The Hot Zone & The New Republic

Ian A. York iayork at panix.com
Wed Jan 17 11:02:27 EST 1996


In article <v01530501ad2201f8595c@[166.84.199.117]>,
Hans Andersson <hasse at PANIX.COM> wrote:
>
>You have been downplaying the risks with filoviruses and trying to build a
>case where newly emerging and highly fatal viruses aren't much of a
>problem.

Hans, please read what Ed has to say.  The lethality of a virus has 
little or nothing to do with the potential public health problem.  For 
example, diseases such as Creutzfeld-Jacob disease are lethal, but they 
are not of concern to the population as a whole because they're not 
particularly infectious.  

The worst case for an Ebola virus outbreak would be the appearance of the 
disease in an urban center in the third world, where identification and 
isolation of patients is difficult.  Well, pay close attention: That's 
pretty much what happened in Zaire, and if you'll notice the world is 
still alive.

>"These viruses could be on our doorstep tomorrow", as one virologist said in a
>magazine article about budget cuts for CDC and USAMRIID.

Look, nobody argues that we should not be paying attention to emergning 
viruses.  But you've lost sight of the diseases that have already 
emerged.  

Should we ignore the risks of a highly contagious, air-spread disease with a 
long infectious period?  Tuberculosis is predicted to kill thirty million 
people in the next decade.  Why aren't you wetting your pants about 
that?  That's infinitely more frightening than the Ebola scenarios you've 
proposed.  

How about a virus that is much, much more lethal than Ebola?  That's
widespread in North America, readily spread between animals (the
reservoir) and humans?  Rabies virus kills between 20,000 and 50,000
people each year; it has a fatality rate of 99.999%. 

How about an immensely contagious viral disease ("the most 
transmissible disease known to man":  Archives of Internal Medicine.  
154(16):1815-20, 1994) that kills around one million children per year?  
Measles is a controllable disease; why aren't you lobbying to get the 
vaccine to the places that need it?  And isn't it terrifying that people 
in North America think of measles as a mildly amusing childhood nuisance?

These are not emerging diseases, Hans.  These are diseases that have 
emerged.  These three alone kill millions of people every year, and we 
don't have to postulate mysterious and hypothetical mutations.  Ebola 
virus has killed some 500 people in the past ten years; that includes the 
worst-case outbreak last year.

No realistic mutation you can propose for filoviruses can make it a worse 
killer than any one of these diseases.

>From a virology point of view, I think that it's perfectly valid to express
>support for virus research and surveillance.

Absolutely.  It helps to understand which diseases are more important.  
Everybody on this newsgroup agrees that virology funding should be 
increased.  Until it is, let's use our knowledge to identify true 
menaces, not the flavour of the month.

Ian

-- 
                      Ian York   (iayork at panix.com)
      "-but as he was a York, I am rather inclined to suppose him a
       very respectable Man." -Jane Austen, The History of England



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