Is the World Prepared for Pandemic?
As new viruses emerge in China and the Middle East, the world is poorly prepared for a global pandemic
IN FEBRUARY an 87-year-old man was admitted to hospital in Shanghai. What started as a cough progressed to a fever. One week later, unable to breathe and with his brain inflamed, he died. Shortly afterwards, a 27-year-old pork butcher was admitted to the same hospital with similar symptoms. He died too, within a week. A 35-year-old housewife who went to hospital in Anhui on March 19th lasted only slightly longer. On March 31st officials confirmed these were the first three cases of a strain of influenza, H7N9, that had never before been seen in humans.
The government responded quickly—a far cry from its reaction, ten years ago, to a similar cluster of cases in Guangdong. That infection turned out to be SARS (severe acute respiratory syndrome). At first, officials tried to hide that disease. The deceit served to ensure its spread and it went on to kill nearly 800 people. Much has changed in the past decade. This time officials quickly posted H7N9’s genetic sequence, then published a detailed report in the New England Journal of Medicine.
Even so, H7N9 has infected at least 82 people and killed 17 of them. The virus’s path of transmission is not well understood. The recent detection of H7N9 in a boy with no apparent symptoms suggests people can carry the virus unwittingly. Meanwhile a new coronavirus (the family of viruses that SARS belongs to) is circulating in the Middle East. It has killed 11 people since it was noticed in September. Though Saudi Arabia has welcomed some foreign investigators, other scientists claim the country should be more transparent.
These cases illustrate both how far the world has come, and how far it still has to travel, on the journey towards building a system that can identify new infectious diseases and snuff them out before they become threatening. As the case of AIDS shows, a novel pathogen that spreads around the world unnoticed by the medical authorities can wreak havoc. More recently, cheap air travel has proved a boon to pathogens keen for a global tour. Fortunately the world has learned from the cases of SARS, H5N1 bird flu (in 2005) and H1N1 swine flu (in 2009). Systems are being put in place to spot potentially pandemic diseases and stop them quickly. These systems, though, are still piecemeal. At present it looks unlikely that either H7N9 or the new coronavirus will become pandemic. But if they do—or if some other powerful new virus or bacterium emerges—it is unclear whether the world will be ready.