September 12, 2011

Torah Kachur

Contagion has spread through box offices around the world pulling in an estimated $23 million dollars on it's opening weekend.  This film is more than just a way to increase hand soap consumption, it has real insight into the fallout of a true pandemic.


We've been at the edge of our seats for years waiting for that promised pandemic that requires us to stockpile water, aspirin and condoms.  H1N1 petered out, bird flu didn't make it much past some chicken farmers and SARS annoyed a lot of air travelers.  These recent outbreaks tested our public health infrastructure and alerted us to the possibility of an influenza virus like the 1918 Spanish flu that killed 14 million people.  But they disappeared with more of a whimper than a blockbuster.


The ingredients for a superflu are quite simple: one virus, a couple of mutations and a susceptible and travel-happy host.  The virus that would cause the next Hollywood-worthy pandemic virus is Influenza A - the common flu virus that hits us every November in flu season.  This group of viruses can infect different hosts including humans, pigs and birds which can act as reservoirs for the virus.  The problem with this cross-species infection is that it gives different strains of the virus the chance to get together, swap cool genes that make them more infectious and then continue the party elsewhere.


         Influenza A Pandemic Contagion

Blue nobby thingy = NA.  Green clovery doohicky = HA.


Two genes in the viral genome, called NA (neuraminidase) and HA (hemagglutinin) are particularily important in the infection cycle and to escape the natural defenses of the immune system.  If either of these genes randomly mutate, or acquire a different variant from a non-human strain, it may make the next batch of viruses undetectable to the immune system.  This realistic possibility could materialize into the next pandemic. 


It is not 'if' it's 'when' and currently WHO and regional organizations like the CDC have pandemic response plans that include widespread vaccinations, travel restrictions and all those other lovely solutions that came up in the movie....without the hot actors (unfortunately).



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