The Next Big One

As new infections surface and spread, science meets the challenges with ingenuity and adaptation.

By Mary Beth Aberlin | June 1, 2013

© ACE_CREATE/ISTOCKPHOTO.COMThese days, warnings of worldwide infection seem like monthly occurrences. And they’re not just in the popular press, but in scientific journals and in bulletins from public-health organizations. Think how many times in the last few years we have been told that a new global pandemic is at least possible, if not imminent—warnings fueled by reports of a newly emerging, particularly deadly virus, or a known pathogen accruing some dangerous new mutation. Think of the controversy that raged last year over whether to allow the publication of papers from two laboratories describing the experimental creation of mutated versions of the highly virulent but not easily spread H5N1 avian influenza virus—strains that were more transmissible between mammals. Warnings rang out about possible pandemics should the lab-mutated viruses accidently escape, and about terrorists using information gleaned from the scientific publications to create biological weapons.

This year’s flu season saw the arrival of yet another new and confounding influenza strain, H7N9, rare and so far not easily transmitted between humans, but especially deadly, at least at first glance. And, on May 12, as The Scientist goes to press, the World Health Organization issued a global alert about yet another highly virulent organism, this time a novel coronavirus—the same type of virus responsible for the SARS epidemic of 2002–2003—which first appeared in Saudi Arabia in September 2012 and is responsible to date for a total of 40 laboratory-confirmed cases of human infection, including 20 deaths. When the infection was first reported, it stoked fears that the enormous number of Muslims gathered in Mecca for the annual October pilgrimage would be a perfect breeding ground for spread of the disease by human contact.

How people live with each other clearly has an effect on how infectious diseases are spread. In “Factoring in Face Time,” Adam Kucharski of Imperial College London’s MRC Centre for Outbreak Analysis and Modelling describes how epidemiologists are trying to contain infectious disease in humans by studying how patterns of social interaction influence their spread. The HIV/AIDS outbreak in the 1980s underscored the importance of studying social connections, but the fear of global pandemics has propelled such research forward. Kucharski describes how data from detailed questionnaires and from subjects wearing electronic sensors (that actually record the number of interactions and distance from other people) have helped generate models now precise enough to allow governments and public-health officials to better contain the spread of possible pandemics.

Because the possibility of a new epidemic often involves a newly emerging infectious agent that arises in an underdeveloped region of the globe, how scientists from the developed world plant their boots on the ground there can be critical. In “It Takes a Village,” former TS intern Beth Marie Mole profiles three scientists whose research in developing countries has been intimately involved with, and enhanced by, working with local communities. She describes how Belgian clinician Peter Piot’s work during the deadly and gruesome Ebola outbreak some 35 years ago laid the groundwork for effectively facing the HIV/AIDS epidemic that followed.

Training locals to manage initiatives that range from effective crop rotation to countering water loss due to climate change also extends to the introduction of novel, low-cost methods for monitoring infection. In "Mobile Microscopes," Jef Akst writes about clever, simple-to-operate cell-phone microscopes that can diagnose malaria from blood samples, tuberculosis from sputum samples, and parasitic worm infections from stool samples.

New pathogens aren’t the only ones emerging and mutating to exploit a new world. Science too is changing, rising to new challenges from novel enemies.

Mary-Beth Aberlin  Editor-in-Chief

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Avatar of: jeenious


Posts: 45

June 4, 2013



Generally speaking, the most important frontiers into which science and technology are moving, are frontiers of ever-smaller bio-significant size scales.   For the first time in human history, we (our scientists) can (even if only indirectly, by way of proxies) observe and measure, and seek ways to manipulate to our human individual and species advantages, more and more details of what goes on at, and below, the nanometer level. 




The work of science is not complete at any size scale, and at all human-accessible scales, science cannot progress without benefit of technology, nor technology without benefit of science.  Though these two  “dimensions” of human discovery and learning are distinct from one another, each "informs" the other indispensably.  But it is soundly arguable, I think, to say that the most important scale level at which we are making new and different inroads into how human physiology can be manipulated to our species’ coping advantage, is at, and below, nanometer level.  New discoveries about subtleties of intra-cellular and intercellular functioning are taking us closer to something we (ideologically perhaps?) anticipate to be what a "healthy" cell is, and does…, what a "healthy" immune system is, what a "healthy" response is to any given irritant, chronic infection, acute trauma or acute infection…




 Presently we do well, in treating cancer, to block a particular increment along an mutagenic pathway, or in treating epidemic diseases to interrupt a runaway cascade such as sepsis in certain pathological processes.  Hopefully someday, however, we will be able – hopefully not too awfully many years into our future, to focus, intead, on how to maintain "HEALTHY" intra-cellular and inter-cellular metabolism overall, cellular waste disposal overall, cell replication in an entire organism, performance of each cells primary function in a healthy way (with a view, also, to what we might dream of as a healthy cell doing its primary job, while working in complex symbiotic harmony with and within an overall organism which, in turn, is functioning in a way that cooperates in an ideal physiological homeostasis with the organism’s species, in an overall (healthy) Earth ecology.




But wait.  There's a dilemma entailed in this forward thinking, isn't there.




What if there is not any such thing as “the” ideal healthy cell, working in conjunction with the ideally healthy immune system, functioning in an ideally healthy human body which is behaving in an ideal way in an ideal species, in an ideal Earth eco-system.  One common view of what the physiology of any species is, and ever shall be, is a war of attrition -- a dynamic in which an endless competition goes on, and there is no such thing as a state that is "healthy."  From such a view, the human body can never achieve "health" in the sense that it would not (and would not need to) field any "defensive weapons" that cause collateral damage, as it were, or suffer harm from "friendly fire" from other players in the host organism’s overall struggle to live and let live.  Among the human body's defenses against certain pathogens and recoveries from traumas, are some that result in collateral damage in the form of inflammation of the body's own health cells.  Sometimes the collateral damage, itself, is more traumatic than would be the perceived “enemy” of the host.  Similarly, our pharmacological medicines, which have brought us many “health” advantages, almost come as trade-offs, providing benefit in one way, but doing damage to healthy cells or organs or vital physiological processes.  Whereas Isaac Newton observed in physics, in regard to every “action’s” having an equal and opposite reactions, in biological systems the notion of “equal and opposite” fades off into, biologically far more ramified than any characterization as “equal and opposite” would fit.  (At SOME level it is conceivable that there is an equal and opposite push-pull, or give-take, but “living processes,” as we know them and seek to deal with them at as-near-as-possible the levels we so-far feel we understand and can manipulate to our species and individual coping advantage, we deal in a very practical sense with affects of affects of occurrences at levels of scale smaller than those we have, as yet, found ways to observe, measure or manipulate to our coping advantage.  




 But the dilemma – whereby every coping advantage the human brain comes up with is a trade-off against a collateral coping disadvantage (some examples veritably local and instant, but others delayed or cumulative) – does not go away.  (For every set of coping advantages in, say, agriculture, there is a set of disadvantages, although the disadvantage may be local and immediate, and the disadvantages years in building up to a tipping point, or occurring at another geographical place.  Today’s irrigated crop advantages are local and immediate, for example, whereas the impact on underground aquifers, or in gradually escalating toxic run-off may make a downstream area barren.  And, so it is, it seems, with the branch of “coping” we think of as “medical care.”  In a sense, we joust with ever-morphing windmills – the morphing of the windmills being but the footprint we leave when we ‘win.”  Of course, too, our solar system, and our island planet Earth, continue to age and change in many ways for reasons not anthropomorphic, as well as from our anthropomorphic footprint.




Philosophically we could ask, “Do we, who seek to progress in our "war against the forces that would terminate or disadvantage our species existence,” misperceive our information-accumulation and information coping availing as though it were an ultimately winnable war?  Or, in our game with nature, so to speak, do we raise the ante, only to prompt "nature" to respond by calling us on our bet, and raising the ante we have to match?




Or, more specifically for purposes of the present question, do we perceive “good health” to be an achievable, sustainable goal. 




In our medical science thinking (from a pure-logic or mathematically rigorous approach) we could ask, "Why fight with too much heroics a war that never stops escalating, and that we can never win?"




However illogical it might be to argue that we Earth-humans have the potential to "win," a war against disease and trauma and death (and social conflicts, and even military wars), perhaps our highest and best pursuit of goals as "health and happiness" is justified by our enjoyment of immediate, local advantages only, and enjoyment of the effort qua THE  EFFORT, ITSELF.  Quixotic though any effort may be to "conquer" disease, suffering, aging, famine, hunger (the more food we have, the more we multiply), death... perhaps what makes life worth living is the "the game."




























If there is no such thing as perfect health, or no such thing as any cure to any of humankind's problems that is not merely a new level of current and local trade-offs or, pushing a snowball of consequences of local and immediate winning up a hill of impact on our future progeny – if every perceived victory over some aspect of “nature” is but a synthesis that insinuates and initiates into being its own natural antithesis – then there is no winning against nature; there is only a moving about of the furniture, as it were. 




 Maybe it’s better, if we find a way to survive and be happier at any given moment, then that is as good as it’s ever going to get.  The more diseases we prevent or cure… the more food we produce… the more babies survive and the longer they live on average.  It's all worthwhile if we do not look too far up the road to where science and technology are leading us, and weigh the disadvantageous consequences of our advantages.    




Perhaps the best we can do, as a species, is live for today, and seek to use our science to enable us to discover the meaning, and the route to, "health," and "perfect technology," and "perfect comfort," and "perfect happiness."




 If consequences are not local and immediate, then perhaps we should not allow ourselves to think about them. 




 No, wait.  That wouldn't be very nice, or very smart, would it?








 Why does everything have to be so complicated?




 (: > )


August 12, 2013

There are many diseases nowadays. 

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