jueves, septiembre 15, 2011

The Real Threat of "Contagion"

By W. Ian Lipkin, a professor of epidemiology and a professor of neurology and pathology at Columbia University (THE NEW YORK TIMES, 12/09/11):

I admit I was wary when I was approached, late in 2008, about working on a movie with the director Steven Soderbergh about a flulike pandemic. It seemed that every few years a filmmaker imagined a world in which a virus transformed humans into flesh-eating zombies, or scientists discovered and delivered the cure for a lethal infectious disease in an impossibly short period of time.

Moviegoers might find fantasies like these entertaining, but for a microbe hunter like me, who spends his days trying to identify the viruses that cause dangerous diseases, the truth about the potential of global outbreaks is gripping enough.

Then I discovered that Mr. Soderbergh and the screenwriter on the project, Scott Z. Burns, agreed with me. They were determined to make a movie — “Contagion,” which opened this weekend — that didn’t distort reality but did convey the risks that we all face from emerging infectious diseases.

Those risks are very real — and are increasing drastically. More than three-quarters of all emerging infectious diseases originate when microbes jump from wildlife to humans. Our vulnerability to such diseases has been heightened by the growth in international travel and the globalization of food production. In addition, deforestation and urbanization continue to displace wildlife, increasing the probability that wild creatures will come in contact with domesticated animals and humans.

When I was a kid, the launching of Sputnik made us aware that the United States was falling behind the Soviet Union in the race for space. Now all of us are in a battle that is potentially devastating, only it is not against another country, but against microbes. Could a movie like “Contagion” be an effective vehicle for sounding the alarm?

In the hope that it would, I signed on as a paid technical consultant on the film. The first order of business was a casting call for the virus itself. Together with my team at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health, I devised the imaginary virus that wreaks havoc in the film. We used as our inspiration the Nipah virus, which in Malaysia in the late 1990s jumped from bats to pigs to humans, causing respiratory disease and encephalitis and resulting in more than 100 deaths before it was contained by quarantine.

My team built a 3-D model of our virus and then worked out how it would spread and evolve, how it would be discovered, how the public health and medical communities and governments would respond regionally and internationally, how vaccines would be developed and distributed. In the film, it takes the lives of millions of people.

Is this fiction? Yes. Is it real? Absolutely. During the SARS outbreak of 2003, the first pandemic of the 21st century, I flew to Beijing at the invitation of the Chinese government to help address the situation there. My memories of deserted streets, food and supply shortages, and political instability are reflected in scenes in “Contagion.” I hope the public and our lawmakers will see the movie as a cautionary tale. Pandemics have happened before. And they will happen again.

What can we do to prepare ourselves? A presidential directive in 2007 led to the establishment of the National Biosurveillance Advisory Subcommittee, at the Centers for Disease Control and Prevention, to assess our biosurveillance capabilities and make recommendations for improving detection, prevention and management of biohazards. The subcommittee, which includes representatives from federal, state and local agencies, academia and industry (and on which I serve as co-chairman), has issued reports that provide a road map for steps we have to take to protect our future.

First, we need to recognize that our public health system is underfinanced and overwhelmed. We must invest in sensitive, inexpensive diagnostic tests and better ways of manufacturing and distributing drugs and vaccines. Although new technology now allows us to design many vaccines in days, manufacturing strategies for influenza vaccines have not changed in decades. Some experts will say that the time frame within which “Contagion” introduces the film’s MEV-1 vaccine is unrealistically short; however, it need not be so. We can and must reduce the several months required to create and test a vaccine before beginning large-scale production and distribution.

Second, more and better coordination is needed among many local, federal and international agencies. Joint effort is required to monitor human, animal and environmental health, optimize electronic health records, mine nontraditional data sources like the Internet for early signs of outbreaks and invest in a state-of-the-art work force.

“Contagion” makes the case that scientists and public health professionals who put themselves on the line to fight infectious diseases are heroes. I hope that, like Sputnik, it will inspire young people to pursue these careers and help the rest of the country understand the importance of these efforts. It is what the world urgently needs.

Fuente: Bitácora Almendrón. Tribuna Libre © Miguel Moliné Escalona

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