The Thing That Makes a Virus Hunter Nervous (Guardians: Part 2)
Posted by Richard Conniff on April 17, 2013
The good news? Science has become remarkably adept at identifying and containing potential outbreaks right at the start, even in the most remote locations, and often when only a handful of people—rather than hundreds—have become sick. In other words, they generally halt the outbreak before it can turn up on a 747 bound for New York City.
Some of the credit goes to rapidly advancing technologies, from Internet data mining to DNA fingerprinting. In the early 1980s, for instance, it took 3 devastating years to identify the virus that causes AIDS. With modern gene sequencing, says Columbia University virus hunter W. Ian Lipkin, M.D., it would take just 48 hours today. And part of the credit belongs to governments, which have learned painful lessons about the consequences of allowing a new disease to get out of hand: Since 1981, AIDS has killed more than 30 million people worldwide, with no end in sight.
But if we are lucky enough to see another year pass without some pandemic lurching up out of nowhere to kill vast swaths of humanity, it’s mainly because of the people who now constantly watch for early signs of trouble—as well as the ones who parachute in when things go wrong to save lives and stop epidemics. They tend to be unusual characters, people who can chat casually about “flavors” of Ebola and about the addictive thrill of their work on the front lines of possible outbreaks. But they also know firsthand what it takes to keep the world safe—and how to stay healthy themselves, even as people all around them die.
At CDC headquarters in Atlanta one day recently, as the coronavirus investigation was wrapping up, a daily map of trouble spots included an Ebola outbreak in the Democratic Republic of the Congo, Marburg fever in Uganda, cholera in Haiti, polio in Pakistan, and dengue fever in Portugal. Hantavirus, which is transmitted through urine, droppings, or saliva mainly from deer mice (and which also disproportionately affects men), had recently killed three vacationers at Yosemite National Park, and a case of Crimean-Congo hemorrhagic fever had just turned up in, of all places, Glasgow, Scotland.
It is a dangerous world out there, especially because of the kinds of travel we now consider normal. In his office in the division of global migration and quarantine at the CDC, director Martin Cetron, M.D., plays a computerized display tracking a single day’s passenger flights, streams of yellow lights gently flowing in from the farthest corners of the earth, coalescing in bright megalopolitan splotches of light, then radiating outward again. “This is what makes me nervous,” he says.
Nearly a billion people a year cross international borders, some of them inevitably carrying infections. Each international flight landing on U.S. runways also carries, on average, 1.6 live mosquitoes. In 1999, one theory holds, some of these jet-setting mosquitoes may have delivered West Nile encephalitis to New York. West Nile has since spread to 48 states and killed about 1,500 in the United States. As bad as that outbreak was, afflictions that are far more widespread may yet come if what Dr. Cetron calls the “invisible infrastructure” of disease prevention ever falters.
Simon Richardson, now 29, spent much of the past 6 years backpacking his way from Australia, through Southeast Asia and India, and around Africa, never experiencing anything worse than “the odd tummy bug.” He was a rafting guide in New Zealand, a trekking guide in Thailand, and a scuba instructor in Mozambique. Finally, he returned home to England and joined the British Army, ranking in the top 2 percent on the fitness test. Then the pain hit, in the left side of his chest.
“I thought I pulled a muscle, so I stopped lifting weights for a few weeks. Then I thought it was flu. But it just kept getting worse and worse.” He went from being able to run a mile in under 5 minutes to a point where he couldn’t run a mile at all. In the hospital, doctors took a sample of lung tissue with an endoscopic tube and gave him a diagnosis of tuberculosis that “was like getting punched in the stomach.” His friends just gave Richardson a blank stare when he told them. Most remembered tuberculosis only from old movies where pale victims coughed up blood and then died.