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Wednesday, Nov 25, 2009
Avian flu is a big news story now, and there's been a lot of reporting on it, but still little context. Your approach to thinking about the deep ecology of disease is unique. You describe the social conditions that provide tinder for a pandemic spark: the livestock revolution, the agro-industrial poultry production and so on. How is the stage set for a potential pandemic?
I'll start with an anecdote. A few years ago I took my son to East Greenland. The East Greenlanders were the last population in the Northern Hemisphere to meet Europeans. In fact, two Danish naval lieutenants who finally managed to get up the treacherous coast of East Greenland were really expecting to meet Vikings, not Inuit. This was at a time when the germ theory of disease already existed in embryonic form, thanks to Koch and Pasteur. And so the East Greenlanders were intensely studied. At point of contact, they were a lean people, eating 98-99 percent seal meat. They had no infectious disease apart from the cold. Their health condition was probably the primordial condition of humans in the 90 percent of our history when we were hunter-gatherers. Then, there were no large concentrations of human beings -- or, more importantly, large enough concentrations of human beings living side by side with large enough concentrations of animals to allow animal viruses or bacteria to jump to humans and assume a chronic or epidemic form.
It was as if the Danish scientists in the 1890s studying East Greenlanders looked back through 10,000 years of human history, before the era infectious diseases -- because most infectious diseases came through the domestication of mammals and birds. That kind of disease is a product of dense populations or urbanization or large-scale agricultural society.
That's what creates "disease transitions"?
"The Monster at Our Door: The Global Threat of Avian Flu"
By Mike Davis
New Press
192 pages
Nonfiction
Yes. It seems that diseases have emerged in fairly abrupt fashion, in what historians of disease call disease transitions. When the Mongols created their wonderful Eurasian world empire and made commerce between the Yellow Sea and the Atlantic possible, they also created a pathway for diseases like the Black Death to reach Europe. Every major step in the biological unification of the human race brings a massacre of populations. The European arrival in the New World led to the deaths of 90 percent of the population there. Those were disease transitions. And there's broad agreement amongst historians of disease that we're living through a fourth disease transition.
Resulting from economic and social globalization.
Fifteen years ago, an anthology of infectious disease studies was published warning that globalization would bring back old diseases in more virulent forms and lead to the emergence of novel, new diseases. There are various reasons: changing barriers between human and wild animal populations, integrated commerce and the absence of a counterpart investment in global public health. A few years later, Laurie Garrett wrote a Pulitzer Prize-winning book, "The Coming Plague," much to the same effect.
Why is China the geographic origin of these coming plagues?
In the past, it was believed that almost all influenza originates in South China, where there's this highly successful, extraordinarily productive agriculture that mixes domestic birds with pigs and fish and human beings. It's an ideal crucible for bird diseases passing to mammals and ultimately to humans.
A widening crucible, as China expands, urbanizes, industrializes its agriculture --
A little footnote here: Since the 1980s, 200 million people have left the Chinese countryside for Chinese cities. In less than a decade, China has added more people to its cities than did all of Europe in the 19th century, the so-called age of industrial revolution and city building. These people in the cities are demanding more protein, and that demand is being met with chicken. Chicken is now the second major protein after pork, which it will soon replace -- if Avian flu doesn't scare everybody off chicken, that is.
This has created unprecedented concentrations of poultry. In Southeast Asia, a lot of the chicken is manufactured by a huge company based in Thailand called CP, which has created an enormous, multinational factory-farming poultry operation. CP, incidentally, was involved in covering up the outbreak of avian flu in Thailand, and it even shipped sick chickens to Europe for sale. So you have these factors: an integrated, industrialized system of poultry production that looks more like the continuous flow of an oil plant than anything looking like animal husbandry; the fantastic rise in demand for animal protein; the increasing concentrations of people in larger and larger cities, many of them poor. Across Southeast Asia, the huge poultry farms sit side by side with small poultry farms, wild birds and human populations.
It seems like these factors clear a wide open path for new disease. Massive industrialized poultry provides a medium for the flu to move from a rare disease among wild migrating birds to the chronic, recurring bird epidemic that it has become. Since the disease mutates so adeptly, it then jumped species. And then it's a matter of time before a few more mutations or a combination with human influenza makes it communicative between people.
It is an unprecedented phenomenon. This is happening not only in Asia. Two years ago, a different strain of avian flu jumped to people in Holland, killing a veterinarian with very similar symptoms as those in Southeast Asia. Last year, the same thing happened in British Columbia. People got sick but nobody died. What's happening, essentially, is that we have changed the ecology of influenza. We provide food for its survival and evolution. Each time it moves into a new niche, H5N1 jumps another species barrier that was believed to be insuperable. Cats didn't get influenza. They do now: This thing killed most of the tigers in the Bangkok zoo. And every time it moves geographically or crosses species, it diversifies the opportunities to change itself into a form that would spread in the same way ordinary flu does.
And unlike SARS, which caused a huge world scare in 2003, avian flu would be very difficult to quarantine. Because a person with SARS is contagious while also symptomatic, whereas with the flu, you're contagious before you actually get sick.
And this means that flu can, because it spreads easily as a respiratory infection, avoid almost any barrier put in its path. It's already on the move. Avian flu is in Russia, and arriving at the gates of Europe. More disturbing, the disease has almost certainly migrated with infected wild birds to the great lakes of East Africa. There, it essentially goes off the radar screen because there is no surveillance system. Countries like Ethiopia won't even discuss the issue with the World Health Organization. Countries like Uganda and Tanzania would love to be able to monitor avian flu, but they don't have the means to do it whatsoever. So right now, this disease with its vast potential to become the second great plague of globalization after AIDS/HIV just submerged, and when it reappears, it may be too late.
