Virus Vrydag

Alliteration because this is a post about viruses. And it is a Friday. And Vrydag is Friday in Afrikaans.
Also Virus is Virus in Afrikaans. So we’re all good.

My inbox was full of posts and articles about viruses today. Real viruses, not digital ones. I’m not sure what prompted this outbreak, but if you have even a passing interest in microbiology and biomedical science, they’re quite interesting.

First up, a two-parter: this TED-talk from CSIR laser scientist Patience Mthunzi.

Could we cure HIV with lasers?

and this response:
Fullscreen capture 2016-08-12 105612 AM.bmp

because, as UCT virus scientist Ed Rybicki says:

Sorry, and I realise that she’s a passionate and well-meaning woman who has a TED talk and everything, but this idea is right up there with using electrotherapy to treat HIV infections. In short, it might work at the single-cell level, but is hopelessly impractical to use on whole people.


Next up: Polio is back in Nigeria.

After more than two years without wild poliovirus in Nigeria, the Government reported today that 2 children have been paralyzed by the disease in the northern Borno state.

A huge push on a very successful worldwide vaccine programme against polio has yielded incredible results. It does/did appear that polio is/was heading the same way as smallpox.


But continuing religious opposition, together with political upheaval in northern Nigeria has meant that the campaign has been failing at local level. These two cases, which have resulted in two children being paralysed for life, are both a setback and a reminder that we’re not quite there yet and that any thoughts of eradication were decidedly, and sadly, premature.

Room for one more? Good. Because it’s really interesting.

It’s a long one, but if you want to try to take some positives away from the West Africa Ebola Outbreak which began 2 years ago this month (yes, I know), then it would be the lessons that we have learned about how to contain future outbreaks. Not just Ebola outbreaks, but any outbreaks. Especially those in the developing world.

These lessons will stand us in better stead when the next challenge arises, says the London School of Hygiene and Tropical Medicine’s Professor David Heymann:

“By using language that they could understand we were able to get communities to work very rapidly to stop transmission,” said Prof Heymann, who feels this was not the initial priority in West Africa. “We’re too biomedical in all our approaches, but we’ve learned that community engagement is the key as we’ve gone along.”

“If communities can be empowered with understanding about how to bury their own people safely and how to prevent themselves getting infected, outbreaks can be stopped. That’s how they’ve been stopped in the past and will be stopped in the future.”

Much of this isn’t rocket science. In fact, none of it it is rocket science. Rocket science isn’t going to help you prevent the spread of a killer virus in West Africa. Getting to the moon, perhaps. But telling scared villagers how they can avoid dying from a seemingly unstoppable disease process? No. This basically comes down to using the correct language (something we’ve talked about before on the blog) and going through the correct channels. In effect, just communicating effectively.

If that’s the rather simple foundation for a more successful response to the next outbreak – whatever that might be – then lives are going to be saved. And that’s obviously a very good thing.

H58 is coming

Well, in fact, H58 is already here. And it’s going to kill you.

Let’s take a step back for just  a moment here though. And let’s consider Ebola, which is something else that kills you a lot. The (probably a little underestimated) figures for the 2014 (but still ongoing) West Africa Ebola epidemic suggest that 11,000 people died. That’s pretty awful. But it pales into some sort of disgraceful insignificance when you compare it with the 200,000 people who die from typhoid each year.

Typhoid is indisputably nasty. That said, it’s different from Ebola in that while it’s much more widespread, the mortality rates are not quite as high. And a lot of that is probably down to the fact that it’s caused by a bacterium (it’s called Salmonella typhi and yes, it’s related to the food poisoning bug that you get from not cooking your chicken enough) and not by a virus. As any fule kno, bacterial diseases can be treated with antibiotics, killing the bugs and making the person remain alive. Good news for typhoid sufferers.

That is, until now.


Because a new strain of Salmonella typhi is here: Salmonella typhi H58. And H58 is resistant to antibiotics like ciprofloxacin and azithromycin – drugs that people use to treat typhoid. According to the Guardian:

An international team of researchers analysed the DNA of nearly 2000 typhoid pathogens from countries across Asia and Africa and found that a single multiple- drug resistant strain had swept through Asia and crossed into Africa over the past 30 years.
Nearly half of the organisms studied belonged to the resistant strain, called H58, which has steadily pushed out older strains that are susceptible to common antibiotics people buy over the counter or take to protect themselves from the disease.

And H58 is rapidly becoming the dominant strain of S.typhi, easily pushing the other, lesser, more antibiotic-susceptible, more treatable, less deadly strains out of the way:

In some regions, H58 is displacing strains that have been established for hundreds of years: “We were all amazed at what we saw. When you see the data, it’s pretty stark. It’s very convincing that it’s becoming the dominant strain,” said Gordon Dougan, a senior researcher at the Sanger Institute near Cambridge.
“This beast can get into a new area and it’s at an advantage, because a lot of competition is wiped out by antibiotics.”

Hear that? When a senior researcher at the Sanger Institute near Cambridge calls it a beast, you know it’s properly dangerous. Senior researchers at the Sanger Institute near Cambridge aren’t employed to throw words like that around willy-nilly. They’re beige and they’re dull and they’re sensible. The accountants auditors of the microbiological world. Using the word “beast” to describe a strain of bacteria is off-the-fricking-scale to a senior researcher at the Sanger Institute near Cambridge. This is obviously serious stuff.

Serious, and urgent:

The global spread of the strain requires “urgent international attention,” the scientists write in the report. “This is killing 200,000 people a year and no one is really noticing,” said Nick Feasey, a co-author on the study at Liverpool Tropical School of Tropical Diseases.

So – a time for action then? I doubt it. I’ve been telling you all for ages that we’re all going to die horrible deaths at the (metaphorical) hands of drug-resistant bacteria, and no-one has done a damn thing about it.

One of the reasons for this continued lack of decisive action against the spread of antibiotic resistance is that it’s an insidious thing; there’s been no one defining event – no instant train smash – to draw attention to it. Sadly, with the destruction of infrastructure in Nepal – where H58 is prevalent – after the recent earthquakes, we might well see a big spike in the number of cases, which may stick it into the global spotlight until the next plane crash, court case or contentious political statement.

All of which are obviously far more important.

UPDATE: Finally, someone is listening

John Snow for the Ebola era

Here’s a very important point:

It’s impossible to treat an epidemic when you know next to nothing about the population it’s ravaging.

Just thought I’d plonk this here for your reading delectation. It’s a good starting point as to how the principles of John Snow and the Broad Street pump are still relevant and how they can be applied to the Ebola outbreak in West Africa, and also how and why that’s not happening.
The piece itself is unremarkable, but the sum of its parts and all that…

It’s an instance where the gloss of digital ubiquity hides our lack of real understanding. Where technological solutionism masks the fact that nothing has been solved.

A lesson for us all in how technological Utopianism isn’t always quite the flawless answer to everything. There’s a lesson for SA’s TB diagnostic progamme in there too, but I’m wholly unwilling to elaborate on that bit.

Thoughts on Ebola screening

Having been to the UK this last week, having traveled (twice, nogal) through the global hub that is Dubai, and with Ebola knocking ISIS from the headlines at the moment, I thought I’d jot down a few thoughts I had while attempting not to contract Ebola or any other virus.

Firstly, that headline thing. Yes. Ebola is the number one headline in the UK news at the moment. Mainly stories around the country’s preparation for any incoming cases and the screening at the airports. Or ‘airport’, anyway. Fly into Manchester and you’re home free – no scans, no questions asked, no nothing. Just a hint for any suicide bioterrorists there.
So yes, number one headline, despite the fact that there are no UK cases. It’s an odd way of allaying fears and avoiding hysteria and it’s cementing my opinion that Ebola is a “superstar disease”. The current outbreak is bad news, certainly, but needs to be put in context – perhaps with some sort of graphic:


The fact that it needs ringing in yellow says a lot. And yes, I realise that the Ebola thing is current and it’s acute, but still. This outbreak has killed thirty times fewer people than even “Fire, heat, and hot substances”. And let me tell you, some of those hot substances can be pretty damn deadly. But joking aside, you’re seventy times more likely to die of malnutrition than Ebola and we don’t seem to be quite as concerned with that. That’s rather sad.

But if the rest of the world is to have a reaction to Ebola and is to try and prevent its spread, then it needs to be a sensible and organised approach so as to be effective, hence my confusion at the screening being solely at Heathrow (and possibly Gatwick and bizarrely, on Eurostar trains). If you’re serious about screening passengers and keeping Ebola out of the UK (and despite the fact that it’s not a particularly effective means of determining who’s carrying the infection), then why not do it at Manchester airport as well?
There’s no point in locking your front door if you’re going to leave all your windows open.

No-one at Manchester batted an eyelid when I flew in from Dubai, even though there are excellent links from there to West Africa. Every bit as good as the ones to Heathrow.
And, with that in mind, I saw nothing – NOTHING – at Dubai about Ebola. And that place is like some terrestrial version of a Star Wars space station – what an extraordinary mix of people and nationalities. If Ebola is to get a foothold anywhere else, then it may well be through Dubai. But there’s no mention of it there at all.
Finally, Cape Town, which (amazingly? reassuringly?) had the best response of the airports I used. And that was merely an announcement asking me to “go and talk to the people at the Health Desk if I’d been to West Africa in the last few weeks”. This self-reporting with a disease which carries a stigma like an STD? It’s not exactly foolproof, is it?

I’m really not sure there is good reason for screening passengers arriving at any airport, although there are some experts who believe that there are other benefits besides the limited chance of detecting anyone carrying the virus:

Prof David Evans, a virologist at the University of Warwick, says that while testing passengers is “unlikely to detect symptomatic cases” as they arrive in this country, “the introduction of inbound passenger testing will both raise awareness and provide information that should ensure that passengers who subsequently develop symptoms can rapidly seek medical advice and, if needed, treatment.” The measures are, therefore, sensible, “primarily because they raise awareness of the disease in travellers and their contacts.”

But it also seems utterly pointless if you’re not going to do it thoroughly.

UPDATE: And, as if by magic…

What a good idea, guys…

Ebola: Headlines vs Facts

I’m not saying that the Ebola situation is in any way “good”, nor am I saying that it is “under control”. But those facts aside, we still need some degree of perspective.
And stuff like this doesn’t help with that approach:

Ebola ‘could become airborne’: United Nations warns of ‘nightmare scenario’ as virus spreads to the US
Exclusive: Anthony Banbury, chief of the UN’s Ebola mission, says there is a chance the deadly virus could mutate to become infectious through the air


And technically, I suppose, he’s correct. In the same way that I “could” win tomorrow’s lottery. It “could” happen, but actually it’s “not going to” happen.
And you only have to read the piece to see how his words have been… ironically… mutated to fit the article’s agenda.

Because then, further down the article, this:

Although experts agree that the risks from Ebola are severe they do not believe the virus could become airborne.
Professor David Heymann CBE, chairman of Public Health England and professor of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine, said no virus transmitted by bodily fluids – as Ebola is – had ever mutated to airborne transmission.

Note the somewhat smaller typeface. And the lack of drama. That’s simply because when everyone is writing about Ebola, you need to make your piece stand out if you want it to be read and:

Experts say there’s ‘no danger’ of Ebola becoming airborne


just doesn’t cut the mustard in terms of attracting readers to your column, your site and its adverts.

Really, you’d expect better of the Telegraph. Although perhaps not of 2Oceansvibe.

UPDATE: Katherine Rushton tweeted her article like this:

Hmm. Business Editor writes Microbiology story.




Speculation that Ebola virus disease might mutate into a form that could easily spread among humans through the air is just that: speculation, unsubstantiated by any evidence.

This kind of speculation is unfounded but understandable as health officials race to catch up with this fast-moving and rapidly evolving outbreak.

“Speculation, unsubstantiated by any evidence.”
Again. Not great for The Telegraph.