Everyone Needs to Know (WENTK) series offers a balanced and authoritative primer on complex current event issues and countries. Written by leading authorities in their given fields, in a concise question-and-answer format, inquiring minds soon learn essential knowledge to engage with the issues that matter today. Starting July 2014, OUPblog will publish a WENTK blog post monthly.
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Image credit: Ebola virus particles by Thomas W. Geisbert, Boston University School of Medicine. Public Domain via Wikimedia Commons.
The post Limiting the possibility of a dangerous pandemic appeared first on OUPblog.
Contagion,” the extraordinary film portraying the outbreak of lethal virus that spreads rapidly around the world, may seem eerily familiar: from the medieval plague to the Spanish flu of 1918-19 to more recent fears of avian influenza, SARS, and H1N1 “swine flu”, contagions have long characterized the human condition. The film captures almost perfectly what a contemporary worst-case scenario might look like, and is eerily familiar because it trades on realistic fears. Contagion, the transmission of communicable infectious disease from one person to another (either by direct contact, as in this film — sneezing or coughing or touching one’s nose or mouth, then a surface like a tabletop or doorknob that someone else then touches
by Cassie, Associate Publicist
Michael B. A. Oldstone is a Member (Professor) at the Scripps Research Institute, where he directs a laboratory of viral immunobiology. He is also the author of Viruses, Plagues, and History: Past, Present, and Future, a look at viruses from smallpox to ebola to West Nile to the flu. In this excerpt, Oldstone explains how pigs, dogs, and ferrets help scientists discover that the flu was a virus, not bacteria.
Although suspected influenza epidemics occurred during several decades of the 1700s, Robert Johnson, a physician from Philadelphia, is generally credited with the first description of influenza during the 1793 epidemic. With his description available and improved public health statistics, epidemics were documented in 1833, 1837, 1847, 1889–90, and 1918.
However, the identity of the infectious agent that caused influenza remained debatable. In Germany, Richard Pfeiffer discovered “bacteria” present in great numbers in the throats and lungs of patients with influenza. Because of this agent’s large size, it could not pass through a Pasteur-Chamberland-type filter, causing many observers to speculate that influenza originated from a bacterium and not a virus.
Only by serendipity was the true nature of influenza as a virus discovered. This is a tale of pigs, hounds, foxes, and ferrets—all of which played decisive roles in the determination that influenza was a virus…
The story begins with J. S. Koen of Fort Dodge, Iowa, an inspector for the U.S. Bureau of Animal Husbandry. In 1918, he observed in pigs a disease that resembled the raging human influenza plague of 1918–19:
Last fall and winter we were confronted with a new condition, if not a new disease. I believe I have as much to support this diagnosis in pigs as the physicians have to support a similar diagnosis in man. The similarity of the epidemic among people and the epidemic among pigs was so close, the reports so frequent, that an outbreak in the family would be followed immediately by an outbreak among the hogs, and vice versa, as to present a most striking coincidence if not suggesting a close relation between the two conditions. It looked like “flu,” and until proved it was not “flu,” I shall stand by that diagnosis.
Koen’s views were decidedly unpopular, especially among farmers raising pigs, who feared that customers would be put off from eating pork if such an association were made. Ten years later, in 1928, a group of research veterinarians in the U.S. Bureau of Animal Husbandry, led by C. N. McBryde, reported the successful transmission of influenza infection from pig to pig by taking mucus and tissue from the respiratory tracts of sick pigs and placing it into the noses of healthy pigs. However, these investigators were unable to transmit the disease after passing the material through a Pasteur-Chamberland-type filter. Therefore, no evidence was yet available that a virus caused influenza. That situation changed when Richard Shope, working at the Rockefeller Institute of Comparative Pathology at Princeton, New Jersey, repeated McBryde’s experiments within a year of the negative report. By reproducing influenza disease in healthy pigs after inoculating them with material taken from sick pigs and passed through the Pasteur-Chamberland filter, Shope provided the first evidence that viruses transmitted influenza of swine.
…Initially, dogs were used for research on the [canine distemper] virus and for studies to develop the vaccine, but problems soon surfaced. Among the difficulties was the issue that some dogs had become immune because of a previous encounter with canine distemper virus so did not contract the disease when exposed; additionally, antivivisectionists and some pet owners objected to using “man’s best friend” as a research tool. These problems vanished when ferrets were substituted for dogs. Hound keepers on the English country estates had noticed that ferrets also developed distemper, presumably transmitted from dogs. Soon ferrets replaced dogs in canine distemper studies at both the Wellcome and the MRC laboratories.
In 1933, the first epidemic of influenza since 1919 struck London and, as before, spread quickly. Among the many humans infected were several members of the research staff at Wellcome and MRC laboratories. However, unexpectedly, ferrets kept at the Wellcome laboratory also became ill, with symptoms of wheezing, sneezing, and coughing reminiscent of human influenza infection. When Wilson Smith, a senior researcher at the MRC unit, recognized the situation, he infected ferrets with nasal washings from influenza-infected patients. As the ferrets came down with the influenza-like syndrome, both Smith and Christopher Andrewes examined them. A story soon told was that a sick ferret sneezed in Christopher Andrewes’ face. A few days later, Andrewes came down with influenza. Smith obtained washings from Andrewes’s throat, passed the material through a Pasteur-Chamberland-like filter, then injected the filtrate into healthy ferrets. Soon they too began sneezing and coughing, discharging phlegm from the nose and eyes and spiking a temperature. Here was the first evidence that a virus caused human influenza, at the same time fulfilling Koch’s postulates.
Following his studies with tuberculosis, Robert Koch formalized the criteria eventually called Koch’s postulates to distinguish a microbe causing disease from one that is a happenstance passenger. According to the postulates, a link between agent and disease is valid when the organism is regularly found in the lesions of the disease; the organism can be isolated in pure culture on artificial media; inoculation of this culture produces a similar disease in experimental animals, and the organism can be recovered from the lesions in these animals. These postulates require modification for viruses, however, because they cannot be grown on artificial media (viruses require living cells for their replication), and some are pathogenic only for humans. Nevertheless, these experiments with ferrets, humans, and influenza virus filled the bill for a modified Koch’s postulate. Considering the role serendipity played in the use of ferrets and the initial isolation of human influenza virus, one agrees with Pasteur: “Chance favors the prepared mind.”
Author: Jean Little
Published: 2007 Scholastic (on JOMB)
ISBN: 0439988373
Chapters.ca Amazon.com
Beautifully bound in a soft unevenly edged journal and told with humour, innocence, intimacy and affection, the daily entries of a fictional twelve year old disclose the spellbinding details of life during the Spanish flu epidemic of 1918-19.
Our daughter Lucy (9) also contributes to the discussion of the book, which she tells us is part of her current favourite series.
More war and peace on JOMB:
More illness on JOMB:
HOTLINE VOICES: Author Michelle Mulder from Victoria, British Columbia shares her thoughts on The Composition (by Antonio Skarmeta and Alfonso Ruano). Thanks, Michelle!
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Author: Alice L. Bartels
Sarah Ellis wrote A Prairie as Wide as the Sea, which you mention, and if only I’d known about Lucy’s new favourite series, I could have let you know that Sarah herself was in Lucy’s home town only just last week to talk about her newest Dear Canada book, Days of Toil and Tears!
Darn! That’s the second close call we’ve had with Sarah Ellis — Mark was moments away from interviewing Sarah following her keynote at ALA last year.
Lucy has already begged us to pick up Days of Toil and Tears so watch for her review here this autumn…
Thanks for listening, Carol. I’m sure our paths will cross sometime, seeing as we’re at the Green Door every Friday for dinner!