Thursday, October 25, 2012

Threatwatch: Find the germs, don't sack the messenger

Threatwatch is your early warning system for global dangers, from nuclear peril to deadly viral outbreaks. Debora MacKenzie highlights the threats to civilisation ? and suggests solutions

Governments have a holy horror of being associated with germs ? and this suits the germs just fine. Official denial about BSE, SARS and H5N1 bird flu exacerbated their spread, while India's main concern about a worrying antibiotic resistance gene seems to be that it was named for where it was discovered ? New Delhi.

In all those cases scientists have been intimidated and stopped from working on the microbe the government deems bad PR. Now Saudi Arabia has sacked its top virus-hunter for discovering a virus that hardly threatens anyone.

This is all the more sad because the Saudis know better than most how vital it is to share surveillance on infectious disease. They host the largest annual human gathering on earth: the Hajj, the annual pilgrimage to Mecca taking place this week that attracts three million Muslims, 1.8 million from abroad.

With crowded, stressed people all carrying different germs, contagion is inevitable ? "Hajj cough" is common ? and a serious outbreak could be dire. So in a military-scale operation, Saudi health authorities screen and treat arriving pilgrims for conditions from food poisoning to plague, and require vaccination for meningitis and other maladies. This year they refused pilgrims from Uganda and the Democratic Republic of Congo, for fear they were infected by recent outbreaks of Ebola.

Mystery pneumonia case

Ziad Memish, deputy Saudi minister for public health and head of the WHO Collaborating Centre for Mass Gathering Medicine in Riyadh, knows the need for science in all this. He helped found an exemplary international collaboration to study health at the Hajj, and wrote recently that "sharing of information and research findings are critically important elements of the programme".

So you'd think he'd appreciate Ali Zaki, a virologist at the Dr. Soliman Fakeeh Hospital in Jeddah, already the first to identify dengue fever and a new tick-borne flavivirus in Saudi Arabia. In August Zaki sent a sample from a mysterious, fatal case of pneumonia to Ron Fouchier, a virologist in Rotterdam, the Netherlands.

Fouchier discovered a novel coronavirus in it. Zaki posted this on ProMed, the internet mailing list for emerging disease. Within days, a UK hospital discovered an identical case who had also been in Saudi Arabia.

Also within days, "an investigation team from the Saudi ministry of health arrived at the hospital to investigate me aggressively, threatening me about what I had done," Zaki told New Scientist. Shaken, he took emergency leave in Cairo ? and, he says, was told it was not safe to come back. His employment has been terminated.

Pilgrims assured

You can almost understand officials being upset about news of a novel virus a few weeks before millions of visitors arrive. But because of the prompt action, it was quickly established that the virus probably doesn't transmit among humans. In October Memish could assure pilgrims that it posed little risk.

Memish complains on ProMed that loose talk about viruses does more harm than good, and that internal reporting mechanisms were circumvented. "We only knew about the concerns about the novel coronavirus from ProMed in September," months after the patient died, Memish told New Scientist. "I think this would not be acceptable to any health authority in the world, especially with preparations for the Hajj at their peak."

You can see his point. But if the ministry had been informed would the sample still have been sent out immediately? Without that I doubt there would have been similarly rapid discovery ? few can match Fouchier's team for that. Would it have been better to go slow, only to discover during the Hajj that this lethal new virus could go epidemic? The frantic science Zaki unleashed was just the sort of joined-up international action public health experts plead for.

The situation won't improve until countries really commit to being open about infection. Yet the evidence suggests that at some level, maybe well above the health ministry, Saudi Arabia didn't want to be associated with a new virus. It was initially named, as usual, for its country of origin; that was changed at Saudi insistence. Now a scientist has paid the price for doing work we all need, whether or not we are hajjis.

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Source: http://feeds.newscientist.com/c/749/f/10897/s/24d073be/l/0L0Snewscientist0N0Carticle0Cdn224170Ethreatwatch0Efind0Ethe0Egerms0Edont0Esack0Ethe0Emessenger0Bhtml0Dcmpid0FRSS0QNSNS0Q20A120EGLOBAL0Qonline0Enews/story01.htm

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