Emerging diseases challenge doctors

Young doctors need to expand their medical horizons to take into account terrorism, juvenile violence, and rogue elephants when considering the planet’s emerging diseases.

This was the message from St. Matthews University School of Medicine Associate Professor Gerardo Ochoa-Vargas, who spoke to medical students on Friday.

In a seminar, tantalisingly titled ‘On Bats, Apes, Pigs, Elephants and Terrorists’, Dr. Ochoa-Vargas touched on how each of those unlikely subjects played a part in the emergence of new diseases globally.

He told students that the medical profession needed to change its mindset from dealing with traditional diseases to considering how global warming or international travel or the displacement of species from their natural environment would affect the spread of existing diseases and the emergence of new ones.

‘Several factors continue to contribute to emerging diseases scenarios, for example, global warming, natural disasters – when a hurricane hits a territory and burdens the public health system – markets and roads, the practice of spreading not only merchandise, but also diseases between territories,’ he said

He cited the growing issue of refugees and emigration as another factor in the spread of diseases across borders.

Unlikely factors, such as juvenile delinquency, paedophilia and violence also played roles in emerging diseases, he said.

‘Many things work together to create situations in which we are going to see the appearance of new diseases – economical crises, nuclear reactors, avian flu, tsunamis, wars, terrorist attacks, refugees and AIDS,’ he told students.

The rise in obesity, testicular cancer and suicide worldwide were also worrying factors that students would need to examine once they embarked on medical careers.

Speaking on the recent emergence of swine flu, he said: ‘Right now, the disease is highly infectious, but not very lethal. However, a shift can happen at any moment.’

By 19 June, the day of his lecture, there had been 180 deaths and 44,000 cases of swine flu, or H1N1, worldwide.

Mr. Ochoa-Vargas also described how social attitudes can also affect the spread of a disease. He said homophobia could cause people to fail to seek treatment for HIV or AIDS because individuals feared for their lives, not from the disease itself, but because they were afraid of being violently targeted.

‘It is a major factor,’ he said.

Mr. Ochoa-Vargas said the displacement of organisms out of their natural territories meant that bacteria and viruses were spreading to different species.

He described the case of the Nipah virus in Malaysia. There pig farms were built in the rainforest, the home of fruit bats, which defecated on the pig food, introducing the virus to the pigs and then to humans. The virus has a high mortality rate.

‘By displacing and reaching into areas, you can have a potential disaster,’ he explained.

He used the example of young, orphaned elephants in eastern South Africa that killed between 50 and 50 rhinos.

‘These juvenile elephants did not have role models,’ he said, adding that when older elephants were introduced to the herd, the violent behaviour of the young elephants stopped.

He used this as an example to explain how hysteria over paedophilia meant that adults were becoming afraid to interact with children, meaning role models were also disappearing from human society. He cited a case of a young girl who drowned because passers-by were afraid to jump in the water and rescue her in case they were accused of inappropriate behaviour.

Terrorism, both home-grown and foreign, with its threat of bio-weapons was also an element that could play a factor in emerging diseases, the doctor warned, describing how people could find information online on how to create a deadly virus.

‘I want you to know there are options and choices and solutions, but they are really difficult. I think if we continue to use the same approach to the phenomena we have in use and relying on experts and the consensus that is created, we are doomed.’

He advised that education was key to understanding and dealing with the many diverse factors involved in emerging diseases. Ending on an upbeat note, he showed a slide of how basic hand washing eliminated all traces of bacteria on an individual’s hand, highlighting that while the scenarios behind the emergence of diseases were complex, there was a chance that the solutions to some were quite simple.