London – The symptoms appear suddenly with a headache, high fever, abdominal and joint pain, and vomiting. As the illness progresses, patients can develop large areas of bruising and uncontrolled bleeding. In at least 30 percent of cases, Crimean-Congo viral haemorrhagic fever is fatal.
This month a 38-year-old garage owner from Glasgow, who had been to his brother’s wedding in Afghanistan, became the UK’s first confirmed victim of the tick-borne viral illness when he died at the infectious disease unit at London’s Royal Free Hospital.
It is a disease widespread in domestic and wild animals in Africa and Asia – and one that has jumped the species barrier to infect humans with deadly effect.
The unnamed man’s death was not the only time a foreign virus had recently struck in Britain for the first time.
Last month, a 49-year-old man entered a London hospital with a raging fever, severe cough and difficulty in breathing.
He bore all the hallmarks of the deadly severe acute respiratory syndrome (Sars) virus that killed nearly 1 000 people in 2003, but blood tests quickly showed this terrifyingly virulent infection was not Sars. Nor was it any other virus yet known to medical science.
Worse still, the gasping, sweating patient was rapidly succumbing to kidney failure, a potentially lethal complication that had not been seen before in such a case.
As medical staff quarantined their critically ill patient, fearful questions began to mount. The stricken man had recently come from Qatar in the Middle East. What had he picked up there? Had he already infected others?
Using the latest hi-tech gene-scanning technique, scientists at the Health Protection Agency started to piece together clues from tissue samples taken from the Qatari patient, who was hooked up to a life-support machine.
The results were extraordinary. The virus was from the same family as Sars, but its make-up was completely new. It had come not from humans, but from animals. Its closest known relatives had been found in Asiatic bats.
The investigators also discovered that the virus had already killed someone. Searches of global medical databases revealed the same virus lurking in samples taken from a 60-year-old man who had died in Saudi Arabia in July.
When the agency warned the world of the newly emerging virus last month, it ignited fear among medical experts.
Could this be the next bird flu, or even the next ‘‘Spanish flu’’ – the world’s biggest pandemic, which claimed between 50 million and 100 million lives across the globe from 1918 to 1919?
In all these outbreaks, the virus responsible came from an animal.
The terrifying fact is that viruses that manage to jump to us from animals – called zoonoses – can wreak havoc because of their ability to spread rapidly through the population.
One leading British virologist, Professor John Oxford at Queen Mary Hospital, University of London, warns that we must expect an animal-originated pandemic to hit the world within the next five years, with potentially cataclysmic effects.
Such a contagion, he believes, will be a new strain of super-flu, a highly infectious virus that may originate in Asia or Africa, and be contracted by one person from a wild animal or domestic beast.
By the time the first victim has succumbed to this unknown new illness, they will have spread it by coughs and sneezes to family, friends and all those gathered anxiously around them.
Thanks to our crowded, hyper-connected world, this doomsday virus will already have begun crossing the globe by air, rail, road and sea before even the best brains in medicine have begun to chisel at its genetic secrets.
If this new virus follows the pattern of the pandemic of 1918-1919, it will cruelly reap mass harvests of young and fit people.
They die because of something called a “cytokine storm”, a vast overreaction of their strong and efficient immune systems that is prompted by the virus.
This uncontrolled response burns them with a fever and wracks their bodies with nausea and massive fatigue.
Oxford bases his prediction on historical patterns.
The past century has certainly provided us with many disturbing precedents. For example, the 2003 global outbreak of Sars was transmitted to humans from Asian civet cats in China.
Nowadays, the threat from such zoonoses is far greater than ever, thanks to modern technology and human population growth. Mass transport such as airliners can quickly fan outbreaks of newly emerging zoonoses into deadly global wildfires.
The Sars virus was spread when a Chinese professor of respiratory medicine treating people with the syndrome fell ill when he travelled to Hong Kong, carrying the virus with him.
By February 2003, it had covered the world by hitching easy lifts with airline passengers. Between March and July 2003, some 8 400 probable cases of Sars had been reported in 32 countries.
It is a similar story with H1N1 swine flu, the 2009 influenza pandemic that infected hundreds of millions throughout the world. It is now believed to have originated in herds of pigs in Mexico before infecting humans who boarded flights to myriad destinations.
On top of this, our risk of catching such deadly contagions from wild animals is growing massively thanks to humankind’s encroachment into the world’s jungles and rainforests, where we increasingly come into contact with unknown viral killers that have been incubating in wild creatures for millennia.
This month, an international research team announced it had identified a new African virus that killed two teenagers in the Democratic Republic of the Congo in 2009.
The virus induced acute haemorrhagic fever, which causes catastrophic widespread bleeding from the eyes, ears, nose and mouth, and can kill in days.
A 15-year-old boy and a 13-year-old girl who attended the same school both fell ill suddenly and succumbed rapidly. A week after the girl’s death, a nurse who cared for her developed similar symptoms. He only narrowly survived.
The new microbe is named Bas-Congo virus (BASV), after the province where its three victims lived. It belongs to a family of viruses known as rhabdoviruses, which includes rabies.
A report in the journal PLoS Pathogens says the virus probably originated in local wildlife and was passed to humans through insect bites or some other as-yet unidentified means.
In a new book that should give us all pause for thought, award-winning US natural history writer David Quammen points to a host of animal-derived infections that now claim lives with unprecedented regularity. The trend can only get worse, he warns.
Quammen highlights the Ebola fever virus, which first struck in Zaire in 1976. The virus’s power is terrifying, with fatality rates as high as 90 percent. The latest mass outbreak of the virus, in the Congo last month, is reported to have killed 36 people out of 81 suspected cases.
According to Quammen, Ebola probably originated in bats. The bats then infected African apes, quite probably through the apes coming into contact with bat droppings. The virus then infected local hunters who had eaten the apes as bush meat.
Quammen believes a similar pattern occurred with the HIV virus, which probably originated in a single chimpanzee in Cameroon.
Studies of the virus’s genes suggest it may have first evolved as early as 1908. It was not until the 1960s that it appeared in humans, in big African cities. By the 1980s, it was spreading by airlines to the US. Since then, Aids has killed around 30 million people and infected another 33 million.
There is one mercy with Ebola and HIV. They cannot be transmitted by coughs and sneezes.
Viruses such as Ebola have another limitation – they kill and incapacitate people too quickly, before the virus can cast its deadly tentacles across the world’s population.
But there is one zoonosis that can do all the right (or wrong) things. It is our old adversary, flu. It is easily transmitted through the air, via sneezes and coughs.
Sars can do this, too. But flu has a further advantage. As Quammen points out: “With Sars, symptoms tend to appear in a person before, rather than after, that person becomes highly infectious.
“That allowed many Sars cases to be recognised, hospitalised and placed in isolation before they hit their peak of infectivity. But with influenza and many other diseases, the order is reversed.”
Such reasons lead Oxford, a world authority on epidemics, to warn that a new global pandemic of animal-derived flu is inevitable.
”I think it is inevitable that we will have another big global outbreak of flu,” he says. “We should plan for one emerging in 2017-2018.”
He warns that vigilant surveillance is the only real answer we have. “New flu strains are a day-to-day problem and we have to keep on top of them.”
The professor is worried our politicians are not taking this certainty of mass death seriously.
Such laxity could come at a human cost so unprecedentedly high it would amount to criminal negligence. The race against newly emerging animal-derived diseases is one we have to win every time. A pandemic virus needs to win only once and it could be the end of humankind. – Daily Mail