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ISP #31 – Epidemics and Pandemics!!
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WE’RE ALIVE! And we’ve got a good one! From August 31, 2014… yes, we’re that far behind…
Epidemic vs. Pandemic: From Slate.com – The CDC’s official definition of an epidemic is: “The occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time.” Since some diseases become more prevalent or lethal over time, while others become less severe, the CDC must adjust its statistical models to alter the definition of what’s truly more than expected.
A pandemic is an epidemic that occurs across several countries and affects a sizable portion of the population in each, although there’s no formal definition of what constitutes “sizable.” According to the CDC, the last influenza pandemic took place in 1968-69, when the Hong Kong flu killed 33,800 Americans between September and March.
Ebola / Marburg:
Two diseases that are similar, and similarly frightening are Marburg Virus Disease and Ebola Virus Disease. Trust me, you don’t want either of these monsters.
Marburg
Let’s talk about Marburg first. Marburg is a rare but severe hemorrhagic fever which affects both human and nonhuman primates. Marburg is a genetically unique zoonotic (or, animal-borne) RNA virus of the filovirus family. The Cuevavirus and five species of Ebola virus are the only other known members of the filovirus family. Marburg was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (which is now Serbia). Thirty one people fell ill, initially laboratory workers followed by several medical personnel and family member who had cared for them. Seven deaths were reported. The first people infected had been exposed to imported African green monkeys or their tissues while conducting research. One additional case was diagnosed retrospectively. Fatality rates in Marburg range outbreaks range from 24% to 88%
- Symptoms: The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Diarrhoea can persist for a week. The appearance of patients at this phase has been described as showing “ghost-like” drawn features, deep-set eyes, expressionless faces, and extreme lethargy. In the 1967 European outbreak, non-itchy rash was a feature noted in most patients between 2 and 7 days after onset of symptoms. Many patients develop severe haemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. Fresh blood in vomit and faeces is often accompanied by bleeding from the nose, gums, and vagina. Spontaneous bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can be particularly troublesome. During the severe phase of illness, patients have sustained high fever. Involvement of the central nervous system can result in confusion, irritability, and aggression. Orchitis has been reported occasionally in the late phase of disease (15 days). In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.
- Diagnosis:
- enzyme-linked immunosorbent assay (ELISA);
- antigen detection tests;
- serum neutralization test;
- reverse-transcriptase polymerase chain reaction (RT-PCR) assay; and
- virus isolation by cell culture.
- Treatment: Severe cases require intensive supportive care, as patients are frequently in need of intravenous fluids or oral rehydration with solutions containing electrolytes. There are no specific treatments available for Marburg, although some drug therapies have show promising results in laboratory studies.
- Outbreaks:
- 1967 Marburg and Frankfurt, West Germany and Belgrade, Yugoslavia. 7/31 deaths.
- 1975 Rhodesia and Johannesburg, South Africa. ⅓ deaths.
- 1980 Kenya. ½
- 1987 Kenya. 1/1
- 1988 Koltsovo, Soviet Union. 1/1 (laboratory accident)
- 1990 Koltsovo, Soviet Union. 0/1 (laboratory accident)
- 1998 – 200 Durba and Watsa, Democratic Republic of Congo. A total of 154 cases and 128 deaths of marburg virus infection were recorded during this outbreak. The case fatality was 83%. Two different marburg viruses, MARV and Ravn virus (RAVV), co-circulated and caused disease. It has never been published how many cases and deaths were due to MARV or RAVV infection.
- 2004 – 2005 Angola. 227/252
- 2007 Uganda. ⅓
- 2008 Uganda & Netherlands. 1/1
- 2012 Uganda 9/18
- Weaponization: The Soviet Union had an extensive offensive and defensive biological weapons program that included MARV. At least three Soviet research institutes had MARV research programs during offensive times: the Virology Center of the Scientific-Research Institute for Microbiology in Zagorsk (today Sergiev Posad), the Scientific-Production Association “Vektor” (today the State Research Center of Virology and Biotechnology “Vektor”) in Koltsovo, and the Irkutsk Scientific-Research Anti-Plague Institute of Siberia and the Far East in Irkutsk. As most performed research was highly classified, it remains unclear how successful the MARV program was. However, Soviet defector Ken Alibek claimed that a weapon filled with MARV was tested at the Stepnogorsk Scientific Experimental and Production Base in Stepnogorsk, Kazakh Soviet Socialist Republic(today Kazakhstan), suggesting that the development of a MARV biological weapon had reached advanced stages. Independent confirmation for this claim is lacking. At least one laboratory accident with MARV, resulting in the death of Koltsovo researcher Nikolai Ustinov, occurred during offensive times in the Soviet Union and was first described in detail by Alibek. After the collapse of the Soviet Union, MARV research continued in all three institutes
Ebola
Arguably nastier than Marburg, Ebola virus disease (EVD) is a severe, often fatal illness, with a case fatality rate of up to 90%. It is one of the world’s most virulent diseases.The infection is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. During an outbreak, those at higher risk of infection are health workers, family members and others in close contact with sick people and deceased patients. Ebola outbreaks can devastate families and communities. Ebola first appeared in 1976 in 2 simultaneous outbreaks in Nzara, Sudan and in Yambuku, Democratic Republic of Congo. The latter was a village situated near the Ebola river, from which the disease takes its name.
Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with Marburgvirus and Cuevavirus – which regrettably, I have nothing on that for this episode . Genus Ebolavirus comprises 5 distinct species:
- Bundibugyo ebolavirus
- Zaire ebolavirus
- Reston ebolavirus (Named for the strain discovered in Reston, WV. More on that shortly)
- Sudan ebolavirus
- Taï Forest ebolavirus
Some facts about Ebola
- Transmission: Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest. Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness. Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.
- Symptoms: EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes. People are infectious as long as their blood and secretions contain the virus. Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory. The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.
- Diagnosis:
- antibody-capture enzyme-linked immunosorbent assay*
- antigen detection tests*
- serum neutralization test*
- reverse transcriptase polymerase chain reactions assay*
- electron microscopy
- virus isolation by cell culture*
- Treatment?: No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use. Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids. No specific treatment is available. New drug therapies are being evaluated.
- Outbreaks:
- 1976 Democratic Republic of Congo. Ebola Zaire – 280/318 (88%)
- 1976 Sudan. Ebola Sudan – 151/284 (53%)
- 1977 Democratic Republic of Congo. Ebola Zaire – 1/1
- 1979 Sudan. Ebola Sudan – 22/34 (65%)
- 1994 Gabon. Ebola Zaire – 31/52 (65%)
- 1994 Cote d’Ivoire. Taï Forest – 0/1
- 1995 Democratic Republic of Congo. Ebola Zaire – 254/315 (81%)
- 1996 (Jan-Apr) Gabon. Ebola Zaire – 21/31 (68%)
- 1996 (Jul-Dec) Gabon. Ebola Zaire – 45/65 (75%)
- 1996 South Africa. Ebola Zaire – 1/1
- 2000 Uganda. Ebola Sudan – 224/425 (53%)
- 2001-2002 Gabon. Ebola Zaire – 53/65 (82%)
- 2001-2002 Congo. Ebola Zaire – 44/59 (75%)
- 2003 (Jan-Apr) Congo. Ebola Zaire – 128/143 (90%)
- 2003 (Nov-Dec) Congo. Ebola Zaire – 29/35 (83%)
- 2004 Sudan. Ebola Sudan – 7/17 (41%)
- 2005 Congo. Ebola Zaire – 187/264 (71%)
- 2007 Democratic Republic of Congo. Ebola Zaire – 14/32 (44%)
- 2007 Uganda. Ebola Bundibugyo – 37/149 (25%)
- 2008 Democratic Republic of Congo. Ebola Zaire – 14/32 (44%)
- 2011 Uganda. Ebola Sudan – 1/1
- 2012 Uganda. Ebola Sudan – 17/24 (71%)
- 2012 Uganda. Ebola Sudan – 4/7 (57%)
- 2012 Democratic Republic of Congo – 29/57 (51%)
- 2014: The ongoing, as of recording this show, outbreak of Ebola in West Africa actually began in December of 2013, but was not detected until 2014. It began in Guinea and has since spread to Liberia, Sierra Leone and Nigeria. Individual cases related to this outbreak, which not in every case turned out to be positive for Ebola, have landed in Benin, Democratic Republic of Congo, Ghana, Saudi Arabia, Spain and the United States (expand on that here).
- Natural Hosts: Both Marburg and Ebola are harbored in fruit bats. The bats do not show obvious signs of illness. It would appear that different species may harbor it and that their overlapping ranges mean that an overlap of range of the virus exists as well.
- Weaponization?: Similar to Marburg, Ebola is believed to be a component in the weaponization of infectious diseases since 1992. Sources I found cited Russian weapons development as the suspected source. Because the United States would never do such a horrific thing. Amirite? (enough sarcasm?)
Ebola Reston (the potential Hooooly shit): First described in 1990 as a new “strain” of Ebola virus, a result of mutation. It is the single member of the species Reston ebolavirus. It’s named after Reston, Virginia where the virus was first discovered. It was discovered in crab-eating macaques from Hazelton Laboratories in 1989. This drew a lot of media attention due to the proximity of Reston to the Washington, DC metro area, and the lethality of a closely related Ebola virus. Despite it’s status as a level-4 organism, Reston virus is non-pathogenic to humans, though hazardous to monkeys. The perception of its lethality was compounded due to the monkey’s coinfection with Simian hemorrhagic fever virus. (Level 4: Virus Hunters of the CDC)
Ebola in 2014: Beginning in December 2013 in Guinea, but not detected until March 2014, after which it spread to Liberia, Sierra Leone, Nigeria, and Senegal. The outbreak is caused by the Zaire ebolavirus. As of August 26th, 3,069 suspected cases and 1,552 deaths. Another outbreak in the Democratic Republic of Congo has killed 13 people as of August 26th. It’s believed to be unrelated to the West African outbreak.
Influenza 1918: (Read the Wikipedia article.) It’s great.
Black Death:
History
The Black Death had one of the highest body counts of any disease ever known to man. Between 1346 and 1353, it killed between 75 and 200 million people in Eurasia – between 30% and 60% of the region’s populace. At the time, the world’s population was only about 450 million, and the plague far outpaced the global birth rate, reducing the population to around 350 to 375 million.
The actual origin of the disease isn’t entirely clear, but most historians think it began in central Asia, travelling along the Silk Road trade route and reaching the Crimea by 1343. From there, it traveled across and around the Mediterranean by way of infected fleas on the rats commonly found on merchant ships. After that, it was spread on land both by rats and by humans, most often by coughing or contact with flea-carrying infected animals.
Earlier this year, an article popped up claiming that rats had been “exonerated” for being plague carriers, but it was really just coverage of a press conference about a new documentary about the Black Death; the documentary correctly blamed rats and rat fleas, but the news coverage itself incorrectly believed they were saying the rats weren’t to blame.
In his Florentine Chronicle, Baldassarre Bonaiuti talks of what life was like for the average citizen while the plague was at its peak:
All the citizens did little else except to carry dead bodies to be buried. At every church they dug deep pits down to the water-table; and thus those who were poor who died during the night were bundled up quickly and thrown into the pit. In the morning when a large number of bodies were found in the pit, they took some earth and shoveled it down on top of them; and later others were placed on top of them and then another layer of earth, just as one makes lasagne with layers of pasta and cheese.
It wasn’t just in Europe, either. The plague spread throughout the Middle East, including Iraq, Iran, and Syria. It killed about 40% of Egypt’s population. Only severely isolated locations were really safe.
Following the original pandemic, the plague continued to ravage Europe well into the 17th century, at times killing by the tens or hundreds of thousands. A third resurgence started in China in the 19th century, spreading to every inhabited continent. 10 million people died in India alone.
Cause and Symptoms
Healers at the time had absolutely no idea what the hell was going on. The disease spread and killed too quickly for any real reliable treatment information to spread – if any was even found at all, which is unlikely.
Jews faced widespread persecution, often being accused of poisoning wells to cause the plague (hence the fallacy of that name). Some 210 Jewish communities were utterly destroyed.
Lepers and other people with skin diseases – even things as simple as acne – were also blamed for the plague, and thus singled out and exterminated. Europeans also blamed astrological forces and earthquakes.
The Black Death is actually several different kinds of plague wrapped up in a nice little bundle of doom carried by the Yersinia pestis bacterium. Bubonic, pneumonic, and septicemic plague were among the most common varieties. To make things worse, the poor bastards who got infected with one form quite often wound up with the rest as well.
Bubonic plague
Bubonic plague causes buboes – that is, a swollen lymph node. They look a bit like huge blisters, usually appearing under the armpit, in the groin, or on the neck. Doctors at the time of the Black Death often thought that the buboes should be burst open to leech the plague from the body, but modern medicine considers this treatment useless at best and harmful at worst (since the wound would be at high risk of infection).
But the buboes weren’t the end of the fun. Gangrene of the extremities (toes, fingers, lips, and the tip of the nose) was common, as were chills, a general sense of being ill, high fevers, extreme fatigue, muscle cramps, seizures, heavy and continuous vomiting of blood, aching limbs, coughing, gastrointestinal problems, delirium, coma, and – best of all! – extreme pain caused by decay or decomposition of the skin while the person is still alive.
The mortality rate for bubonic plague, left totally untreated, is between 40 and 60%.
Pneumonic plague
As I mentioned before, in some cases, the plague could also be spread through coughing. In Popular Science’s article clearing up the confusion about rats being cleared of blame, they explain how:
In some people, bubonic plague spreads to the lungs, although it isn’t known whether this is because they are more susceptible to lung infections or because certain Yersinia strains are better equipped to infiltrate the lungs. Either way, this is a secondary pneumonic plague infection. If a person with secondary pneumonic plague sneezes or coughs on someone else, that someone else may get a primary pneumonic plague infection.
Pneumonic plague is much more virulent and rare than bubonic plague, and also much more severe. It can result from the inhalation of aerosolized plague bacteria, or when septicemic plague spreads into the lungs from the bloodstream. There have even been cases of pneumonic plague resulting from the dissection or handling of contaminated animal tissue.
The most obvious symptom is a severe, often bloody cough. This is accompanied by fever, headache, weakness, rapidly developing pneumonia, shortness of breath, and chest pain. Infected people can suffer respiratory failure and shock, and death can occur as soon as within 36 hours. Left untreated, the mortality rate is almost 100%.
Septicemic plague
Septicemic plague occurs when an existing primary bubonic plague infection spreads from the lymph system into the circulatory system. And holy shit is it ever bad news.
One of the nastiest symptoms of septicemic plague is the terrifyingly named disseminated intravascular coagulation, which is a widespread activation of the clotting cascade that causes blood clots to form in the small blood vessels throughout the body. Bad news. This causes serious problems with blood flow, ultimately leading to multiple organ damage or failure. What’s more, because so much clotting is going on, the regular clotting process faces a shortage of platelets and clotting factors, leading to severe bleeding from wounds – like, say, a lanced bubo. (Ironically enough, draining the lymph nodes actually is recommended as part of the treatment of septicemic plague.)
Other symptoms include things like abdominal pain; bleeding under the skin; bleeding from the mouth, nose, and rectum; diarrhea; fever; chills; low blood pressure; nausea; organ failure; vomiting; shock; gangrene; and difficulty breathing. But here’s the kicker – sometimes it will kill you before you show any symptoms at all.
Thankfully, septicemic plague is also the rarest form of the plague. It only occurs in a small minority of cases of infection with Yersinia pestis.
Effects on society
The Black Death essentially marked the end of the Middle Ages and the beginning of the Renaissance. So many people died that European society was devastated and had to rebuild itself almost from the ground up, taking well over a century for the population to fully recover. Their whole way of life changed. Political, social, and economic systems collapsed under widespread unrest, and huge swaths of the population just stopped engaging in society altogether to reduce the risk of being exposed to infection. The church lost much of influence as people began to distrust its promises of God’s mercy, healing, and so on, and it didn’t help that monks and priests (who often tended to the dead) were especially hard-hit by the disease.
Imagine seeing 30-60% of the people you know die after showing the symptoms I mentioned. Imagine the kind of impact that would have on your outlook for the future. People suddenly realizing that humanity could be on the verge of being wiped out at any time kind of gave them a new perspective on things.
Steven West of the Philosophize This! podcast summarizes the whole situation quite well:
… [T]hen the faithful law of supply and demand started to take over. Peasants became increasingly more valuable as more and more of them died. The supply of peasants couldn’t keep up with the demand of work that needed to get done to feed society. When a company today can’t get enough people to willingly do a job for a certain salary, they are forced to raise the salary, and that is exactly what happened in Western Europe during the fall of the Middle Ages. Though it was completely illegal, the desperate times allowed for peasants to shop around with other land owners to try to make a better wage. These subjugated people were finally seeing what it was like to be a free citizen with a skill set that people valued. What started as merely a pandemic disease that led to a population crisis, quickly turned into an economic crisis as well, because the owners of these fields couldn’t afford to pay for the rising cost of their workforce. This threatened a complete collapse of the Agriculture of the region, so what the governments did to try to combat this was impose a wage freeze.
This wage freeze in coalition with several other small regulations and the massive tax increase on citizens to fight the 100 years war with France led to peasants banding together and attempting to overthrow their governments. So what started as a population crisis, quickly turned into an economic crisis that then turned into a political crisis. …
This crisis heralded the beginning of the Renaissance – the rebirth of European society as something new and previously unknown.
Status in the modern world
So what about now? Surely we’ve got this beaten by now, right?
Well… do you own a cat? Does it ever bring you dead mice? I sure hope that you handle them with gloves, and that you keep an eye out for symptoms in your pussy. Because the plague is not dead. Not in any way, shape, or form.
Yes, in this advanced modern world, Yersinia pestis is still very much active. Plague outbreaks are nowhere near as large or as frequent as they used to be, but they definitely still happen.
Since 2002, the World Health Organisation has reported seven plague outbreaks, though some may go unreported because they often happen in remote areas. Between 1998 and 2009, nearly 24,000 cases were reported, including about 2,000 deaths, in Africa, Asia, the Americas and Eastern Europe. 98 percent of the world’s cases occur in Africa.
Every year, between 4000 and 5000 people still come down with the septicemic plague.
Wikipedia notes:
On July 10, 2014, in an online news story article, by Keith Coffman of Reuters, featured on the MSN U.S. News website, it was stated that a Colorado man, whose condition the report said was not known, had been diagnosed with the pneumonic plague. The man was found to have the disease after the family dog died unexpectedly and a necropsy conducted on it revealed it had died from the disease.
As of July 18, 2014, three more cases were reported in Colorado. However, the outbreak appears to be over, according to state officials.
Plague has been active in black-tailed prairie dog populations for the past 40–50 years. In the United States outbreaks only occur in the western States and they are devastating, with mortality rates near 100% because the animals have no immunity to the plague. Survivors are the ones that happened not to become infected and colonies that recover from a plague outbreak remain at risk.
Currently, 5 to 15 people in the United States are estimated to catch the disease each year—typically in western states. And there’s good news! One case of a drug-resistant form of Yersinia pestis was found in Madagascar in 1995. Experts believe that, should another drug-resistant form evolve somewhere more populated, we could face yet another pandemic – and I can only imagine what that would be like in today’s world, as connected and global as we are. The death toll could reach the billions.
Treatment
Bubonic and pneumonic plague are both very aggressive infections requiring early treatment. Antibiotics must be given within 24 hours of first symptoms to reduce the risk of death.
Several classes of antibiotics are effective in treating plague. Mortality associated with treated cases of bubonic plague is about 1–15%.
Be sure to have a will prepared.
Honorable(?) Mentions
- Bird Flu: Avian flu is carried in many wild birds and doesn’t tend to make the host ill. Some domesticated birds (chickens, ducks, pet birds, pet cats, etc) are susceptible to avian flu and can be lethal to them. People can contract some strains of avian flu and since 2004, 638 cases of human infection of a strain of avian flu, H5N1 it’s called, have been reported with 379 deaths. That’s 59% mortality rate. So thankfully it’s not very readily spread in human populations.
- HIV / AIDS (1981 and probably longer):This will have its own show one day and this is its teaser. Everyone is aware, to some extent, of HIV/AIDS. So a very brief summary here. On June 5, 1981, The U.S. Center for Disease Control and Prevention published a Morbidity and Mortality Weekly Report describing cases of a rare lung infection, Pneumocystis carinii pneumonia, in five young, previously healthy, gay men in Los Angeles. All the men have other unusual infections as well, indicating that their immune systems are not working; two have already died by the time the report is published. This edition of the MMWR marks the first official reporting of what will become known as the AIDS epidemic. Fast forward to 2014 and we know SO much more about it. About its origin, its epidemiology, treatment, and more. According to the World Health Organization, an estimated 36 million people have died since the first reported cases in ‘81. Currently 35.2 million people are living with HIV/AIDS. Stay tuned for WAY more info on this in a future episode.
- The Common Cold: ATCHOO!! There are many different viruses that can cause cold symptoms, but about half the time a cold is caused by a class of viruses call rhinoviruses. It gets into the cells lining your nose and starts reproducing. It is not a result specifically of cold weather, but cold weather does tend to cause people to congregate together indoors more, which makes transmission of the virus easier.
- 1633-1634 Smallpox Epidemic in New England: This smallpox epidemic hit the Massachusetts colony in 1633, affecting settlers and Native Americans. The casualties included 20 settlers from the Mayflower and their only physician Dr. Samuel Fuller… who probably tried to bleed the smallpox out, I imagine. Also 15 children died as well as untold numbers of Native Americans who were wholly unfamiliar with the disease.
- 1977 Mexican Hot Sauce Botulism Outbreak: In 1977, 59 people fell ill due to a botulism outbreak. It began when a Mexican restaurant in Pontiac served hot sauce made out of improperly home-canned jalapeño peppers. The first cases of type B botulism were reported to state health officials three days later, according to the U.S. Centers for Disease Control and Prevention, and what is today called the Michigan Department of Community Health. Ultimately, 58 Michiganders and one person visiting from Ohio were sickened, some very seriously. No one died. Trini and Carmen’s restaurant had previously used fresh peppers, but switched to canned ones March 28. The vegetables were canned in the fall of 1976, in anticipation of an expected shortage of jalapeños that winter. The outbreak was the second one in the U.S. that year caused by incorrectly canned jalapeños. Symptoms included constipation, double vision, sensitivity to light, speech problems, nausea and vomiting, stomach pains, diarrhea, headaches, dizziness and general weakness. Oakland County officials closed the eatery March 31 and seized 147 jars of peppers. The American Journal of Epidemiology later reported that the canner used proper jars, lids and rings, but didn’t reboil some jars after filling them: “After a number of days, some of the jars began to explode on their shelves. … The jars that did not explode were kept.” The largest previous botulism outbreak was in Michigan in 1921, when three people died and 29 people got sick with type A botulism after eating commercially-canned spinach, according to the CDC.
- 2010 – 2014 Whooping Cough Epidemic: Pertussis, commonly called whooping cough is a highly contagious bacterial disease caused by Bordetella pertussis. Symptoms are initially mild, and then develop into severe coughing fits, which produce the namesake high-pitched “whoop” sound in infected babies and children when they inhale air after coughing. You can thank anti-vaxxer shitbirds for the reemergence of Pertussis and 9,447 cases reported in 2010 resulting in 10 deaths. 42,277 in reported cases in 2012 including 20 pertussis-related deaths. 28,639 cases in 2013 with increased rates of adolescents 13-15 years of age. And so far in 2014 17,325 cases of pertussis have been reported to CDC with 3 deaths resulting.
Epidemics and Pandemics in pop culture:
Outbreak (loosely based on ebola)
The “Bring Out Your Dead” scene in Monty Python and the Holy Grail
The Andromeda Strain (book & film)
28 Days Later & 28 Weeks Later
The Happening (JO – I liked it and here’s why)
Blindness (Book & Film)
Right At Your Door (Film … kiiinda fits?)
WUTs
Creationism coming to Ohio classrooms? Not without a court fight
Ohio’s current science standards spell out how evolution should be taught in schools… but do not address how religious views on the origins of the earth and of people should be handled. That’s left to districts, although courts have set limits.
Now, muddled language in House Bill 597 – a proposal to kill the multi-state Common Core and other state education standards – aims to let schools mix religious views with scientific ones, according to the bill’s sponsors.
…
Bill sponsors also want different political views on scientific issues, like global warming, to be required to be taught.
Language in the bill is unclear. Along with killing the Common Core and other standards adopted by the state in recent years, the bill proposes new standards in their place. The proposed science standards would “prohibit political or religious interpretation of scientific facts in favor of another.”
…
State Rep. Andy Thompson, a Marietta Republican who co-sponsored the bill, told The Plain Dealer this week that the language allows districts to teach faith-based beliefs as part of science classes. He said specifically that it would allow Intelligent Design – a creationist view that life and the world are too complex to have been arisen by chance and must have been created by a supernatural force.
“It gives some flexibility to districts to pursue what they think is most appropriate to their students,” Thompson said. “We want to have the ability to share perspectives that differ. Teaching one thing to the exclusion of anything else limits the discussion.”
Thompson also told the Columbus Dispatch that students should hear about Intelligent Design along with evolution.
“I think it would be good for them to consider the perspectives of people of faith,” the Dispatch reported. “That’s legitimate.”
Oh, yay! Intelligent design again! Because we definitely didn’t see how horribly this went over in the Kitzmiller v. Dover case nine years ago, where the Dubya-appointed Republican federal judge wrote a scathing opinion against the school district and the “breathtaking inanity” of their decision to promote ID, which was nothing more than “cloaking religious beliefs in scientific-sounding language.”
And this “we should teach different perspectives” nonsense has no place in science class. It’s like saying, “yes, science tells us that gravity attracts massive objects to each other, but I choose to believe that it’s really the earth giving us a big hug.”
Also, can I tell you how much it infuriates me that legislators are explicitly saying that scientific facts are open to religious or political interpretation? Here’s the deal: reality does not care at all how you feel about it. Reality just does what it does.
Here’s the actual new text from the science standards [emphasis added]:
The standards in science shall be based in core existing disciplines of biology, chemistry, and physics; incorporate grade-level mathematics and be referenced to the mathematics standards; focus on academic and scientific knowledge rather than scientific processes; and prohibit political or religious interpretation of scientific facts in favor of another.
As a side note, language nearly identical to the last clause is also being proposed with regards to social studies classes. Five bucks says that this is just opening the door for allowing the teaching that America is a Christian nation.
Feedback
We finally got our first feedback. From a comment on Erno’s trailer video: From Aussie King(?): “Hope to see the same legal action that happened against Westboro Church against u all”. Me too. They won, fucknugget.
“think it won’t happen? Think again, we love our veterans and nobody I’ve met will defend ur disgusting attitude.” We never said a single fucking negative thing about veterans you illiterate unclefucker.
“I don’t even need to watch this piece of crap like 39 other ppl didn’t”. And yet this mouth breather thinks he’s making a rational comment about what he didn’t watch…
“just came to to say fk u and have fun being a loser, maybe one day one of those lesbian feminazi’s u hang with will actually have sex with u like u’ve been trying to for so long, i doubt it tho.”
Links and Attributions
WHO – Pandemic and Epidemic Diseases
Slate – Outbreaks vs. Epidemics
New Evidence Exonerates Rats as Bearers of Black Death
No, Rats Are Not Exonerated From The Black Death
Philosophize This! Podcast – Episode 22 – Blast off to the Renaissance!
Disseminated intravascular coagulation (Wikipedia)
Cronaca fiorentina di Marchionne di Coppo Stefani (Wikipedia)
Baldassarre Bonaiuti (Wikipedia)
CDC – Marburg Hemorrhagic Fever
WHO – Ebola virus disease facts sheet
Wikipedia – Ebola virus disease
Science News – Airborne transmission of Ebola unlikely, monkey study shows
Wikipedia – 2014 West Africa Ebola virus outbreak
BBC – Ebola ‘spreading too fast’
BBC – Nigeria placed on red alert over Ebola death.
http://allafrica.com/stories/201407310920.html
http://www.bbc.com/news/world-africa-28485041
http://www.usatoday.com/story/news/world/2014/08/12/priest-ebola-dies/13939545/
http://www.cnn.com/2014/08/12/health/ebola-outbreak/index.html?hpt=hp_t2
Ann Coulter says Ebola-infected missionary is “idiotic and narcissistic” for helping (possibly sensationalized title, will read to be certain)
Wikipedia – Global Spread of H5N1
How Stuff Works – What causes the common cold?
Massachusetts smallpox epidemic, 1633
36 episodi
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Manage episode 122242280 series 94767
WE’RE ALIVE! And we’ve got a good one! From August 31, 2014… yes, we’re that far behind…
Epidemic vs. Pandemic: From Slate.com – The CDC’s official definition of an epidemic is: “The occurrence of more cases of disease than expected in a given area or among a specific group of people over a particular period of time.” Since some diseases become more prevalent or lethal over time, while others become less severe, the CDC must adjust its statistical models to alter the definition of what’s truly more than expected.
A pandemic is an epidemic that occurs across several countries and affects a sizable portion of the population in each, although there’s no formal definition of what constitutes “sizable.” According to the CDC, the last influenza pandemic took place in 1968-69, when the Hong Kong flu killed 33,800 Americans between September and March.
Ebola / Marburg:
Two diseases that are similar, and similarly frightening are Marburg Virus Disease and Ebola Virus Disease. Trust me, you don’t want either of these monsters.
Marburg
Let’s talk about Marburg first. Marburg is a rare but severe hemorrhagic fever which affects both human and nonhuman primates. Marburg is a genetically unique zoonotic (or, animal-borne) RNA virus of the filovirus family. The Cuevavirus and five species of Ebola virus are the only other known members of the filovirus family. Marburg was first recognized in 1967, when outbreaks of hemorrhagic fever occurred simultaneously in laboratories in Marburg and Frankfurt, Germany and in Belgrade, Yugoslavia (which is now Serbia). Thirty one people fell ill, initially laboratory workers followed by several medical personnel and family member who had cared for them. Seven deaths were reported. The first people infected had been exposed to imported African green monkeys or their tissues while conducting research. One additional case was diagnosed retrospectively. Fatality rates in Marburg range outbreaks range from 24% to 88%
- Symptoms: The incubation period (interval from infection to onset of symptoms) varies from 2 to 21 days. Illness caused by Marburg virus begins abruptly, with high fever, severe headache and severe malaise. Muscle aches and pains are a common feature. Severe watery diarrhoea, abdominal pain and cramping, nausea and vomiting can begin on the third day. Diarrhoea can persist for a week. The appearance of patients at this phase has been described as showing “ghost-like” drawn features, deep-set eyes, expressionless faces, and extreme lethargy. In the 1967 European outbreak, non-itchy rash was a feature noted in most patients between 2 and 7 days after onset of symptoms. Many patients develop severe haemorrhagic manifestations between 5 and 7 days, and fatal cases usually have some form of bleeding, often from multiple areas. Fresh blood in vomit and faeces is often accompanied by bleeding from the nose, gums, and vagina. Spontaneous bleeding at venepuncture sites (where intravenous access is obtained to give fluids or obtain blood samples) can be particularly troublesome. During the severe phase of illness, patients have sustained high fever. Involvement of the central nervous system can result in confusion, irritability, and aggression. Orchitis has been reported occasionally in the late phase of disease (15 days). In fatal cases, death occurs most often between 8 and 9 days after symptom onset, usually preceded by severe blood loss and shock.
- Diagnosis:
- enzyme-linked immunosorbent assay (ELISA);
- antigen detection tests;
- serum neutralization test;
- reverse-transcriptase polymerase chain reaction (RT-PCR) assay; and
- virus isolation by cell culture.
- Treatment: Severe cases require intensive supportive care, as patients are frequently in need of intravenous fluids or oral rehydration with solutions containing electrolytes. There are no specific treatments available for Marburg, although some drug therapies have show promising results in laboratory studies.
- Outbreaks:
- 1967 Marburg and Frankfurt, West Germany and Belgrade, Yugoslavia. 7/31 deaths.
- 1975 Rhodesia and Johannesburg, South Africa. ⅓ deaths.
- 1980 Kenya. ½
- 1987 Kenya. 1/1
- 1988 Koltsovo, Soviet Union. 1/1 (laboratory accident)
- 1990 Koltsovo, Soviet Union. 0/1 (laboratory accident)
- 1998 – 200 Durba and Watsa, Democratic Republic of Congo. A total of 154 cases and 128 deaths of marburg virus infection were recorded during this outbreak. The case fatality was 83%. Two different marburg viruses, MARV and Ravn virus (RAVV), co-circulated and caused disease. It has never been published how many cases and deaths were due to MARV or RAVV infection.
- 2004 – 2005 Angola. 227/252
- 2007 Uganda. ⅓
- 2008 Uganda & Netherlands. 1/1
- 2012 Uganda 9/18
- Weaponization: The Soviet Union had an extensive offensive and defensive biological weapons program that included MARV. At least three Soviet research institutes had MARV research programs during offensive times: the Virology Center of the Scientific-Research Institute for Microbiology in Zagorsk (today Sergiev Posad), the Scientific-Production Association “Vektor” (today the State Research Center of Virology and Biotechnology “Vektor”) in Koltsovo, and the Irkutsk Scientific-Research Anti-Plague Institute of Siberia and the Far East in Irkutsk. As most performed research was highly classified, it remains unclear how successful the MARV program was. However, Soviet defector Ken Alibek claimed that a weapon filled with MARV was tested at the Stepnogorsk Scientific Experimental and Production Base in Stepnogorsk, Kazakh Soviet Socialist Republic(today Kazakhstan), suggesting that the development of a MARV biological weapon had reached advanced stages. Independent confirmation for this claim is lacking. At least one laboratory accident with MARV, resulting in the death of Koltsovo researcher Nikolai Ustinov, occurred during offensive times in the Soviet Union and was first described in detail by Alibek. After the collapse of the Soviet Union, MARV research continued in all three institutes
Ebola
Arguably nastier than Marburg, Ebola virus disease (EVD) is a severe, often fatal illness, with a case fatality rate of up to 90%. It is one of the world’s most virulent diseases.The infection is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people. During an outbreak, those at higher risk of infection are health workers, family members and others in close contact with sick people and deceased patients. Ebola outbreaks can devastate families and communities. Ebola first appeared in 1976 in 2 simultaneous outbreaks in Nzara, Sudan and in Yambuku, Democratic Republic of Congo. The latter was a village situated near the Ebola river, from which the disease takes its name.
Genus Ebolavirus is 1 of 3 members of the Filoviridae family (filovirus), along with Marburgvirus and Cuevavirus – which regrettably, I have nothing on that for this episode . Genus Ebolavirus comprises 5 distinct species:
- Bundibugyo ebolavirus
- Zaire ebolavirus
- Reston ebolavirus (Named for the strain discovered in Reston, WV. More on that shortly)
- Sudan ebolavirus
- Taï Forest ebolavirus
Some facts about Ebola
- Transmission: Ebola is introduced into the human population through close contact with the blood, secretions, organs or other bodily fluids of infected animals. In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest. Ebola then spreads in the community through human-to-human transmission, with infection resulting from direct contact (through broken skin or mucous membranes) with the blood, secretions, organs or other bodily fluids of infected people, and indirect contact with environments contaminated with such fluids. Burial ceremonies in which mourners have direct contact with the body of the deceased person can also play a role in the transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness. Health-care workers have frequently been infected while treating patients with suspected or confirmed EVD. This has occurred through close contact with patients when infection control precautions are not strictly practiced.
- Symptoms: EVD is a severe acute viral illness often characterized by the sudden onset of fever, intense weakness, muscle pain, headache and sore throat. This is followed by vomiting, diarrhoea, rash, impaired kidney and liver function, and in some cases, both internal and external bleeding. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes. People are infectious as long as their blood and secretions contain the virus. Ebola virus was isolated from semen 61 days after onset of illness in a man who was infected in a laboratory. The incubation period, that is, the time interval from infection with the virus to onset of symptoms, is 2 to 21 days.
- Diagnosis:
- antibody-capture enzyme-linked immunosorbent assay*
- antigen detection tests*
- serum neutralization test*
- reverse transcriptase polymerase chain reactions assay*
- electron microscopy
- virus isolation by cell culture*
- Treatment?: No licensed vaccine for EVD is available. Several vaccines are being tested, but none are available for clinical use. Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral rehydration with solutions containing electrolytes or intravenous fluids. No specific treatment is available. New drug therapies are being evaluated.
- Outbreaks:
- 1976 Democratic Republic of Congo. Ebola Zaire – 280/318 (88%)
- 1976 Sudan. Ebola Sudan – 151/284 (53%)
- 1977 Democratic Republic of Congo. Ebola Zaire – 1/1
- 1979 Sudan. Ebola Sudan – 22/34 (65%)
- 1994 Gabon. Ebola Zaire – 31/52 (65%)
- 1994 Cote d’Ivoire. Taï Forest – 0/1
- 1995 Democratic Republic of Congo. Ebola Zaire – 254/315 (81%)
- 1996 (Jan-Apr) Gabon. Ebola Zaire – 21/31 (68%)
- 1996 (Jul-Dec) Gabon. Ebola Zaire – 45/65 (75%)
- 1996 South Africa. Ebola Zaire – 1/1
- 2000 Uganda. Ebola Sudan – 224/425 (53%)
- 2001-2002 Gabon. Ebola Zaire – 53/65 (82%)
- 2001-2002 Congo. Ebola Zaire – 44/59 (75%)
- 2003 (Jan-Apr) Congo. Ebola Zaire – 128/143 (90%)
- 2003 (Nov-Dec) Congo. Ebola Zaire – 29/35 (83%)
- 2004 Sudan. Ebola Sudan – 7/17 (41%)
- 2005 Congo. Ebola Zaire – 187/264 (71%)
- 2007 Democratic Republic of Congo. Ebola Zaire – 14/32 (44%)
- 2007 Uganda. Ebola Bundibugyo – 37/149 (25%)
- 2008 Democratic Republic of Congo. Ebola Zaire – 14/32 (44%)
- 2011 Uganda. Ebola Sudan – 1/1
- 2012 Uganda. Ebola Sudan – 17/24 (71%)
- 2012 Uganda. Ebola Sudan – 4/7 (57%)
- 2012 Democratic Republic of Congo – 29/57 (51%)
- 2014: The ongoing, as of recording this show, outbreak of Ebola in West Africa actually began in December of 2013, but was not detected until 2014. It began in Guinea and has since spread to Liberia, Sierra Leone and Nigeria. Individual cases related to this outbreak, which not in every case turned out to be positive for Ebola, have landed in Benin, Democratic Republic of Congo, Ghana, Saudi Arabia, Spain and the United States (expand on that here).
- Natural Hosts: Both Marburg and Ebola are harbored in fruit bats. The bats do not show obvious signs of illness. It would appear that different species may harbor it and that their overlapping ranges mean that an overlap of range of the virus exists as well.
- Weaponization?: Similar to Marburg, Ebola is believed to be a component in the weaponization of infectious diseases since 1992. Sources I found cited Russian weapons development as the suspected source. Because the United States would never do such a horrific thing. Amirite? (enough sarcasm?)
Ebola Reston (the potential Hooooly shit): First described in 1990 as a new “strain” of Ebola virus, a result of mutation. It is the single member of the species Reston ebolavirus. It’s named after Reston, Virginia where the virus was first discovered. It was discovered in crab-eating macaques from Hazelton Laboratories in 1989. This drew a lot of media attention due to the proximity of Reston to the Washington, DC metro area, and the lethality of a closely related Ebola virus. Despite it’s status as a level-4 organism, Reston virus is non-pathogenic to humans, though hazardous to monkeys. The perception of its lethality was compounded due to the monkey’s coinfection with Simian hemorrhagic fever virus. (Level 4: Virus Hunters of the CDC)
Ebola in 2014: Beginning in December 2013 in Guinea, but not detected until March 2014, after which it spread to Liberia, Sierra Leone, Nigeria, and Senegal. The outbreak is caused by the Zaire ebolavirus. As of August 26th, 3,069 suspected cases and 1,552 deaths. Another outbreak in the Democratic Republic of Congo has killed 13 people as of August 26th. It’s believed to be unrelated to the West African outbreak.
Influenza 1918: (Read the Wikipedia article.) It’s great.
Black Death:
History
The Black Death had one of the highest body counts of any disease ever known to man. Between 1346 and 1353, it killed between 75 and 200 million people in Eurasia – between 30% and 60% of the region’s populace. At the time, the world’s population was only about 450 million, and the plague far outpaced the global birth rate, reducing the population to around 350 to 375 million.
The actual origin of the disease isn’t entirely clear, but most historians think it began in central Asia, travelling along the Silk Road trade route and reaching the Crimea by 1343. From there, it traveled across and around the Mediterranean by way of infected fleas on the rats commonly found on merchant ships. After that, it was spread on land both by rats and by humans, most often by coughing or contact with flea-carrying infected animals.
Earlier this year, an article popped up claiming that rats had been “exonerated” for being plague carriers, but it was really just coverage of a press conference about a new documentary about the Black Death; the documentary correctly blamed rats and rat fleas, but the news coverage itself incorrectly believed they were saying the rats weren’t to blame.
In his Florentine Chronicle, Baldassarre Bonaiuti talks of what life was like for the average citizen while the plague was at its peak:
All the citizens did little else except to carry dead bodies to be buried. At every church they dug deep pits down to the water-table; and thus those who were poor who died during the night were bundled up quickly and thrown into the pit. In the morning when a large number of bodies were found in the pit, they took some earth and shoveled it down on top of them; and later others were placed on top of them and then another layer of earth, just as one makes lasagne with layers of pasta and cheese.
It wasn’t just in Europe, either. The plague spread throughout the Middle East, including Iraq, Iran, and Syria. It killed about 40% of Egypt’s population. Only severely isolated locations were really safe.
Following the original pandemic, the plague continued to ravage Europe well into the 17th century, at times killing by the tens or hundreds of thousands. A third resurgence started in China in the 19th century, spreading to every inhabited continent. 10 million people died in India alone.
Cause and Symptoms
Healers at the time had absolutely no idea what the hell was going on. The disease spread and killed too quickly for any real reliable treatment information to spread – if any was even found at all, which is unlikely.
Jews faced widespread persecution, often being accused of poisoning wells to cause the plague (hence the fallacy of that name). Some 210 Jewish communities were utterly destroyed.
Lepers and other people with skin diseases – even things as simple as acne – were also blamed for the plague, and thus singled out and exterminated. Europeans also blamed astrological forces and earthquakes.
The Black Death is actually several different kinds of plague wrapped up in a nice little bundle of doom carried by the Yersinia pestis bacterium. Bubonic, pneumonic, and septicemic plague were among the most common varieties. To make things worse, the poor bastards who got infected with one form quite often wound up with the rest as well.
Bubonic plague
Bubonic plague causes buboes – that is, a swollen lymph node. They look a bit like huge blisters, usually appearing under the armpit, in the groin, or on the neck. Doctors at the time of the Black Death often thought that the buboes should be burst open to leech the plague from the body, but modern medicine considers this treatment useless at best and harmful at worst (since the wound would be at high risk of infection).
But the buboes weren’t the end of the fun. Gangrene of the extremities (toes, fingers, lips, and the tip of the nose) was common, as were chills, a general sense of being ill, high fevers, extreme fatigue, muscle cramps, seizures, heavy and continuous vomiting of blood, aching limbs, coughing, gastrointestinal problems, delirium, coma, and – best of all! – extreme pain caused by decay or decomposition of the skin while the person is still alive.
The mortality rate for bubonic plague, left totally untreated, is between 40 and 60%.
Pneumonic plague
As I mentioned before, in some cases, the plague could also be spread through coughing. In Popular Science’s article clearing up the confusion about rats being cleared of blame, they explain how:
In some people, bubonic plague spreads to the lungs, although it isn’t known whether this is because they are more susceptible to lung infections or because certain Yersinia strains are better equipped to infiltrate the lungs. Either way, this is a secondary pneumonic plague infection. If a person with secondary pneumonic plague sneezes or coughs on someone else, that someone else may get a primary pneumonic plague infection.
Pneumonic plague is much more virulent and rare than bubonic plague, and also much more severe. It can result from the inhalation of aerosolized plague bacteria, or when septicemic plague spreads into the lungs from the bloodstream. There have even been cases of pneumonic plague resulting from the dissection or handling of contaminated animal tissue.
The most obvious symptom is a severe, often bloody cough. This is accompanied by fever, headache, weakness, rapidly developing pneumonia, shortness of breath, and chest pain. Infected people can suffer respiratory failure and shock, and death can occur as soon as within 36 hours. Left untreated, the mortality rate is almost 100%.
Septicemic plague
Septicemic plague occurs when an existing primary bubonic plague infection spreads from the lymph system into the circulatory system. And holy shit is it ever bad news.
One of the nastiest symptoms of septicemic plague is the terrifyingly named disseminated intravascular coagulation, which is a widespread activation of the clotting cascade that causes blood clots to form in the small blood vessels throughout the body. Bad news. This causes serious problems with blood flow, ultimately leading to multiple organ damage or failure. What’s more, because so much clotting is going on, the regular clotting process faces a shortage of platelets and clotting factors, leading to severe bleeding from wounds – like, say, a lanced bubo. (Ironically enough, draining the lymph nodes actually is recommended as part of the treatment of septicemic plague.)
Other symptoms include things like abdominal pain; bleeding under the skin; bleeding from the mouth, nose, and rectum; diarrhea; fever; chills; low blood pressure; nausea; organ failure; vomiting; shock; gangrene; and difficulty breathing. But here’s the kicker – sometimes it will kill you before you show any symptoms at all.
Thankfully, septicemic plague is also the rarest form of the plague. It only occurs in a small minority of cases of infection with Yersinia pestis.
Effects on society
The Black Death essentially marked the end of the Middle Ages and the beginning of the Renaissance. So many people died that European society was devastated and had to rebuild itself almost from the ground up, taking well over a century for the population to fully recover. Their whole way of life changed. Political, social, and economic systems collapsed under widespread unrest, and huge swaths of the population just stopped engaging in society altogether to reduce the risk of being exposed to infection. The church lost much of influence as people began to distrust its promises of God’s mercy, healing, and so on, and it didn’t help that monks and priests (who often tended to the dead) were especially hard-hit by the disease.
Imagine seeing 30-60% of the people you know die after showing the symptoms I mentioned. Imagine the kind of impact that would have on your outlook for the future. People suddenly realizing that humanity could be on the verge of being wiped out at any time kind of gave them a new perspective on things.
Steven West of the Philosophize This! podcast summarizes the whole situation quite well:
… [T]hen the faithful law of supply and demand started to take over. Peasants became increasingly more valuable as more and more of them died. The supply of peasants couldn’t keep up with the demand of work that needed to get done to feed society. When a company today can’t get enough people to willingly do a job for a certain salary, they are forced to raise the salary, and that is exactly what happened in Western Europe during the fall of the Middle Ages. Though it was completely illegal, the desperate times allowed for peasants to shop around with other land owners to try to make a better wage. These subjugated people were finally seeing what it was like to be a free citizen with a skill set that people valued. What started as merely a pandemic disease that led to a population crisis, quickly turned into an economic crisis as well, because the owners of these fields couldn’t afford to pay for the rising cost of their workforce. This threatened a complete collapse of the Agriculture of the region, so what the governments did to try to combat this was impose a wage freeze.
This wage freeze in coalition with several other small regulations and the massive tax increase on citizens to fight the 100 years war with France led to peasants banding together and attempting to overthrow their governments. So what started as a population crisis, quickly turned into an economic crisis that then turned into a political crisis. …
This crisis heralded the beginning of the Renaissance – the rebirth of European society as something new and previously unknown.
Status in the modern world
So what about now? Surely we’ve got this beaten by now, right?
Well… do you own a cat? Does it ever bring you dead mice? I sure hope that you handle them with gloves, and that you keep an eye out for symptoms in your pussy. Because the plague is not dead. Not in any way, shape, or form.
Yes, in this advanced modern world, Yersinia pestis is still very much active. Plague outbreaks are nowhere near as large or as frequent as they used to be, but they definitely still happen.
Since 2002, the World Health Organisation has reported seven plague outbreaks, though some may go unreported because they often happen in remote areas. Between 1998 and 2009, nearly 24,000 cases were reported, including about 2,000 deaths, in Africa, Asia, the Americas and Eastern Europe. 98 percent of the world’s cases occur in Africa.
Every year, between 4000 and 5000 people still come down with the septicemic plague.
Wikipedia notes:
On July 10, 2014, in an online news story article, by Keith Coffman of Reuters, featured on the MSN U.S. News website, it was stated that a Colorado man, whose condition the report said was not known, had been diagnosed with the pneumonic plague. The man was found to have the disease after the family dog died unexpectedly and a necropsy conducted on it revealed it had died from the disease.
As of July 18, 2014, three more cases were reported in Colorado. However, the outbreak appears to be over, according to state officials.
Plague has been active in black-tailed prairie dog populations for the past 40–50 years. In the United States outbreaks only occur in the western States and they are devastating, with mortality rates near 100% because the animals have no immunity to the plague. Survivors are the ones that happened not to become infected and colonies that recover from a plague outbreak remain at risk.
Currently, 5 to 15 people in the United States are estimated to catch the disease each year—typically in western states. And there’s good news! One case of a drug-resistant form of Yersinia pestis was found in Madagascar in 1995. Experts believe that, should another drug-resistant form evolve somewhere more populated, we could face yet another pandemic – and I can only imagine what that would be like in today’s world, as connected and global as we are. The death toll could reach the billions.
Treatment
Bubonic and pneumonic plague are both very aggressive infections requiring early treatment. Antibiotics must be given within 24 hours of first symptoms to reduce the risk of death.
Several classes of antibiotics are effective in treating plague. Mortality associated with treated cases of bubonic plague is about 1–15%.
Be sure to have a will prepared.
Honorable(?) Mentions
- Bird Flu: Avian flu is carried in many wild birds and doesn’t tend to make the host ill. Some domesticated birds (chickens, ducks, pet birds, pet cats, etc) are susceptible to avian flu and can be lethal to them. People can contract some strains of avian flu and since 2004, 638 cases of human infection of a strain of avian flu, H5N1 it’s called, have been reported with 379 deaths. That’s 59% mortality rate. So thankfully it’s not very readily spread in human populations.
- HIV / AIDS (1981 and probably longer):This will have its own show one day and this is its teaser. Everyone is aware, to some extent, of HIV/AIDS. So a very brief summary here. On June 5, 1981, The U.S. Center for Disease Control and Prevention published a Morbidity and Mortality Weekly Report describing cases of a rare lung infection, Pneumocystis carinii pneumonia, in five young, previously healthy, gay men in Los Angeles. All the men have other unusual infections as well, indicating that their immune systems are not working; two have already died by the time the report is published. This edition of the MMWR marks the first official reporting of what will become known as the AIDS epidemic. Fast forward to 2014 and we know SO much more about it. About its origin, its epidemiology, treatment, and more. According to the World Health Organization, an estimated 36 million people have died since the first reported cases in ‘81. Currently 35.2 million people are living with HIV/AIDS. Stay tuned for WAY more info on this in a future episode.
- The Common Cold: ATCHOO!! There are many different viruses that can cause cold symptoms, but about half the time a cold is caused by a class of viruses call rhinoviruses. It gets into the cells lining your nose and starts reproducing. It is not a result specifically of cold weather, but cold weather does tend to cause people to congregate together indoors more, which makes transmission of the virus easier.
- 1633-1634 Smallpox Epidemic in New England: This smallpox epidemic hit the Massachusetts colony in 1633, affecting settlers and Native Americans. The casualties included 20 settlers from the Mayflower and their only physician Dr. Samuel Fuller… who probably tried to bleed the smallpox out, I imagine. Also 15 children died as well as untold numbers of Native Americans who were wholly unfamiliar with the disease.
- 1977 Mexican Hot Sauce Botulism Outbreak: In 1977, 59 people fell ill due to a botulism outbreak. It began when a Mexican restaurant in Pontiac served hot sauce made out of improperly home-canned jalapeño peppers. The first cases of type B botulism were reported to state health officials three days later, according to the U.S. Centers for Disease Control and Prevention, and what is today called the Michigan Department of Community Health. Ultimately, 58 Michiganders and one person visiting from Ohio were sickened, some very seriously. No one died. Trini and Carmen’s restaurant had previously used fresh peppers, but switched to canned ones March 28. The vegetables were canned in the fall of 1976, in anticipation of an expected shortage of jalapeños that winter. The outbreak was the second one in the U.S. that year caused by incorrectly canned jalapeños. Symptoms included constipation, double vision, sensitivity to light, speech problems, nausea and vomiting, stomach pains, diarrhea, headaches, dizziness and general weakness. Oakland County officials closed the eatery March 31 and seized 147 jars of peppers. The American Journal of Epidemiology later reported that the canner used proper jars, lids and rings, but didn’t reboil some jars after filling them: “After a number of days, some of the jars began to explode on their shelves. … The jars that did not explode were kept.” The largest previous botulism outbreak was in Michigan in 1921, when three people died and 29 people got sick with type A botulism after eating commercially-canned spinach, according to the CDC.
- 2010 – 2014 Whooping Cough Epidemic: Pertussis, commonly called whooping cough is a highly contagious bacterial disease caused by Bordetella pertussis. Symptoms are initially mild, and then develop into severe coughing fits, which produce the namesake high-pitched “whoop” sound in infected babies and children when they inhale air after coughing. You can thank anti-vaxxer shitbirds for the reemergence of Pertussis and 9,447 cases reported in 2010 resulting in 10 deaths. 42,277 in reported cases in 2012 including 20 pertussis-related deaths. 28,639 cases in 2013 with increased rates of adolescents 13-15 years of age. And so far in 2014 17,325 cases of pertussis have been reported to CDC with 3 deaths resulting.
Epidemics and Pandemics in pop culture:
Outbreak (loosely based on ebola)
The “Bring Out Your Dead” scene in Monty Python and the Holy Grail
The Andromeda Strain (book & film)
28 Days Later & 28 Weeks Later
The Happening (JO – I liked it and here’s why)
Blindness (Book & Film)
Right At Your Door (Film … kiiinda fits?)
WUTs
Creationism coming to Ohio classrooms? Not without a court fight
Ohio’s current science standards spell out how evolution should be taught in schools… but do not address how religious views on the origins of the earth and of people should be handled. That’s left to districts, although courts have set limits.
Now, muddled language in House Bill 597 – a proposal to kill the multi-state Common Core and other state education standards – aims to let schools mix religious views with scientific ones, according to the bill’s sponsors.
…
Bill sponsors also want different political views on scientific issues, like global warming, to be required to be taught.
Language in the bill is unclear. Along with killing the Common Core and other standards adopted by the state in recent years, the bill proposes new standards in their place. The proposed science standards would “prohibit political or religious interpretation of scientific facts in favor of another.”
…
State Rep. Andy Thompson, a Marietta Republican who co-sponsored the bill, told The Plain Dealer this week that the language allows districts to teach faith-based beliefs as part of science classes. He said specifically that it would allow Intelligent Design – a creationist view that life and the world are too complex to have been arisen by chance and must have been created by a supernatural force.
“It gives some flexibility to districts to pursue what they think is most appropriate to their students,” Thompson said. “We want to have the ability to share perspectives that differ. Teaching one thing to the exclusion of anything else limits the discussion.”
Thompson also told the Columbus Dispatch that students should hear about Intelligent Design along with evolution.
“I think it would be good for them to consider the perspectives of people of faith,” the Dispatch reported. “That’s legitimate.”
Oh, yay! Intelligent design again! Because we definitely didn’t see how horribly this went over in the Kitzmiller v. Dover case nine years ago, where the Dubya-appointed Republican federal judge wrote a scathing opinion against the school district and the “breathtaking inanity” of their decision to promote ID, which was nothing more than “cloaking religious beliefs in scientific-sounding language.”
And this “we should teach different perspectives” nonsense has no place in science class. It’s like saying, “yes, science tells us that gravity attracts massive objects to each other, but I choose to believe that it’s really the earth giving us a big hug.”
Also, can I tell you how much it infuriates me that legislators are explicitly saying that scientific facts are open to religious or political interpretation? Here’s the deal: reality does not care at all how you feel about it. Reality just does what it does.
Here’s the actual new text from the science standards [emphasis added]:
The standards in science shall be based in core existing disciplines of biology, chemistry, and physics; incorporate grade-level mathematics and be referenced to the mathematics standards; focus on academic and scientific knowledge rather than scientific processes; and prohibit political or religious interpretation of scientific facts in favor of another.
As a side note, language nearly identical to the last clause is also being proposed with regards to social studies classes. Five bucks says that this is just opening the door for allowing the teaching that America is a Christian nation.
Feedback
We finally got our first feedback. From a comment on Erno’s trailer video: From Aussie King(?): “Hope to see the same legal action that happened against Westboro Church against u all”. Me too. They won, fucknugget.
“think it won’t happen? Think again, we love our veterans and nobody I’ve met will defend ur disgusting attitude.” We never said a single fucking negative thing about veterans you illiterate unclefucker.
“I don’t even need to watch this piece of crap like 39 other ppl didn’t”. And yet this mouth breather thinks he’s making a rational comment about what he didn’t watch…
“just came to to say fk u and have fun being a loser, maybe one day one of those lesbian feminazi’s u hang with will actually have sex with u like u’ve been trying to for so long, i doubt it tho.”
Links and Attributions
WHO – Pandemic and Epidemic Diseases
Slate – Outbreaks vs. Epidemics
New Evidence Exonerates Rats as Bearers of Black Death
No, Rats Are Not Exonerated From The Black Death
Philosophize This! Podcast – Episode 22 – Blast off to the Renaissance!
Disseminated intravascular coagulation (Wikipedia)
Cronaca fiorentina di Marchionne di Coppo Stefani (Wikipedia)
Baldassarre Bonaiuti (Wikipedia)
CDC – Marburg Hemorrhagic Fever
WHO – Ebola virus disease facts sheet
Wikipedia – Ebola virus disease
Science News – Airborne transmission of Ebola unlikely, monkey study shows
Wikipedia – 2014 West Africa Ebola virus outbreak
BBC – Ebola ‘spreading too fast’
BBC – Nigeria placed on red alert over Ebola death.
http://allafrica.com/stories/201407310920.html
http://www.bbc.com/news/world-africa-28485041
http://www.usatoday.com/story/news/world/2014/08/12/priest-ebola-dies/13939545/
http://www.cnn.com/2014/08/12/health/ebola-outbreak/index.html?hpt=hp_t2
Ann Coulter says Ebola-infected missionary is “idiotic and narcissistic” for helping (possibly sensationalized title, will read to be certain)
Wikipedia – Global Spread of H5N1
How Stuff Works – What causes the common cold?
Massachusetts smallpox epidemic, 1633
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