Natural or Manmade, Infectious Diseases Showed they Still Have u

THE fear of infectious disease has largely faded in the wealthy West over the past century, thanks to sanitation, antibiotics and the like. But it re-emerged with a vengeance this year when some humans switched allegiance and began working on the side of the killers.

Weapons-grade anthrax sent through the mail in the US has killed five people so far. Although the perpetrator's identity remains a mystery, the FBI suspects a rogue scientist. And it's not just rogue scientists that have been giving infectious agents a helping hand-far from it. In January, New Scientist revealed that Australian scientists had accidentally created a killer mousepox virus, unwittingly providing a blueprint for the ultimate bioweapon.

Then there were the agricultural epidemics. This year, a particularly virulent strain of foot and mouth disease hit Britain after rampaging through Asia and the Middle East. It probably arrived in contaminated meat products, and got into the swill fed to pigs. Four million animals were slaughtered, and around £3 billion lost in trade, tourism and in eradicating the disease.

The events of 2001 are forcing governments to change their attitude towards epidemics-be they natural or deliberate, animal or human. And for the first time since genetic engineering became routine in the 1970s, molecular biologists are talking seriously about the need to police their patch. And this time they are not just talking about voluntary moratoriums. Some are prepared to support what has long been anathema to scientists worldwide-legal restrictions and nonscientists overseeing what researchers can do.

The engineered mousepox was the catalyst for this about-face. Many scientists had assumed it would be extremely tricky to genetically engineer a microbe to make it more virulent than aeons of evolutionary fine-tuning had achieved. But the assumption was proved naive when a team of Australian scientists accidentally converted the usually mild mousepox into a virus that wipes out every mouse it infects. Bioterrorists now have a blueprint for modifying other poxes that infect humans. It was a harsh wake-up call for biologists.

"When you wield power equivalent to nuclear weapons, you need some oversight," says John Steinbruner of the Center for International and Security Studies in Maryland. His is one of several organisations, including the US National Academy of Sciences and the Federation of American Scientists, that are thrashing out ways to regulate research.

The key will probably be defining-and possibly banning-"inherently dangerous" research. So far, though, there is no agreement on the details. One huge obstacle is the fear that restrictive regulations will do more harm than good. After all, understanding what makes an infectious agent virulent, say, or what turns the immune system on and off, could be used to save lives as well as to take them.

The US Congress is already rushing through legislation requiring, among other things, background checks on scientists who work with certain infectious agents. But even the most stringent regulations in the world can't rule out nefarious uses of biology. The anthrax attacks have focused minds on how to recognise a bioterrorist attack quickly enough to prevent catastrophic loss of life. One proposal put before a committee of the US House of Representatives in November is the Rapid Syndrome Validation Project.

RSVP is based on the premise that the best way to spot a suspicious outbreak is to map symptoms as quickly as possible, showing when and where people fall sick with any one of six "syndromes"-broad categories of serious disease including acute bloody diarrhoea, and fever with disorientation or delirium. But doctors are notoriously bad at notifying authorities of outbreaks, even if they are legally required to do so. To get around that problem, RSVP is easy to use-all you need is a Web browser-and provides medical carrots such as help with diagnosis and information about similar cases.

Data on factors such as wind patterns can be superimposed on the map. This might reveal whether an outbreak is natural or due to someone driving a van spewing out anthrax through a city. And you can make that judgment in time to act: statistics dictate that even if 10,000 people have been exposed, only a few hundred will get sick at first. So as long as the disease in question takes several days to take hold-as anthrax and smallpox do-you've still got a chance to save most of the infected people.

To get around the reporting problem, the US is also trying to develop a system called LEADERS that takes information from computerised hospital records. But even as ambitious projects are being planned, low-tech methods are already notching up victories. ProMed-mail, an Internet mailing list with 25,000 subscribers in 160 countries, has shown the dramatic impact of the neighbourhood watch approach to disease surveillance. Anyone who has information about disease outbreaks of any kind can send it to ProMed. Expert moderators quickly vet reports before posting them to everyone on the list.

The system is forcing governments to be more open. For example, a recent outbreak of foot and mouth in Argentina, initially denied by the government, was broadcast worldwide by ProMed. For the moment at least, this is probably the best way we have of monitoring natural and deliberate outbreaks of disease.

Sounding the alert when an outbreak occurs is one thing, but what about stopping it in its tracks? If the wildfire spread of foot and mouth is anything to go by, free trade and travel can make that nigh on impossible. And although there's no evidence that the outbreak was a deliberate piece of economic sabotage, the idea alone has sent a chill through countries like Australia that are free of the disease.

Australia has long shored up the advantage of its isolation with stringent quarantine laws, extensive monitoring and diagnostic facilities. But even Australia has been scared into raising further defences in light of the devastation wreaked by foot and mouth in Britain. It is committing A$590 million (£214 million) to new measures. Every container and piece of mail coming onto the continent will be inspected or X-rayed, and at least 80 per cent of passengers will have their luggage X-rayed or searched.

A year ago such efforts might have seemed like overkill. Now war games based on anthrax attacks in London or a killer flu are becoming routine, as the West wakes up to the fact that infectious diseases still have the power to cause death and destruction on a major scale.

Rachel Nowak

SOURCE: New Scientist 22 December 2001