Monthly Archives: October 2011

From guest blogger, Justin Birch: The Eradication of Viral Scourges

A Farewell to Rinderpest and Small Pox

On Aug. 8th, the United Nations Food and Agriculture Organization (FAO) hosted a ceremony at its headquarters in Rome to officially announce that the rinderpest virus had been eradicated. This marked the resolution of decades of coordinated effort to combat what had been, for centuries and possibly millenia, the most devastating and dreaded bovine virus. It now goes down in history as the only the second virus to ever be successfully eradicated.

Rinderpest had imposed a horrific toll on both animals and the communities reliant on them for commerce and sustenance. The most recent major outbreak in the early 1980s spread across much of Africa and cost at least $500 million in direct losses. Rinderpest, like many similar diseases, disproportionately ravaged less developed nations which depend more heavily on animals for food and draft power. While much of the recent history of rinderpest outbreaks can be measured in chiefly financial terms, the virus has contributed to extraordinary human suffering.

When it was introduced to Africa by Italians importing Indian cattle, the resulting outbreak killed an estimated 90 percent of the local cattle population. It also contributed to the Great Ethiopian Famine of 1892, which resulted in fatalities estimated to be as high as onethird of the countrys population. Local communities lost not only the animals they depended on for meat and dairy products for sale and consumption, but also the beasts of burden necessary for the tilling of fields and transportation of crops and goods. The huge number of cattle and oxen carcasses also helped provide the unsanitary conditions that fostered one of the worst regional outbreaks of cholera and small pox.

The eradication of rinderpest removes one more source of poverty and misery in the world. Of equal importance, it establishes that the eradication of small pox was not a one-off event, and that eradication efforts against other diseases can be successful. The campaign against small pox had been extraordinary, warranted by the extraordinary costs it had imposed on humanity throughout history. Edward Jenner, the man who discovered the first small pox vaccine, called it “the most dreadful scourge of the human species,” and with good reason. It was responsible for 300 million deaths in the 20th century alone, and as late as 18th century killed one of every seven children born in Russia, and one of every ten born in France or Sweden. It is responsible for more human deaths than any other virus, and far more than all human wars combined. As late as 1967, when the global initiative to eradicate it was restructured under the World Health Organization, it threatened 60 percent of the global population.

Today, the first time the average American student will encounter it is in an immunology class at their university or the OpenCourseWare of an online school. It is academic, or a curiosity, rather than a real threat. The eradication of both rinderpest and small pox was made possible due to successful regional elimination efforts combined with international coordination. The fact remains, however, that a live strain anywhere is a threat to everyone everywhere. In 1976, rinderpest had been contained to just three countries. The resulting complacency allowed for a massive spread of rinderpest throughout Africa and East and South Asia, including the aforementioned 1984 outbreak. This is a strong reminder of the importance of the total eradication of a virus in comparison to simple elimination. It also highlights the severe obstacles posed to eradication effort by regional underdevelopment and conflicts.

In 1998, Sir Gordon R. Scott of the Center for Tropical Veterinary Medicine at the University of Edinburgh, who was a longtime leader in the effort, gave a bleak appraisal of the prospects for rinderpest eradication based on a concern that still resonates today:

The major obstacle is man’s inhumanity to man. Rinderpest thrives in a milieu of armed conflict and fleeing refugee masses. Until world peace is secured, the nays win the argument.

Even though rinderpest was successfully eradicated, and the last naturally occurring case was only three years after Scott’s assessment, rinderpest repeatedly defied prior eradication efforts and had rebounded after being isolated in regions were people suffered from deprivation and violence. So had small pox. So does polio today. While polio cases are extremely rare and present in just a handful of countries, even a handful of cases can turn into a fresh epidemic if proper care is not taken. The decade of observation from the last case of rinderpest in 2001 to the announcement of eradication in 2011 was justified because as an eradication initiative winds down, so does the production of vaccines and the sense of urgency by governments and NGOs. During this period, a renewed outbreak poses an even greater risk because the resources to manage it have been dramatically reduced. This makes conflict zones and persistent humanitarian disaster areas a very real threat to the welfare of the rest of the world. Ignoring them is both a strategic and moral failing.

It’s important to look back on both our prior victories and our prior hardships. For the former, we are reminded of how severely and utterly devastating a viral outbreak can be, and by extension we are encouraged to be more vigilant. For the latter, we are reminded of what we have accomplished, through cooperation, coordination, and extraordinary effort and sacrifice. Small pox plagued our species, and claimed lives so routinely that it became a fact of life for much of the world. Today, its absence is just as taken for granted. With any luck, polio will soon be just as forgotten, as will many other formerly devastating diseases, once they are truly eradicated.

Latest Headlines

GUYS: DON’T GET A PROSTATE-SPECIFIC ANTIGEN TEST

This question has been bandied about for a more than a decade now. The problem with the test is that is doesn’t seem to predict who is at risk for dying of prostate cancer. On the other hand, a test can cause a man to undergo unnecessary diagnostics and surgery, and result in impotence and incontinence. (This is bad because men like sex, and don’t like peeing in their pants.)

Is this the whole story?

BY THE WAY, HAITI IS STILL REELING FROM CHOLERA

Doctors with Borders reports that cases of cholera are increasing in Port-au-Prince.

HAVING A HEART ATTACK WHILE WEARING MY PINK BUSTIER

My son’s Sports Illustrated:Kids arrived the past week, with an NFL player resplendent in a pink football uniform. The latest edition of our local weekly newspaper was tinted pink. Products from hand cream to gloves are being marketed in pink, in order that we increase our awareness of breast cancer. Which makes me wonder: Is there any way, other than the government mandating an hourly pledge of allegiance to the war on breast cancer, that we could increase our awareness of breast cancer?

Don’t get me wrong–breast cancer is a scourge that afflicts an enormous number of women, and therefore requires attention and vigilance. However, heart disease is the number one killer of women, and there are three times as many non-breast cancer  conditions that sicken and kill women as breast cancer . At this point in our history,  is there really a lack of awareness of breast cancer? Off the top of your head, can you tell me what is the third major cause of death in US females?

Didn’t think so.

IT’S TIME TO GET YOUR FLU VACCINE