outbreak: epidemics in a connected world

Val and I were in Washington, D.C. for a week. He attended a training course in the city and I was on vacation mode, fresh from boot camp. I was so happy because this trip made one of my wishes true: I got to visit the Smithsonian!

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Before my career path led towards cereal chemistry, I always wanted to become an epidemiologist. I attribute this fascination to "Outbreak", a novel by Robin Cook. So when I saw the exhibit about outbreaks at the Smithsonian Museum of Natural History, I was so thrilled! I particularly liked this exhibit because it emphasised the magnified risk of epidemics due to the improved global connectivity.

Humans faced several major microbial nemeses. Bubonic plague led to the Black Death in the 14th century. Smallpox effectively eradicated significant proportions of indigenous peoples when Europeans began colonising the New World. Influenza caused pandemics in the 20th century; people are encouraged to have their flu shots in autumn to build their immune systems. Amoebiasis is known as a tropical disease, killing tens of thousands of people annually. HIV, and the syndrome associated with it–AIDS– started making the rounds controversially because it was first detected in homosexual patients and is sexually transmitted. Cholera is also most often associated with developing countries where poor sanitation persist, affecting millions of people a year.

  

  

But how do the pathogens travel all over the world? What conditions make them endemic in one region and not in another? 

Looking more closely into the life cycles and modes of transmission of the different microorganisms allows us to understand and prevent their spread... and avert epidemics. Admittedly, it's becoming challenging because these microorganisms don't sit idle and wait until the medical community has developed an antidote. The pathogens continue evolving and adapting to their environment. Just look at how difficult it is to beat influenza. While we get vaccinated for what is predicted to be the dominant strain, the flu viral genetic material create new strains by mixing with flu viruses from other animals. The new strains potentially reach humans through swine (through consumption or exposure to their environment?), for example, and the flu outbreak starts again!

And then there are the diseases linked with mosquitoes and other insects. I've known people who died of dengue fever, for instance... but because it's endemic to the Philippines, it is "normal" for me to hear news about people sick with it. This doesn't discount the pain and the danger patients go through; rather, it's meant to indicate that many people are afflicted with it. Standing water in tire stacks, pails, even in gutters could be breeding grounds for the mosquitoes bringing the pathogens with them. I've learned to ensure that these mosquito havens were not to be found at home.

Some ailments are more sophisticated... they have the potential of blowing big time because of global trade and travel. For example, meats from sick animals (or even live animals) could be carriers of potential epidemic microorganism. Trading these across borders increase the risk of outbreaks because the animals live in confined spaces, making disease transmission easier. Finding patient zero would be a huge challenge for epidemiologists in this case. 

How do we prevent the spread of these microorganisms? 

The easiest way is to make sure that we wash our hands before we consume food and we cover our mouths while sneezing or coughing. We also need to make sure that we cook food properly and eat in restaurants where food is prepared in a hygienic manner. Then there's getting vaccinated when needed. Also, we need to stop fear-mongering, especially towards the more controversial outbreaks. Princess Diana was one of the best examples of breaking many misconceptions about the transmission of AIDS. In contrast, Ebola fever has yet to find a high-profile champion who can break down the social stigma surrounding the disease, particularly about the survivors.  

There are other ways of helping stop epidemics without being an epidemiologist. The Smithsonian Museum of Natural History posted some ideas on how we can further help. Because in the end, we're all in this together.

My dream of being an epidemiologist is no longer about being in the front lines, as one who's in direct contact with patients. As I matured in science, I learned that if ever I'll be in this field one day, I'll contribute more effectively in the laboratory and in analysing data, perhaps even in preventing the next big one. We'll see...