The Coming Plague (142 page)
Authors: Laurie Garrett
29
J. L. Melnick and T. G. Metcalf, “Distribution of Viruses in the Water Environment,” in B. Fields, M. A. Martin, and D. Kamely, eds.,
Genetically Altered Viruses and the Environment
(New York: Cold Spring Harbor Laboratory, 1985), 95â102.
Genetically Altered Viruses and the Environment
(New York: Cold Spring Harbor Laboratory, 1985), 95â102.
30
World Bank,
World Development Report 1993: Investing in Health
(New York: Oxford University Press, 1993).
World Development Report 1993: Investing in Health
(New York: Oxford University Press, 1993).
31
The horrendous condition of the earth's seas has been described in great detail elsewhere. See, for example, Proceedings,
Dahlem Conference on Ocean Margin Processes in Global Change
, Berlin, March 18â22, 1990 (New York: John Wiley & Sons, 1990); K. Schneider, “Ozone Depletion Harming Sea Life,”
New York Times
, November 16, 1991: 19; K. Sherman and L. M. Alexander,
Biomass Yields and Geography of Large Marine Ecosystems
(Boulder, CO: Westview Press, 1989); Groups of Experts on the Scientific Aspects of Marine Pollution (GESAMP),
The State of the Marine Environment
, United Nations Environment Programme Regional Seas Reports and Studies, No. 115, Nairobi, 1990; and J. Pineda, “Predictable Upwelling and the Shoreward Transport of Planktonic Larvae by Internal Tidal Bores,”
Science
253 (1991): 548â49.
Dahlem Conference on Ocean Margin Processes in Global Change
, Berlin, March 18â22, 1990 (New York: John Wiley & Sons, 1990); K. Schneider, “Ozone Depletion Harming Sea Life,”
New York Times
, November 16, 1991: 19; K. Sherman and L. M. Alexander,
Biomass Yields and Geography of Large Marine Ecosystems
(Boulder, CO: Westview Press, 1989); Groups of Experts on the Scientific Aspects of Marine Pollution (GESAMP),
The State of the Marine Environment
, United Nations Environment Programme Regional Seas Reports and Studies, No. 115, Nairobi, 1990; and J. Pineda, “Predictable Upwelling and the Shoreward Transport of Planktonic Larvae by Internal Tidal Bores,”
Science
253 (1991): 548â49.
32
Center for Marine Conservation,
Global Marine Biological Diversity, a Strategy for Building Conservation into Decision Making
, report to the World Bank, Washington, D.C., 1993.
Global Marine Biological Diversity, a Strategy for Building Conservation into Decision Making
, report to the World Bank, Washington, D.C., 1993.
33
See, for example, C. W. Sullivan, K. R. Arrigo, C. R. McClain, et al., “Distributions of Phytoplankton Blooms in the Southern Ocean,”
Science
262 (1993): 1832â37.
Science
262 (1993): 1832â37.
34
A rough estimate of the planet's species distributions, as estimated by Marjorie Readka-Kudla, in a presentation to the annual meeting of the American Association for the Advancement of Science, San Francisco, February 1994, would be as follows:
| Species Category | Number of Known Species | % of Total Number of Planetary Species |
|---|---|---|
| Terrestrial chordates | 2,000 | 0.1 |
| Insects | 750,000 | 54.0 |
| Fungi | 47,000 | 3.0 |
| Marine chordates | 3,000 | 0.2 |
| Freshwater chordates | 1,000 | 0.08 |
| Viruses and prokaryotes | 6,000 | 4.00 |
| Algae | 27,000 | 2.0 |
| Terrestrial plants | 250,000 | 18.0 |
Distributed over the planet as follows:
| Ecosystem | Km 2 (in millions) | % of Earth's Surface |
|---|---|---|
| Total global surface area | 511 | 100 |
| Global landmass | 170.3 | 33.3 |
| [Rain forests (1990)] | 11.9 | 2.3 |
| Oceans | 340.1 | 66.7 |
| [Coral reefs] | 0.6 | 0.1 |
| [Coastal zones] | 40.9 | 8.0 |
35
R. I. Glass, M. Claeson, P. A. Blake, et al., “Cholera in Africa: Lessons on Transmission and Control for Latin America,”
Lancet
338 (1991): 791â95.
Lancet
338 (1991): 791â95.
36
A. K. Siddique, A. H. Baqui, A. Eusof, et al., “Survival of Classic Cholera in Bangladesh,”
Lancet
337 (1991): 1125â27.
Lancet
337 (1991): 1125â27.
37
M. S. Islam, B. S. Drasar, and D. J. Bradley, “Long-Term Persistence of Toxigenic
Vibrio cholerae
01 in the Mucilaginous Sheath of a Blue-Green Alga,
Anabaena variabilis,” Journal of Tropical Medicine and Hygiene
93 (1990): 133â39; and A. Hug, P. A. West, E. B. Small, et al., “Influence of Water Temperature, Salinity and pH on Survival and Growth of Toxigenic
Vibrio cholerae
Copepods in Laboratory Microcosms,”
Applied Environmental Microbiology
48 (1984): 420â24.
Vibrio cholerae
01 in the Mucilaginous Sheath of a Blue-Green Alga,
Anabaena variabilis,” Journal of Tropical Medicine and Hygiene
93 (1990): 133â39; and A. Hug, P. A. West, E. B. Small, et al., “Influence of Water Temperature, Salinity and pH on Survival and Growth of Toxigenic
Vibrio cholerae
Copepods in Laboratory Microcosms,”
Applied Environmental Microbiology
48 (1984): 420â24.
Further work demonstrated that the
V. cholerae
could thrive on or inside of a range of freshwater and saltwater algae. See M. J. Islam, “Increased Toxin Production by
Vibrio cholerae
01 During Survival with a Green Alga,
Rhizoclonium fontanum
, in an Artificial Aquatic Environment,”
Microbiology and Immunology
34 (1990): 557â563; M. S. Islam, B. S. Drasar, and D. J. Bradley, “Attachment of Toxigenic
Vibrio cholerae
01 to Various Freshwater Plants and Survival with a Filamentous Green Alga,
Rhizoclonium fontanum
,”
Journal of Tropical Medicine and Hygiene
92 (1989): 396â401; and M. S. Islam, B. S. Drasar, and D. J. Bradley, “Survival of Toxigenic
Vibrio cholerae
01 with a Common Duckweed,
Lemma minor
, in Artificial Aquatic Ecosystems,”
Transactions of the Royal Society of Tropical Medicine and Hygiene
84 (1990): 422â24.
V. cholerae
could thrive on or inside of a range of freshwater and saltwater algae. See M. J. Islam, “Increased Toxin Production by
Vibrio cholerae
01 During Survival with a Green Alga,
Rhizoclonium fontanum
, in an Artificial Aquatic Environment,”
Microbiology and Immunology
34 (1990): 557â563; M. S. Islam, B. S. Drasar, and D. J. Bradley, “Attachment of Toxigenic
Vibrio cholerae
01 to Various Freshwater Plants and Survival with a Filamentous Green Alga,
Rhizoclonium fontanum
,”
Journal of Tropical Medicine and Hygiene
92 (1989): 396â401; and M. S. Islam, B. S. Drasar, and D. J. Bradley, “Survival of Toxigenic
Vibrio cholerae
01 with a Common Duckweed,
Lemma minor
, in Artificial Aquatic Ecosystems,”
Transactions of the Royal Society of Tropical Medicine and Hygiene
84 (1990): 422â24.
38
For an excellent summary, see R. R. Colwell and W. M. Spira, “The Ecology of
Vibrio cholerae
,” Chapter 6 in D. Barua and W. B. Greenough III, eds.,
Cholera
(New York: Plenum, 1992).
Vibrio cholerae
,” Chapter 6 in D. Barua and W. B. Greenough III, eds.,
Cholera
(New York: Plenum, 1992).
39
These events are described in the following: P. R. Epstein, T. E. Ford, and R. R. Colwell, “Marine Ecosystems,”
Lancet
342 (1993): 1216â19; A. P. M. Lockwood, “Aliens and Interlopers at Sea,”
Lancet
342 (1993): 942â43; C. Anderson, “Cholera Epidemic Traced to Risk Miscalculation,”
Nature
354 (1991): 255; Colwell and Spira (1992), op. cit.; World Health Organization, “Cholera Alert in Latin America,” Press Release, WHO/8/12 February 1991; “Cholera in the Americas,”
Bulletin of the Pan American Health Organization
25 (1991): 267â77; Centers for Disease Control, “Cholera OutbreakâPeru, Ecuador, and Colombia,”
Morbidity and Mortality Weekly Report
40 (1991): 225â27; E. W. Rice and C. H. Johnson, “Cholera in Peru,”
Lancet
338 (1991): 455; V. M. Witt and F. M. Reiff, “Environmental Health Conditions and Cholera Vulnerability in Latin America and the Caribbean,”
Journal of Public Health Policy
(Winter 1991): 450â63; M. L. Tamplin and C. C. Parodi, “Environmental Spread of
Vibrio cholerae
in Peru,”
Lancet
338 (1991): 1216â17; J. Sepulveda, H. Gómez-Dantes, and M. Bronfman, “Cholera in the Americas: An Overview,”
Infection
20 (1992): 243â48; and R. V. Tauxe and P. A. Blake, “Cholera Epidemic in Latin America,”
Journal of the American Medical Association
267 (1992): 1388â90.
Lancet
342 (1993): 1216â19; A. P. M. Lockwood, “Aliens and Interlopers at Sea,”
Lancet
342 (1993): 942â43; C. Anderson, “Cholera Epidemic Traced to Risk Miscalculation,”
Nature
354 (1991): 255; Colwell and Spira (1992), op. cit.; World Health Organization, “Cholera Alert in Latin America,” Press Release, WHO/8/12 February 1991; “Cholera in the Americas,”
Bulletin of the Pan American Health Organization
25 (1991): 267â77; Centers for Disease Control, “Cholera OutbreakâPeru, Ecuador, and Colombia,”
Morbidity and Mortality Weekly Report
40 (1991): 225â27; E. W. Rice and C. H. Johnson, “Cholera in Peru,”
Lancet
338 (1991): 455; V. M. Witt and F. M. Reiff, “Environmental Health Conditions and Cholera Vulnerability in Latin America and the Caribbean,”
Journal of Public Health Policy
(Winter 1991): 450â63; M. L. Tamplin and C. C. Parodi, “Environmental Spread of
Vibrio cholerae
in Peru,”
Lancet
338 (1991): 1216â17; J. Sepulveda, H. Gómez-Dantes, and M. Bronfman, “Cholera in the Americas: An Overview,”
Infection
20 (1992): 243â48; and R. V. Tauxe and P. A. Blake, “Cholera Epidemic in Latin America,”
Journal of the American Medical Association
267 (1992): 1388â90.
40
El Tor made its way into Brazil through the Amazon and thence to Rio.
41
Centers for Disease Control, “CholeraâNew York, 1991,”
Morbidity and Mortality Weekly Report
40 (1991): 516â18; and Centers for Disease Control, “Cholera Associated with an International Airline Flight,”
Morbidity and Mortality Weekly Report
41 (1992): 134â35.
Morbidity and Mortality Weekly Report
40 (1991): 516â18; and Centers for Disease Control, “Cholera Associated with an International Airline Flight,”
Morbidity and Mortality Weekly Report
41 (1992): 134â35.
In September 1991 health authorities in Alabama discovered
V. cholerae
01 in local seafood. An investigation of the bilge and ballast waters of ships from South America harbored in the Gulf of Mexico revealed that cholera-infested algae were present. See S. A. McCarthy, R. M. McPhearson, A. M. Guarino, and J. L. Gaines, “Toxigenic
Vibrio cholerae
01 and Cargo Ships Entering Gulf of Mexico,”
Lancet
339 (1992): 624â25.
V. cholerae
01 in local seafood. An investigation of the bilge and ballast waters of ships from South America harbored in the Gulf of Mexico revealed that cholera-infested algae were present. See S. A. McCarthy, R. M. McPhearson, A. M. Guarino, and J. L. Gaines, “Toxigenic
Vibrio cholerae
01 and Cargo Ships Entering Gulf of Mexico,”
Lancet
339 (1992): 624â25.
Polymerase chain reaction analysis of the DNA in various Latin American and Gulf of Mexico isolates of
V. cholerae
didn't match up, however. The cholera found in the Gulf was never matched exactly to cholera strains anywhere else in the world, and its origin remained subject for debate in 1994. See I. K. Wachsmuth, G. M. Evins, P. I. Fields, et al., “The Molecular Epidemiology of Cholera in Latin America,”
Journal of Infectious Diseases
167 (1993): 621â26.
V. cholerae
didn't match up, however. The cholera found in the Gulf was never matched exactly to cholera strains anywhere else in the world, and its origin remained subject for debate in 1994. See I. K. Wachsmuth, G. M. Evins, P. I. Fields, et al., “The Molecular Epidemiology of Cholera in Latin America,”
Journal of Infectious Diseases
167 (1993): 621â26.
42
The eight drugs were ampicillin, chloramphenicol, colistin, neomycin, kanamycin, gentamicin, tetracycline, and Fansidar. See R. Tabtieng, S. Wattanasri, P. EcheverrÃa, et al., “An Epidemic of
Vibrio cholerae El Tor Inaba
Resistant to Several Antibiotics with a Conjugative Group C Plasmid Coding for Type II Dihydrofolate Reductase in Thailand,”
American Journal of Tropical Medicine and Hygiene
41 (1989): 680â86.
Vibrio cholerae El Tor Inaba
Resistant to Several Antibiotics with a Conjugative Group C Plasmid Coding for Type II Dihydrofolate Reductase in Thailand,”
American Journal of Tropical Medicine and Hygiene
41 (1989): 680â86.
43
A. A. Ries, D. J. Vugia, L. Beingolea, et al., “Cholera in Piura, Peru: A Modern Urban Epidemic,”
Journal of Infectious Diseases
166 (1992): 1429â33; and Editorial, “Of Cabbages and Chlorine: Cholera in Peru,”
Lancet
340 (1992): 20â21.
Journal of Infectious Diseases
166 (1992): 1429â33; and Editorial, “Of Cabbages and Chlorine: Cholera in Peru,”
Lancet
340 (1992): 20â21.
44
See numerous bulletin reports from officials and scientists working throughout the region, all appearing in
Lancet
342 (1993): 382â83, 387â90, 430â31, 925â27.
Lancet
342 (1993): 382â83, 387â90, 430â31, 925â27.
45
P. R. Epstein, T. E. Ford, and R. R. Colwell, “Marine Ecosystems,”
Lancet
342 (1993): 1216â19; and P. R. Epstein, “Cholera and the Environment,”
Lancet
339 (1992): 1167â68.
Lancet
342 (1993): 1216â19; and P. R. Epstein, “Cholera and the Environment,”
Lancet
339 (1992): 1167â68.
46
R. Shope, “Global Climate Change and Infectious Diseases,”
Environmental Health Perspectives
96 (1991): 171â74.
Environmental Health Perspectives
96 (1991): 171â74.
47
J. de Zulueta, “Changes in the Geographical Distribution of Malaria Throughout History,”
Parasitologia
29 (1987): 193â205.
Parasitologia
29 (1987): 193â205.
48
D. J. Rogers and M. J. Packer, “Vector-Borne Diseases, Models, and Global Change,”
Lancet
342 (1993): 1282â85.
Lancet
342 (1993): 1282â85.
49
The WHO Task Group graded the sensitivities of diseases (or their vectors and transmissibility) in relation to global temperature changes on a scale of 0 to 3, with 0-graded unlikely to be affected at all and 3-graded highly susceptible to temperature variations.
| Disease | 1990 Prevalence | Grade |
|---|---|---|
| Malaria | 270 million | 3 |
| Lymphatic filariasis | 90.2 million | 1 |
| Onchocerciasis | 17.8 million | 1 |
| Schistosomiasis | 200 milion | 2 |
| Sleeping sickness | 25,000/year | 1 |
| Leishmaniasis | 12 million | 1 |
| Dracunculiasis | 1 million | 0 |
| Dengue | NS | 2 |
| Yellow fever | NS | 1 |
| Japanese encephalitis | NS | 1 |
| St. Louis encephalitis | NS | 1 |
| All other insect-borne viral diseases | NS | 1 |
See WHO Task Group, “Potential Health Effects of Climatic Change,” report to the World Health Organization, WHO/PEP/90/10, 1990.
50
A. Leaf, “Potential Health Efforts of Global Climatic and Environmental Changes,”
New England Journal of Medicine
321 (1989): 1577â83; A. Jeevan and M. L. Kripke, “Ozone Depletion and the Immune System,”
Lancet
342 (1993): 1159â60; World Health Organization, “Ultraviolet Radiation Can Seriously Damage Your Health,” Press Release, WHO/102/17 December 1993; W. Goettsch, J. Garssen, A. Deijins, et al., “UV-B Exposure Impairs Resistance to Infection by
Trichinella spiralis,” Environmental Health Perspectives
102 (1994): 298â304; C. Hassett, M. G. Mustafa, W. F. Coulson, and R. M. Elashoff, “Murine Lung Carcinogenesis Following Exposure to Ambient Ozone Concentrations,”
Journal of the National Cancer Institute
75, 4 (1985): 1211â19; L. Calderón-Garcidueñas and G. Roy-Ocotla, “Nasal Cytology in Southwest Metropolitan Mexico City Inhabitants: A Pilot Intervention Study,”
Environmental Health Perspectives
101 (1993): 138â44; and National Research Council,
Biological Markers in Immunotoxicology
(Washington, D.C.: National Academy of Sciences, 1992).
New England Journal of Medicine
321 (1989): 1577â83; A. Jeevan and M. L. Kripke, “Ozone Depletion and the Immune System,”
Lancet
342 (1993): 1159â60; World Health Organization, “Ultraviolet Radiation Can Seriously Damage Your Health,” Press Release, WHO/102/17 December 1993; W. Goettsch, J. Garssen, A. Deijins, et al., “UV-B Exposure Impairs Resistance to Infection by
Trichinella spiralis,” Environmental Health Perspectives
102 (1994): 298â304; C. Hassett, M. G. Mustafa, W. F. Coulson, and R. M. Elashoff, “Murine Lung Carcinogenesis Following Exposure to Ambient Ozone Concentrations,”
Journal of the National Cancer Institute
75, 4 (1985): 1211â19; L. Calderón-Garcidueñas and G. Roy-Ocotla, “Nasal Cytology in Southwest Metropolitan Mexico City Inhabitants: A Pilot Intervention Study,”
Environmental Health Perspectives
101 (1993): 138â44; and National Research Council,
Biological Markers in Immunotoxicology
(Washington, D.C.: National Academy of Sciences, 1992).
51
M. R. Moser, T. R. Bender, H. S. Margolis, et al., “Aircraft Transmission of Influenza A,”
American Journal of Epidemiology
110 (1979): 1.
American Journal of Epidemiology
110 (1979): 1.
52
D. Maki, “Airline Cabin Air Quality,” testimony before the Subcommittee on Technology, Environment and Aviation, House Committee on Science, Space and Technology, July 29, 1993; and A. R. Hinman (1993), “Statement,” ibid.
53
This was also revealed during the congressional hearings, by Niren Nagda, of ICF Kaiser International, an independent toxicology firm. Office standards for the United States were for twenty cubic feet per minute of fresh air in a standard room. In contrast, sold-out flights had an air intake rate of only nine to fourteen feet per minute.
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