Eideard

Skeletons of the plague dead in London’s East Smithfield Cemetery
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Scientists have mapped out the entire genetic map of the Black Death, a 14th century bubonic plague that killed 50 million Europeans in one of the most devastating epidemics in history.

The work, which involved extracting and purifying DNA from the remains of Black death victims buried in London’s “plague pits,” is the first time scientists have been able to draft a reconstructed genome of any ancient pathogen.

Their result — a full draft of the entire Black Death genome — should allow researchers to track changes in the disease’s evolution and virulence, and lead to better understanding of modern-day infectious diseases.

Building on previous research which showed that a specific variant of the Yersinia pestis bacterium was responsible for the plague that ravaged Europe between 1347 and 1351, a team of German, Canadian and American scientists went on to “capture” and sequence the entire genome of the disease.

“The genomic data show that this bacterial strain, or variant, is the ancestor of all modern plagues we have today worldwide. Every outbreak across the globe today stems from a descendant of the medieval plague,” said Hendrik Poinar, of Canada’s McMaster University, who worked with the team…

For this study Poinar’s team analysed skeletal remains from Black Death victims buried in London’s East Smithfield “plague pits,” which are located under what is now the Royal Mint…

Poinar, whose work was published in the journal Nature, said the team found that in 660 years of evolution, the genetic map of the ancient organism had only barely changed. “The next step is to determine why this was so deadly,” he said.

Pathogens and pandemics aren’t about to disappear. Levels of preparedness afforded by modern medicine, vaccination and hygiene are constantly challenged by ignorance and superstition. Indeed, in the United States significant resistance to well-proven methods flows like a river of political pus from the combination of religious nutballs and opportunist populists.

Living in a state that confronts deaths from plague every year, there is currency to the contemplation of historic tragedy. Living in a state where parents can refuse a vaccine for their children on religious grounds thereby endangering other children by the hundreds – research that supports greater depth of response to the dangers of pandemic is a necessity.

Examination of lung tissue and other autopsy material from 68 American soldiers who died of respiratory infections in 1918 has revealed that the influenza virus that eventually killed 50 million people worldwide was circulating in the United States at least four months before the 1918 influenza reached pandemic levels that fall.

The study, using tissues preserved since 1918, was led by Jeffery K. Taubenberger, M.D., Ph.D…The researchers found proteins and genetic material from the 1918 influenza virus in specimens from 37 of the soldiers, including four who died between May and August 1918, months before the pandemic peaked. These four cases are the earliest 1918 pandemic influenza cases they know to be documented anywhere in the world, the scientists say.

The clinical disease and tissue damage seen in the pre-pandemic cases were indistinguishable from those evident in cases that occurred during the height of the pandemic. This suggests, says Dr. Taubenberger, that over the course of the pandemic, the virus did not undergo a dramatic change that could explain the unusually high mortality it ultimately caused.

In the current study, the autopsy materials showed that the virus replicated not only in the upper respiratory tract but also the lower respiratory tract, in a pattern very similar to that of the 2009 pandemic influenza virus. The team also found evidence that two virus variants were circulating in 1918…

Bacterial co-infections were found in all 68 cases studied, the researchers noted. The role played by bacterial co-infections, such as bacterial pneumonia, in contributing to deaths in the 1918 pandemic was previously described by Dr. Taubenberger and his colleagues in a 2008 study. According to the study authors, the new data underscore the crucial role that bacterial infections can play in conjunction with any influenza virus, whether historic or future, and the need for public health officials to prepare to prevent, detect and treat bacterial co-infections during future influenza outbreaks.

Unless, of course, you believe such a pandemic can never happen again, it’s all a plot by pharmaceutical companies and it’s too much trouble to get a flu shot, anyway.

Yes, I got mine a few weeks ago.

The Centers for Disease Control and Prevention is a big, serious government agency with a big, serious job: protecting public health from threats ranging from hurricanes to bird flu.

So when the good doctors of Atlanta warned people this week about how to prepare for a zombie apocalypse, the world took notice.

“That’s right, I said z-o-m-b-i-e a-p-o-c-a-l-y-p-s-e,” Dr. Ali S. Khan wrote on the CDC website this week, adding casually that “Resident Evil” is his “personal favorite” zombie movie.

As it happens, Khan, one of the nation’s top-ranking public health professionals (he’s a rear admiral and an assistant surgeon general), doesn’t actually believe the living dead are about to claw their way out of graves and start chewing on your brain.

But, he and his communications team recently noticed, what they’d want you to do if the world really did suddenly go “Night of the Living Dead” is pretty much the same thing they’d want you to do in case of a hurricane or a major pandemic…

The CDC got a question about zombies during an online chat about radiation leaks related to the meltdown at Japan’s Fukushima Daiichi nuclear plant in March, and they saw traffic spike.

Khan and his communications team knew they’d found a way to get the public interested in disaster preparedness, he said.

So they posted the advice on Monday. Their website crashed on Wednesday.

The advice is mostly stuff you should already know: Make an emergency plan. Stockpile food, water and medicine. Have a utility knife, duct tape and battery-powered radio handy, along with some changes of clothes and bedding…Have basic first aid supplies handy for a hurricane or a pandemic — although, Khan says, “you’re a goner if a zombie bites you.

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The cholera epidemic that has killed 1,110 people and sickened thousands in Haiti is part of a 49-year-old global pandemic and likely was brought to the Caribbean country in a single instance, scientists say…But that was all it took to set off the epidemic, with an already weak sanitation system thrown into chaos by a devastating earthquake in January…

The epidemic in the poorest country in the Western Hemisphere could easily worsen and cholera could linger there for years, they said…

CDC infectious disease specialist Dr. Scott Dowell said it may be impossible to trace how the cholera came to Haiti. An infected person, contaminated food or even a ship’s bilge water could all carry the bacteria, Dowell said.

Genetic fingerprints show the outbreak can be traced to a pandemic that started in Indonesia 49 years ago and has spread around the world, the CDC and PAHO said…

“As far as stamping it out or eliminating it from Haiti, we are not hopeful about that,” Dowell said. “We feel that Haiti is going to be dealing with cholera for several years or several months at least.”

Cholera is spread when the bacteria get into water, almost always via human waste.

Haiti had not seen cholera for 100 years but experts say conditions are ideal for its spread — lack of proper sewerage, people forced to defecate in the open, a tightly packed population, torrential rains and a lack of clean water.

A centuries-long history of political corruption, a culture constantly misled and misdirected by priests, politicians and populist hustlers – and Haiti was a Tsunami of self-destruction waiting to fall upon its people.

Within a context of American and European nations that couldn’t have cared less over time, the poor population of Haiti was always on track for this sort of disaster.

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A year earlier, Margaret Chan had been a surprise candidate in a surprise election (the previous incumbent died halfway through his term), but she won with a clear majority to become the first Chinese national to run a major UN agency. A rule change in 2005 (the WHO no longer has to beg states for information about threats to global health, but can just demand it) also makes her the most powerful public health official in history.

Tiny in her orange jacket and neat little orange-brown Miu Miu mules, she wears that authority not lightly, exactly, but naturally: in an organisation famed for its bureaucratic circumlocutions, she is refreshingly direct. It’s a strength she’s aware of – “I have a reputation for being a straight-talker, I will tell them the story like it is” – but that makes it no less striking, or true…

Months later, on 11 June 2009, she found herself the first WHO chief in 41 years to stand before the world and announce that a new virus had reached pandemic proportions. Right up until the last minute, scientists were calling her up and warning her to be careful about raising the threat alert so high — but the strict definition of “pandemic” is a new disease spreading uncontrollably through numerous countries, and on that count her decision has been completely borne out. On 11 June, swine flu had been registered in 74 countries; when we meet in Geneva four weeks later, it has just been confirmed in 140 countries.

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The World Health Organization has told its member nations it is declaring a swine flu pandemic — the first global flu epidemic in 41 years.

The move came after an emergency meeting with flu experts here [Geneva] that was convened after a sharp rise in cases in Australia, which reported 1,224 cases on Wednesday, and rising numbers in Britain, Japan, and elsewhere in Asia.

In a statement sent to member countries, the W.H.O. said it decided to raise the pandemic alert level from phase 5 to 6, indicating a global pandemic outbreak, The Associated Press said, attributing the information to health officials from Scotland, Indonesia and Thailand. An official announcement of the change was due at 6 p.m. Geneva time Thursday (12 p.m. in New York).

In an effort to avoid triggering panic with such an announcement, W.H.O. officials are expected to include with their formal announcement a caveat that the flu is not more deadly now that it has been declared a pandemic. Rather, the announcement reflects the global spread of the disease, not an increase in its severity.

According to W.H.O rules, the organization should declare a pandemic once it finds evidence of widespread “community transmission” — meaning beyond travelers, schools and immediate contacts — on two continents…

The declaration of a pandemic will trigger drug makers to speed up production of a swine flu vaccine and prompt governments to devote more money to containing the virus. While international health officials have said the flu appears to be less deadly than the annual bouts of seasonal flu that sweep the globe each year, they have warned that the virus could mutate into a more lethal strain during the southern hemisphere’s upcoming winter flu season.

China appears to be ahead of most western nations at producing vaccine. They expect to be ready sometime in July. European and American producers have focused on the traditional winter flu season and are moving more slowly.

Here in North America an obvious trigger for pandemic status has been Canada which reported 533 new cases in a 2-day period.

Mexican soldiers delivering masks for public distribution
Daylife/Reuters Pictures used by permission

Countries planned quarantines, tightened rules on pork imports and tested airline passengers for fevers as global health officials tried Sunday to come up with uniform ways to battle a deadly strain of swine flu. Nations from New Zealand to France reported new suspected cases.

World Health Organization Director-General Margaret Chan held teleconferences with staff and flu experts around the world but stopped short of recommending specific measures to stop the disease, urging governments to step up their surveillance of suspicious outbreaks.

Governments including China, Russia and Taiwan began planning to put anyone with symptoms of the deadly virus under quarantine…

Some nations issued travel warnings for Mexico.

Chan called the outbreak a public health emergency of ”pandemic potential” because the virus can pass from human to human. Her agency was considering whether to issue nonbinding recommendations on travel and trade restrictions, and even border closures. It is up to governments to decide whether to follow the advice…

New Zealand said that 10 students who took a school trip to Mexico ”likely” had swine flu. Israel said a man who had recently visited Mexico had been hospitalized while authorities try to determine whether he had the disease. French Health Ministry officials said four possible cases of swine flu are currently under investigation, including a family of three in the northern Nord region and a woman in the Paris region. The four recently returned from Mexico. Tests on two separate cases of suspected swine flu proved negative, they said…

Mexico closed schools, museums, libraries and theaters in a bid to contain the outbreak after hundreds were sickened there. In the U.S., there have been at least 11 confirmed cases of swine flu in California, Texas and Kansas. Patients have ranged in age from 9 to over 50. At least two were hospitalized. All recovered or are recovering.

The WHO’s pandemic alert level is currently at to phase 3. I’m betting on phase 4 within the week. Phase 5 is what we get when the virus is confirmed in at least two countries in the same region.

Phase 6 would indicate a full-scale global pandemic. Which no one wants to see or experience.