Science and Infectious Disease

Monday, June 19, 2006

Eradicating Disease: Smallpox vs. Malaria

As I continue to do research, I'm finding more information both in support of, and in opposition to, the use of scientific means to treat/"cure" illness. The following two case studies I found interesting. They land on both sides of the issue.

Check it out:
In 1958 the Soviet Union went before WHO (the World Health Organization) and asked for international support in eliminating smallpox. Historically, smallpox has been a particularly vicious killer. It wiped out a quarter of the Roman population around 165 AD and ravaged multiple people groups throughout history (during the British colonization of the Americas, smallpox infested blankets and clothing were given to Native Americans, essentially wiping out the AmerIndian population at several points on the map). By 1958, smallpox killed roughly 2 million a year and was a serious issue in at least 33 countries. Although a vaccine had been discovered (a similar strain of smallpox, known as cowpox, had been in use for years and had a success rate of 99%) smallpox was still a major problem worldwide, and especially in Russia, Africa and Asia. Needless to say, the campaign to eradicate smallpox won international support almost immediately and worldwide vaccinations were put into effect beginning in 1960. Vaccination would reach points of 250 million a year, and teams of researchers travelled the world, seeking out those who had not been vaccinnated, mapping and treating outbreaks, and keeping tabs on varying strains of the smallpox virus. For the next 17 years these travelling researchers would devote their lives to eradicating this disease.
22 years after eradication was proposed, on May 8, 1980, WHO announced the world to be free of smallpox. Now, it is no longer a problem. It has literally been wiped off the face of the planet. (Yes, if you follow the news, there have been some questions raised recently about whether or not smallpox still exists, and if it were to be released upon the planet, yes, there would be a worldwide plague in which essentially a quarter (or more) of the population would die. But, barring this speculation, smallpox is a threat of the past-- one of the greatest acheivements in the history of the war against microbes.)

However.
On the flip side of the issue, around the same time as the campaign against smallpox, WHO also launched a campaign against malaria. The discovery of DDT (see below post) gave hope for the complete elimination of the Anopheles mosquito. Basically, DDT was an insecticide that rested in environments for years after the initial spraying. It had no effect on humans, but would kill certain insects who came in contact with it.
The year 1958 ushered in a worldwide campaign to eliminate malaria, and DDT spraying began simultaneously all over the globe, with at least $23.3 million a year in support from the US Congress. Dr. Paul Russell, a malariologist at Harvard at the time, led the campaign. He was adamant about the speed with which this process must be carried out. Failure to eliminate mosquitos in the proper time period could result in biological resistance to DDT and other insecticides. That could postpone the eradication of malaria indefinitely.
Because of the strict timeline, Congress agreed to fund the campaign through 1963, which was the proposed date for which malaria would essentially have been destroyed.
Needless to say, it didn't work out. By 1963, Russell was close to complete elimination of the disease. In some parts of the world (such as Sri Lanka, who had experienced 1 million cases a year previously and in 1963 had only 18. One eight.) were already celebrating Russell's success. However, he needed only a couple more years of funding to complete his mission. Congress, however, viewed Russell's gains as failure, and proceeded with their plan to withdraw funding. Without this essential chunk of the budget, DDT spraying halted, and little could be done for the fight against malaria. By the time Russell regained enough money to continue the campaign, DDT-resistant mosquitos had begun to emerge. Without additional forms of insecticide, they spread rapidly and took over, increasing the number of cases in places that had been nearly (if not completely) clear just two years earlier. Soon, malaria became even more prevalent, and cases more virulent, than they had been at any point in history. It is considered one of the biggest failures in scientific history.

1 Comments:

At 11:14 PM, Blogger Woody said...

I think another part of the problem is that smallpox is a virus, which one can make a vaccine against, and all you need is a one time shot. Simple.

Malaria is caused by a protozoa, and not only can mosquitos bite and infect humans, but infected humans can travel around the world (malaria stays in remission in your muscles for months or years without symptoms) and be bitten by an uninfected mosquito, which then becomes infected, and goes on to infect others.

Oh, and by the way, Russia is missing one of its vials of smallpox. Seriously. They have no idea where it is, they just know it's missing.

 

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