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April 27th, 2009
11:59 PM ET

The Cosmopolitan Viruses

Program Note: Tune in tonight to hear more from Dr. Nathan Wolfe and the spread of viruses on AC360° at 10 p.m. ET.

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Dr. Nathan Wolfe
Epidemiologist
Global Viral Forecasting Initiative

As someone who studies how pandemics are born and how we may be able to predict and prevent them, I’m, of course, fascinated with the outbreak of Swine Flu. I want to understand its biology. Where it comes from, how it initially took hold, and then managed to spread from person to person, landing in places as distant as Nova Scotia, Brazil, and New Zealand.

But I’m also fascinated at how the public, media and government have responded to it, and what our responses mean for the future of our species. Watching the response to the Swine Flu, it occurs to me that when new outbreaks occur, the media and the public can quickly forget history. SARS and H5N1 (the ‘Bird Flu’) and earlier disease spillovers from animals such as HIV fall quickly out of memory. Somehow Swine Flu seems unique: a frightening threat coming from out of the blue, and one that we need to scramble to address.

The Swine Flu is a threat. We know that flu pandemics have the potential to kill millions. But is it unique? Was it unpredictable? Must we repeat this cycle of complacency, dread, and panic that punctuates our increasingly frequent global outbreaks from SARS to H5N1 to Swine Flu…

We live in an increasingly interconnected world. People from Mexico can get to New Zealand in a day. People from the rural Amazon or Congo can be in Paris or Tokyo in two. And we are in contact with the animals around us that seed these pandemics. That means that what we’re experiencing with Swine Flu will happen again. And again. And again. And again.

Global disease control today is like Cardiology was in the 1950s. Just waiting for the heart attack. With no sense of the reasons pandemics occur or the many potential ways to monitor for them, detect them early, and ultimately prevent them.

Pandemics are hard to predict. But so are hurricanes and tsunamis and earthquakes. Yet we would never question the logic of working to forecast these threats. And arguably the threats represented by viruses are potentially orders of magnitude more devastating. Imagine a hurricane that could strike globally. That could kill millions. That could last for years. Would we not want to forecast that hurricane? Would we accept those that said hurricanes were simply ‘too hard to predict’? I don’t think so.

And Swine Flu is by no means an anomaly. We know that Swine Flu, like the vast majority of new outbreaks come from animals. We can monitor those animals and the humans that come into contact with them so we can catch these viruses early, before they infect major cities, continents and the world.

That is exactly what we do at the Global Viral Forecasting Initiative, in sites throughout the world. And we are not alone. We are among a growing group of partners including WHO (e.g. their Global Outbreak Alert and Response Network), the CDC (e.g. their Global Disease Detection Program), USAID (e.g. their Avian and Pandemic Influenza and Zoonotic Disease Program), and DoD (e.g. their Global Emerging Infections Surveillance and Response System), conservation organizations like The Wildlife Conservation Society and The Wildlife Trust and foundations such as Google.org and the Skoll Urgent Threats Fund, who are working to create a predictive science of pandemics along with the monitoring systems to head them off early before they spread globally.

We should watch the Swine Flu carefully, but we should see it for what it is: one of many pandemics – past and future – that will continue to plague us until we figure out how to predict and prevent them.

soundoff (118 Responses)
  1. Corey B.

    Please explain why the swine flu is mild in the US and there are many deaths in Mexico. It is the same strain. Could it be that Americans have a tendency to get vacinations every year?

    April 28, 2009 at 8:55 am |
  2. Shrina Padayachy

    I understand that the outbreak of swine flu may have originated in Mexico (nothing posted online can attest or deny this thus far); there is however a comment posted on one of the sites that suggest that the World Health Orgnisation have been waiting for another 'big' influenza outbreak. If this is true, why where there no measures put in place in first world countries, where it seems that this virus has rampantly attacked?

    April 28, 2009 at 8:19 am |
  3. suelin

    Mass transport enables a person to move halfway across a country or the world in shortest time, and so too go whatever microbes are attached to their person and in their person.

    Solutions?
    Periodic aerosol sanitizing of the mass transport units
    Public education on personal hygiene, especially washing of hands, and common courtesy (coughing covering the mouth, not spitting in public, etc)
    Public education on healthy lifestyle to increase resistance to microbial influence
    Global policy on managing global health crises
    Public education on managing global health issues on a community level
    Public education on getting correct information from trusted sources to reduce levels of public hysteria and subsequent opportunistic scam artists
    In much the same way that IT persons track and short circuit computer viruses, and issue global advisories, there should be some way of periodically issuing global advisories on health crises and methods to reduce same on a community level.

    April 28, 2009 at 7:51 am |
  4. Andrew Baranyi

    Panic is a powerful tool that the media is so very good at creating, and in this case, hopes of containing an alien sickness surrounded by tense confusion and the unknowing of where things will go from here. It's a freak show, which in some cases, is the most powerful weapon of awareness.

    April 28, 2009 at 6:50 am |
  5. JJason

    What about people who have had Guillian Barre. If immunization against this flu were available, this group of people would not be able to receive it?

    April 28, 2009 at 6:09 am |
  6. Julie San Diego, CA

    Yolanda, don't worry because you live near the border. We have the busiest border crossing in the world down at San Ysidro (San Diego) and I've only heard of one case in our county of approximately 2 million people.

    I like Will's advice: wash your hands and eat your vegetables. Also think about taking a multivitamin, getting some extra sleep, avoiding stressful situations, and mentally programming yourself (I AM SAFE, I WILL NOT GET SICK). The human body has an amazing ability to fight off the most aggressive diseases if given the proper resources to do so.

    We're blessed down here in San Diego, lots of sunshine and fresh fruits and vegetables all year long, plenty of opportunity to exercise in the fresh air and soak up the Vitamin D you get when you expose your skin to sunlight. If people lead healthy lifestyles, there's less chance for a pandemic to take hold.

    April 28, 2009 at 4:01 am |
  7. Karen Guthrie

    So I'm doing chemo. Do I need to really, really take precautions? Especially when my white count's low? Do I have to stay in doors or can I go out and just practice good hygiene like other people (hand washing, keeping hands away from face, etc.)?

    April 28, 2009 at 2:55 am |
  8. Todd

    Two questions... 1) Does anybody know what the incubation period is before the physical symptoms? 2) Everybody talks about Tamiflu, but I'm wondering, If there were an outbreak in the US, would there be enough particle masks to go around to help the spread?

    April 28, 2009 at 1:49 am |
  9. Tom Rogers

    Dr. Wolfe,
    my son has mild asthma. He attends State Univ NY Maritime College which is less than 5 miles away from St Francis Prep, the school with numerous infected students. He is scheduled to go on a school ship for 6 weeks to European ports next month. I'm concerned about him living in close quarters and being a week or more away from hospital care if needed. Since he is young and presumably with a strong immune system, is there any added risk for him due to his mild asthma? Does medication exist that can mitigate a massive immune response that could trigger an asthma attack?
    Tom Rogers
    New York City

    April 28, 2009 at 1:49 am |
  10. Kirsten

    I was curious if a regular flu shot has any positive effect on the swine flu? THANKS

    April 28, 2009 at 1:48 am |
  11. Mark

    If this turns into a pandemic, how would we see it develop? Would we see a hundred percent increase in cases a day or many times that. What is the worst case projection for it to sweep across the country and how long would that take?

    April 28, 2009 at 1:44 am |
  12. Stuart Ungar

    What is the outcome of the autopsies of the people who have died from swine flu in Mexico. What killed them? No one has commented on this aspect.

    April 28, 2009 at 1:44 am |
  13. Silvino

    We had a trip scheduled to Playa del. Carmen this weekend but we cancelled our trip, because this swine flu looks very serious.

    April 28, 2009 at 1:28 am |
  14. Dr. Jane Velez

    I have a question not previously answered:

    I had a serious case the Hong Kong swine flu in 1968. Is it possible that I might have an immumity to this swine fluu, or could I get a milder case if I did get it?

    No one has answered this.

    April 28, 2009 at 12:02 am |
  15. Diane

    Is testing being done on the pig populations in/around Mexico City to identify and isolate the potential source of the virus?

    Also, we get many of our fruits and veggies from Mexico...should we be worried about the swine flu lurking on these?

    April 27, 2009 at 11:52 pm |
  16. Sharon

    Can humans get Bird Flu or Swine Flu from cleaning bird bath or bird feeders?

    April 27, 2009 at 11:50 pm |
  17. Marge

    I am concerned. I have trips scheduled to Mexico. Oct., 10 days in Cancun and in Sept a cruise making 5 stops in Mexico. Are airlines and cruise lines going to respect cancellations because of the Swine Flu?

    April 27, 2009 at 11:45 pm |
  18. Teresa Wells Manahan

    Could vegetarism eliminate the animal borne pandemicess?

    April 27, 2009 at 11:43 pm |
  19. suzanne

    i live in mexico (i am an american citizen), i live about 6 hours from mexcio city (ajijic is located about an hour from guadalajara). i have 2 little ones – 3 and 5 years old, i am 39. the preschool that my kids attend is closed until the 6th of may. i heard (on CNN) that there are about 1 million doses of tamiflu available in mexico city – in a city of 20 million. what about us outside of the US? i understand that humans have no immunity to this new virus. my question is this:
    what can i do to protect myself and my family besides washing hands, staying at home when feeling ill, nd avoiding hand contact?
    why doen´t anyone tell us to take large dosis of vitamin c? or other anti-virals like garlic, grapefruit seed extract, collidial silver? are they effective? how effective are the masks that everyone is wearing?
    thank you for taking the time to read this...
    suzanne – ajijic, jalisco, mexico

    April 27, 2009 at 11:38 pm |
  20. tammie t

    p.s we life in tennessee and he is a pastor of a small church, we have been around no one that has been to mexico but i do work in the cardiac cath lab at our area hospital which covers a large patient population.

    April 27, 2009 at 11:37 pm |
  21. tammie t

    dr. wolfe my husband has been sick for 11 days on mon apr. 20 his white blood cell count was 2.0 on thurs apr 23 it was 23 he has been tested for several diff. viruses ebstein barr, cmv, parvo he got sick on april 17th, and is still sick he has been in the bed since april 17th except to go to the doctor's office , this is not like him at all, he does have a comprimised immune system just because of medications he is on for chronic pain, also he had 5 monocyctes on mon and none on thurs. could this be the swine flu , he had gotten sick before we heard of this flu thank you

    April 27, 2009 at 11:36 pm |
  22. Trish

    Just read the Swine Flu time-line and that would explain a lot of what happened in 1976 and why we don't currently have a vaccine. Thank you!

    April 27, 2009 at 11:36 pm |
  23. Trish

    I am slightly confused about the Swine Flu panic. I seem to recall I had a Swine Flu shot back in the fall of 1976. Would this be a different strain from then and thus be the reason for not having a vaccine?

    April 27, 2009 at 11:29 pm |
  24. Bev, Utah

    My daughter and 3 grandkids are traveling to San Diego area in one week. They will be going to Sea World. I am very concerned about all the Mexican people who come over the border into that area. Should they postpone their trip??

    April 27, 2009 at 11:22 pm |
  25. Wanda

    IS anyone checking in the lab to see if this Swine flu is destroyed by clorox? I live in N. Alabama and I think we (5 of us from 7- 74 years of age have just gotten over it. Always when someone in my family has the flu I can keep it from spreading by wiping everything with clorox. + the other normal precautions We were not tested for having swine flu but I am in my 60's and have never seen a virus like the one we just had.

    April 27, 2009 at 11:12 pm |
  26. Will in California

    I keep hearing from people who returned from Mexico for vacation and either not even hearing anything from Mexican officials about the swine flu or how these Americans think that the news about the virus is being overblown. I believe that the Mexican tourism board with the help of the Mexicoan government is trying to cloak the dangers about the virus in some regions by intentionally refusing to notify tourists about the virus, because worried tourists might leave Mexico and that can affect the tourism industry there. Are they putting tourism profits ahead of tourist safety?

    April 27, 2009 at 11:06 pm |
  27. Rich

    " Must we repeat this cycle of complacency, dread, and panic ..."

    Yes, of course, dont be daft! We are still human, after all.

    April 27, 2009 at 11:03 pm |
  28. Dallas

    Dr. Wolfe,
    What's the concern of someone acquiring swine flu while infected with the annual human flu?

    April 27, 2009 at 10:55 pm |
  29. Lavita

    Has the source of this virus been identified, i.e. the specific pigs from which this virus originated? Have the pigs been captured?

    April 27, 2009 at 10:54 pm |
  30. Karine Mkrtchyan

    Question: How long does it normally take for the symptoms to appear once a person has come into contact with the virus or an individual with the virus? Please advise...

    April 27, 2009 at 10:45 pm |
  31. Laura

    Will the swine flu be a part of the vaccine offered this fall?

    April 27, 2009 at 10:44 pm |
  32. Charlie

    Really there are only so few confirmed cases of Swine Flu in
    the United Sates??!! I know someone in East Tennessee
    who without a doubt has Swine Flu. She just returned from
    New York City this weekend. Has all the symptoms discussed.
    Stated this is the "sickest I have ever been," The regional health dept
    was notified and did not want a swab. So how many cases
    have been ignored?? Labeled as "mild." Let me add that
    this female who is in her 50's has been very ill and I would
    not say this is a mild case. I would think this illness if
    contracted by an elderly, very young, or immunosuppressed
    could cause death. As far as East Tennessee is concerned we
    have no cases......."no official confirmed cases," anyway. Why
    pretend it is not here?? I would guess this is already Pandemic
    and thousands are sick now and spreading the virus. Think
    about it...

    April 27, 2009 at 10:43 pm |
  33. Andy

    Laura, I do not believe that other animals can transmit this viral disease since most of these viruses tend to attach themselves to only certain host cells. However, as this virus is being transmitted between humans, it is also accumulating mutations in its genetic material. Consequently, this makes it harder for us to develop a vaccination to this virus. As Dr. Wolfe had said, we have to be two steps ahead of these viruses if we have any chance of avoiding future pandemics.

    April 27, 2009 at 10:40 pm |
  34. Marca - oklahoma

    Ii can't help but wander about the fruits and vegetables such as tomatoes, spinach, lettuce etc. that are imported from Mexico on a daily basis. Since the virus can live on keyboards, phones , etc. could someone tell me what the shelf life of the virus is?

    April 27, 2009 at 10:40 pm |
  35. Vivian

    We are hearing that the swine flu is a combination of different strains of flu viruses. That being said, isn't there a possibility that due to the fact that so many Americans are encouraged to get a "flu shot" every year, that this year, because they received the flu shot, that it has lessened the effect of the swine flu here in the US?.

    April 27, 2009 at 10:39 pm |
  36. Don Miklas

    Dr. Wolfe,

    I had a flu shot in November, 2008. Is it at all effective against the Swine Flu?

    Best regards,
    Don Miklas

    April 27, 2009 at 10:38 pm |
  37. Beverley Rady

    Dear Dr. Wolfe,
    If diseases can be transmitted from pigs and birds to people, are there specific conditions that are conducive to disease in birds and pigs? how can these conditions be prevented?
    thank you,
    Beverley Rady
    Toronto

    April 27, 2009 at 10:38 pm |
  38. Dawn

    What is exactly being studied in order to determine a whether a virus have been or can be divised in a short period of time? In other words, are those who are ill or those who have died, been tested thorougly?

    April 27, 2009 at 10:32 pm |
  39. Ernesto

    Knowing that this new strain is a triple reassortant (avian, swine and human). Who/which do you think served as the mixing vessel for this new strain to reassort? a pig or human.

    April 27, 2009 at 10:29 pm |
  40. Dawn

    Dr. You may have answered this question but I will pose it again. What exactly are the symptons? I have heard washing hands daily, using a hankerchief, etc but is that enough?

    April 27, 2009 at 10:29 pm |
  41. Beverly Carothers

    Can I depend on antibacterial hand sanitizer when I am not at home to help prevent the swine flu outbreak?

    April 27, 2009 at 10:27 pm |
  42. Linda

    I was part of a group of 8 that traveled through Mexico City airport on on April 1st. Due to flight delays our group spent about 10-12 hours in the airport and ate a meal in an airport restaurant. We continued on to Acapulco and boarded a cruise ship the next day that eventually went through the Panama Canal and ended in Ft. Lauderdale Fl. on April12th. How long in the incubation period for the Swine flu? Is it necessary to see a physician?

    April 27, 2009 at 10:25 pm |
  43. Sharon S

    HELLO OBAMA!!
    Do I hear Karma calling????? Well I guess the REAL GOD got sick of the Antichrist trying to rule his world!!!

    Or maybe us Christians have been praying way too hard!!??

    Whatever works to take Obama and his House of CROOKS down works for me!!!

    GOD BLESS AMERICA!!!

    April 27, 2009 at 10:19 pm |
  44. jeannette

    I work for an airline at the airport with direct contact with passengers, from dignitaries to daily customers that travel back and forth from MEXICO. Is there anything I should do for my safety and my co-workers?

    April 27, 2009 at 10:17 pm |
  45. kristen

    Great blog!! Wow, lots of different organizations/partners working together to create a predictive science of pandemics. Wonder how all these organizations work together; is there one single database all use? Does info flow easily between each organization? It seems impossible to at time to get different organizations to work together.

    April 27, 2009 at 9:30 pm |
  46. CONY FLORES

    La nouvelle est grave, mais le pire est le peu de conscience des autorités, puisque les masques qui sont distribués ne protègent pas de rien.
    Dans une situation comme cela les masques doivent être N95. Tout étudiant de médecine, infirmière ou médecin, peut confirmer ce que je vous informe. Je suis rien qu'une techniciene de pharmacie.

    April 27, 2009 at 9:27 pm |
  47. Rose-Mari Gibson

    How long from the time of infection to time of showing symptoms and then how long is the contamination period. Also, how long does this virius live on items like money, debit cards, clothes. I work in drycleaning and it seems as soon as people come home from holidays the first thing they do is drop of their laundry, is this a problem?

    April 27, 2009 at 9:00 pm |
  48. Anna S

    Check out if AEROCLAVE would help.

    April 27, 2009 at 8:56 pm |
  49. Ana Garcia

    Hi,

    I am a Mexican-Canadian. I am a Canadian Citizen and have lived in Canada for over 10 years now. I believe that people in Mexico are unfortunatgely being affected in a deadly way by the swine flu given the fact that Mexicans use antibiotics quite often. In Mexico you can simply walk to a pharmacy and buy antibiotics without a doctor prescription, as a result every time you get a bad cold you take antibiotics. I could almost say that in average a Mexican may take antibiotics at least 6 times a year, every year. I used to do the same when I was living in Mexico. Now as a Canadian I probably only had antibiotics 5 times in the last 10 years. It is commonly known that an excesive use of antibiotics may cause a body inmunity to the same antibiotics... the more you take them, the least effective they are. If an average 30 year old Mexican has taken antibiotics at least over 100 times in 30 years it is possible that the average antibiotic will not be as effective in their body. As a result those being treated for swine flu in Mexico may be inmmune to the antibiotics and consequently the results are fatal. This is only my personal hypothesis and perhaps only one factor as to why the swine flu is deadly in Mexico.

    April 27, 2009 at 8:50 pm |
  50. Kelly

    We now have a probable case of the swine flu in Livingston County Michigan. Preliminary tests are positive, we are just waiting for confirmation from the CDC. The victim, a 34 year old woman vactioned near the Mexican border in San Antonio Texas. It is being widely reported that she visited a petting zoo with pigs. Can we contract this disease from visiting a petting zoo?

    I also live in a farming community that has a large population of people from Mexico, approx 20%. I have many friends who travel frequently back and forth to Mexico. I am wondering if small towns in America are prepared like New York to watch for and handle an outbreak, especially communities like mine that seem to be at a high risk because of frequent travel to Mexico?

    April 27, 2009 at 8:46 pm |
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