“For every action, there’s an equal and opposite reaction.” We’ve heard that one a million times. If a butterfly flaps its wings, it displaces a small volume of air. Sure, this Newtonian law holds true for classical physics. But does it extend to virology? If the activation of a single G-protein can amplify downstream second messengers by the thousand-fold, our understanding of microbiology indicates that the answer is no. Sci-fi novels and films also tell us otherwise, as does the potential for mass biological warfare. It takes just one isolated act to make the dominoes fall. But human beings only begrudgingly form single-file lines. Unpredictability makes the acquisition of an infectious disease a horrifying prospect, a psychological horror-thriller that plays out in real-time.
The West was never supposed to host the likes of Ebola or AIDS. These exotic invaders are so unlike cancer cells, disgruntled sailors aboard our own ship who have decided to mutiny. Rather, they are like ruthless pirates from a mythological land. Only the unthinkable entropy of the modern world could bring us together. Let’s examine the natural reservoir of these viruses. Researchers suspect that Ebola festers among fruit bats near the eponymous river. For them, it carries no ill effects. And before HIV, chimpanzees and other monkeys have long carried its cognate, the simian immunodeficiency virus (SIV). These are diseases that should have remained endemic to non-human African mammals. How did they become insidious global juggernauts? Someone is to blame, and it’s not necessarily needle-sharers or ultra-promiscuous gay men. They’re just the second messengers, and the bullets they’ve taken, as it were, remind us that no matter how long ago our phylogenies diverged or how unintelligible our respective languages are, we share a common genetic code.
There are two culprits here, and one of them is intangible. That would be the cavalry – globalization and modern transportation. You can travel from Liberia to the Statue of Liberty in 24 hours, well before you become queasy from that roast chimp buffet. Industrialization ensured that when the 2011 Fukushima disaster hit, the literal ripple effect carried nuclear waste all the way into San Francisco Bay. Those types of events will continue to happen every once in a while, and we accept that. On the other hand, we have the foot soldiers. These are the bushmeat poachers and peddlers in sub-Saharan Africa. Do they sell out of malice or ignorance? Sustenance or greed? The motivations of human beings are complicated, and that answer probably depends on who you ask and their propensity for sweeping generalizations. We do know that civilization was founded on agriculture and the domestication of livestock. There is a reason why we don’t eat wild animals. We raise cattle and chickens and pigs in controlled environments. From conception to slaughter, we make sure they are properly fed, and most importantly, are not carrying disease. Fortunately, the developed world has become so specialized that most of us never have to think about this. We entrust that thankless job to others. It’s easy to go to the supermarket and take it all for granted, but if you think about the rarity of foodborne illnesses in daily life here, or massive recalls on items when there’s a breakout, you appreciate all the work that goes on behind the scenes. But in Africa, domesticated livestock is a luxury. Isolated villages need to get their protein intake from somewhere. This factor, combined with longstanding cultural mores, makes bushmeat a legitimate option. Bushmeat markets are ubiquitous across Africa and Asia. An observer in the Congo will find that smoked monkeys, bats, and snakes are more readily available than a nice cut of steroid-free chicken breast or beef. Each species of wild animal may have a prototypical parasite. For example, the African rock python, one of the largest snakes in the world, almost universally harbors a type of worm called Armillifer armillatus. Still, a street vendor will gladly sell you one. From what I’ve gathered, the most recent Ebola epidemic has served to educate village communities on the dangers of bushmeat, but consumption isn’t ever going to approach zero, especially in the face of commercial depletion of safer foods, such as excess fishing off the Gold Coast.
I watched several documentaries on infectious diseases. These included three antiquated NOVA specials: “Typhoid Mary: The Most Dangerous Woman in America,” “Ebola: The Plague Fighters,” and “Surviving AIDS.” I watched the Brad Pitt-narrated “Bird Flu: How Safe Are We?” And finally, I watched watched “The Age of AIDS.” I thought this documentary was well-done and much more relevant than the aforementioned, offering more lucid insight into the cultural context than NOVA managed to do. Of course, it may be unfair to compare the two documentaries. “Surviving AIDS” is more of a case study, but it still felt like an unfinished product to me. These types of science ed. videos have gotten much better over the years, a result of better technology/graphic design, more polished production, and outsourcing to the Web. I actually wondered if NOVA managed to survive the VHS era, and a quick look confirmed that they are still around. However, I got the impression that the company is not cited as much as its rivals. According to one librarian, NOVA is a “bottom-tier” science publisher.
Poor Typhoid Mary. What an unfortunate epithet. Perhaps the worst of all time. Vlad the Impaler? Ivan the Terrible? Nope, she touched the cake, so she’s taking it. I initially felt bad for her. Her story is almost Kafkaesque in its paranoid absurdity. She was just a simple cook trying to survive in a foreign country. Yes, her employers are dropping dead, but she wasn’t too concerned. That happened to everyone back then. Typhoid and other tenement diseases were thought to be the part and parcel of the miasma and crowded squalor of urban life. One day she suddenly finds herself shadowed by mysterious bureaucrats who want to punish her. They never go away. For the rest of her life, she’s spied on, hunted for, and imprisoned. Was Mary dumb or desperate? Probably both, with a dash of personality disorder. She had some nerve resuming the role of cook at a hospital after years on the lam. Like an unremorseful serial killer, she posed a huge danger to society and deserved to be quarantined. I’m used to seeing Anthony Bourdain with gray hair, but I still enjoyed his commentary. That was an unexpected surprise. As for the documentary itself, I don’t quite get it. Were they trying to turn this sad story into a comedy? The re-enactments, which included “Mary Mallon” and “George Soper” testimonials directly to the camera, were certainly laughable. I felt like I was watching “The Office.” This film defies categorization. Was it a documentary or a mockumentary? I’ll be pondering that question for a long time. The legacy of Mary Mallon lives on. Just look at the signs in restaurant bathrooms demanding all employees wash their hands. In New York City, all eateries must prominently display a letter grade based on their level of cleanliness. For all her faults, we must spare some sympathy for Mary. She would not be as misunderstood today; in 2013 Stanford scientists finally uncovered the genetic blueprint for asymptomatic Typhoid carriers.
The next stop is the village of Kikwit in Zaire. There is no running water, no electricity, and minimal literacy. It is not an ideal locale if you’re looking for a medical miracle. We see some incredible footage, from the devastating onslaught of the virus on the human body to the extreme safety precautions taken by handlers of the deceased. I marveled at the bravery displayed by hospital personnel and undertakers, where the smallest slip-up could lead to the exchange of deadly bodily fluids. Their rubber gloves and sandals are a far cry away from the current hazmat suit protocol. We learn about the first outbreak of Ebola in 1976 and how in 1989 the virus infected a bunch of monkeys in the United States. I enjoyed the snippets of conversation from Dr. William Close, the preeminent Ebola expert with the voice of a Shakespearean actor. Who knew that Glenn Close’s father was a famous tropical surgeon? I was in Amsterdam a few years ago and stumbled upon the renowned Tropenmuseum, which is loaded with exhibits and life-sized dioramas from the colonial foray into Africa. The museum was particularly memorable because it had not been updated for the digital age. I hope it remains tech-free and slightly dusty. The Ebola documentary was interesting, but it left me wanting more. I would welcome a Part II, especially when you consider the most recent outbreak, which was headline news throughout the first half of this decade. There is now a vaccine for Ebola, rVSV-ZEBOV.
The final NOVA documentary highlighted the story of Bob Massie, a “long-term non-progressor” and a potential Rosetta Stone for AIDS researchers. Although he has been HIV positive for years, his unique immune system enables an asymptomatic existence. In this regard, he has something of a parallel in Mary Mallon. Massie lives a relatively normal life. He has a wife and two kids. He even plays “Ode to Joy” on the banjo. Incredibly, when they assayed his viral load, his wells were empty compared to the indicative yellow coloring of his compatriots. “Surviving AIDS” is rather limited in scope and struggles in the exposition of its own subjects. Bob Massie is presented as just some ordinary guy, with little mention of his personal history. Did they mention that he was born with hemophilia? I looked him up afterward. He holds degrees from Harvard, Princeton, and Yale. He’s running for governor of Massachusetts this year. We are also introduced to Steve Chrone, who avoided catching the virus from his infected partner. Besides that, almost nothing is mentioned regarding the role of gay men in spreading HIV, in contrast to the documentary we watched in class that discussed how it was originally termed Gay-Related Immune Deficiency (GRID). Crone lacked the CCR5 receptor, the gullible gatekeeper normally fooled by HIV’s Trojan horse. Dr. David Ho, the famed HIV/AIDS researcher and TIME Magazine’s 1996 Person of the Year, cameos a couple scenes, but the filmmakers delivered him little justice.
In the last documentary, we learn about the situation in Botswana. This nation has the highest population of cheetahs in the world, but on the downside, it has been plagued by AIDS. The story of Mma, her abandonment by her husband, and her two HIV-positive daughters was moving. As the story progressed, I felt more hopeful for her and her countrymen. The implementation of mandatory HIV testing epitomizes successful public policy. I watched an interview with a doctor who went to the U.S. for medical school and then came back to practice in Botswana. It is important for American medical schools to train people from around the globe, who can then bring their knowledge back home. The documentary was funded by the Bill and Melinda Gates Foundation. They have achieved so much through their philanthropy, saving millions of lives through the distribution of mosquito netting, grant funding, clean water initiatives, and the like. I have great admiration for what Bill Gates has done with his fortune. What’s next? How do we elevate billions of people to a quality of life that extends beyond mere survival?
Benjamin Samuel Young 