Deadly E. coli outbreak
latest in a parade of woes 
Corrected version of report published June 10, 2011


Many scourges of humanity were either eradicated or greatly suppressed during the last century. Yet, contagious diseases continue to pose severe threats to nations rich and poor, experts say.

The outbreak of a vicious strain of E. coli, known as 0104:H4, in Germany is the latest example of the emergence of a new form of an old disease now resistant to antibiotics and the antibodies of the human immune system. It appears that 0104:H4 picked up resistance to a whole range of antibiotics. The emergence of drug-resistant bacteria is a relentless problem, with hospitals becoming increasingly prone to such contamination.

However, little is publicly known about how 0104:H4 acquired the set of genes necessary for such resistance. The usual suspect is overuse of antibiotics, which brings about what scientists call "selective pressure" to breed the occasional mutants resistant to particular drugs.

On occasion, however, experimental pathogens escape from a laboratory and cause deadly outbreaks. Antibiotic-resistant bacteria are a routine research tool of molecular biologists. E. coli is perhaps the most studied of all the types of bacteria, because of its availability and genetic properties. E. coli strains occur naturally in the human gastrointestinal system and are generally benign, as are most research strains used by scientists. However, scientists find it relatively easy to breed drug-resistant pathogens for either research or biowar purposes (though bioweapons require further processing).

Research into E. coli and other pathogens has burgeoned in recent years because of the explosion of the biotechnology and pharmaceutical industries.

The focal point of the 0104:H4 outbreak Lubeck, Germany, home to the University of Lubeck, a center of medical and biolical research. However, the deadly pathogen -- which could not be linked to specific fresh produce -- is not known to be an escaped research strain. There is no indication as to whether any of the kitchen staff of the Kartoffelkeller pub might have been exposed to an errant research strain.

An example of an escaped pathogen occurred in another German incident in 1967, when a horrific disease jumped from research monkeys to humans.

In years past, there have been several instances of biowar lab accidents resulting in numerous deaths, according to Ken Alibek, a former top manager of Mikhail Gorbachev's vast treaty-breaking bioweapons production program, as noted in his book Biohazard that he wrote with Stephen Handelman [Biohazard: The Chilling True Story of the Largest Covert Biological Weapons Program in the World -- Told from Inside by the Man Who Ran It (Random House 1999).]

The modern "global village" also provides a network for rapid dispersion of strange pathoghens that have lurked for centuries in jungles before infecting loggers or other human intruders, according to Frank Ryan, M.D., in his book Virus X: Tracking the New Killer Plagues Out of the Present and into the Future (Little Brown 1997).

The "global village effect" was demonstrated in the 1918 influenza global pandemic -- which killed between 25 million and 100 million -- when American troop trains and ships spread the contagion after clueless military commanders failed to heed experts and impose timely quarantines. One theory is that the harsh flu strain jumped from a host animal in central Kansas and spread to a nearby camp jammed with young soldiers, according to John M. Barry in The Great Influenza: The Epic Story of the Deadliest Plague in History (Viking 2004).

In the case of 0104:H4 outbreak, authorities have succeeded in limiting its deadly toll by destroying food supplies and by the public's decision to avoid fresh vegetables. However, experts warn,  pathogens which spread by tactile contact, blood transfer or inhalation are not so easily controlled.

In 1993, a strain of E. coli known as 0157:H7 and first identified in 1982 caused a severe food-borne outbreak of bloody diarrhea in the states of Washington, Idaho, Nevada and California, killing four children and sickening 500 other people, with 56 developing kidney failure, according to Ryan. http://www.fprbooks.com/page17.htm. Ryan's description of the symptoms is very close to those cited in the German outbreak. The U.S. outbreak was tied to hamburger meat, whereas the German incident was tied to vegetables, possibly sprouts.

Numerous new or newly identified forms of bacteria pose threats to humanity, including a drug-resistant form of tuberculosis that is currently vexing health authorities worldwide. In the United States, health units make strenuous efforts to make sure TB victims submit to a long, unpleasant regimen of medicine. And yet the disease, once among the worst of scourges and thought to have been conquered, is making a comeback, striking people with weakened immune systems and respiratory problems.

Between 1975 and 1994, Ryan reports, 14 emergent bacterial diseases were identified, including Lyme disease, Legionnaires disease, toxic shock syndrome, two forms of cat scratch disease, the "flesh eating bug" (Beta hemolytic streptococcus), and the seventh cholera pandemic (Vibrio cholerae 0139).

In addition, plague remains a threat, killing a few people around the world every now and then. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001622/. Plague is carried by a rat flea, meaning that the flea's bite can be deadly. Once the blood-borne disease reaches a victim's lungs, pneumonia often occurs. Once this happens, danger of contagion increases exponentially as sneezing and coughing disseminates the bacteria through the air.

For centuries, before the advent of antibacterial drugs, plague -- bubonic, pneumonic and septicemic -- wreaked havoc among Asian and European populations. In the 14th Century, between a quarter and a third of Europe's population died of plague. In 1900, San Francisco was struck by a plague outbreak.

However, the possibility exists that the plague bacteria, Yersinia pestis, could morph into an antibiotic-resistant form. Given the vagaries of human interactions with fellow humans and with the environment, it is difficult to say whether Yersinia pestis faces selective pressure to evolve to such a form.

Emergent viruses pose a severe menace. As explained by Ryan, a virus may co-evolve with a particular species. The virus, which lives benignly in a particular species of plant or animal, serves as a defensive force against species competing for the same food supply, attacking and often annihilating competitors of the host which stray into the wrong habitat.

As humans increasingly infringe into rain forests, such viruses may jump species, moving from, perhaps, monkeys to humans.

In the case of influenza, various species of birds host strains that pose little threat to them. Humans exposed to massive doses of bird-borne flu will often sicken and die, but the disease isn't contagious to other humans. However, occasionally a flu virus morphs in a human or other host, such as a pig, and then becomes contagious to humans.

Though some may assume that the ferociousness of the 1918 outbreak was unique, there is in fact little reason to think such an outbreak won't happen again. Though a vaccine can be tailored to a specific strain, the contagion can outpace inoculation efforts, as was demonstrated in the recent outbreak of swine flu (which proved fatal to some, but which may have weakened as it spread). It often happens that people are inoculated for one strain, only to be infected by an unforeseen strain.

Between 1930 and 1995, according to Ryan, 39 dangerous viruses emerged to afflict humans, including two strains of the notorious AIDS virus, HIV-1 and HIV-2, both traced to African monkeys. Another is Hepatitis C, which damages kidneys and is spread by blood transfusions and unsanitized hypodermic syringes used by addicts.

Ebola Zaire virus, struck Africans with hemorrhagic fever at 90 percent lethality, while Ebola Sudan had a 50 percent lethality rate. In Bolivia (South America), Machupo virus, which also yields a hemorrhagic fever, had high lethality.

Ryan reports that both the United States and Britain had close calls with Ebola.

In 1967, an Ebola class of hemorrhagic fever with 30 percent lethality, broke out in Marburg, Germany.

The outbreak, according to a Wikipedia page, involved 25 primary infections, with 7 deaths, and 6 secondary cases, with no deaths. The primary infections were in laboratory staff exposed to the Marburg virus while working with monkeys or their tissues. The secondary cases involved two doctors, a nurse, a post-mortem attendant, and the wife of a veterinarian. All secondary cases had direct contact, usually involving blood, with a primary case. Both doctors became infected through accidental skin pricks when drawing blood from patients.

In 1993, a disease known as Sin Nombre Hantavirus emerged on a Navajo reservation in New Mexico. The highly lethal virus, which had a preference for young adults, was found to be spread by local rodents, which had proliferated because of abnormally mild weather attributed to the El Nino weather pattern.

According to bioweapons expert Alibek, the Soviet Union weaponized Marburg virus so that it could be used to decimate populations. As happens on occasion in viral studies, a scientist suffered excruciating illness and death after a laboratory accident, Alibek said.

In 1979, a Soviet anthrax production plant in Sverdlovsk leaked aerosol anthrax into the community and numerous people died. The Soviets conducted a massive coverup, attributing the deaths to contaminated meat, Alibek said. Suspicions in the United States were quelled by a Soviet presentation that was accepted by sympathetic American experts, he said.

Alibek wrote that in northwestern China, "satellite photos detected what appeared to be a large fermenting plant and a biocontainment lab close to a nuclear testing ground," adding: "Intelligence sources found evidence of two epidemics of hemorrhagic fever in the area in the late 1980s, where these diseases were previously unknown. Our analyst concluded that they were caused by an accident in a lab where Chinese scientists were weaponizing viral diseases."

An outbreak of SARS (Severe Acute Respiratory Syndrome) in 2002 in China also drew suspicion, though natural causes are deemed more likely. See
http://www.jamestown.org/single/?no_cache=1&tx_ttnews[tt_news]=3580

Alibek tells of American research into germ warfare in World War II. Curiously, making pathogenic powder and sprinkling it on letters was among techniques considered. The anthrax attacks targeting politicians and journalists occurred two years later. The pathogen was delivered as dust sprinkled on mail.

After Alibek's deputy, Vladimir Pasechnik, defected to England, Britain and America confronted the Soviets with the biowar treaty violation. However, said Alibek, he was told that President George H.W. Bush and British leaders had decided against informing the American and British peoples of the defector's disclosures, not wishing to undermine Gorbachev's position.

Taking advantage of the eradication of smallpox, the Soviets developed an especially dreadful form and kept vast stores of the weaponized substance in the event of war with the United States, Alibek wrote. The Soviets had led the drive to eradicate the disease through isolation and vaccination, he said. Once vaccinations were no longer necessary for the planet's inhabitants, the Soviet military saw a golden opportunity for a powerful mass casualty weapon, he said.

Alibek reported that he had discovered that Soviet troops had unleashed germ war weapons against the Germans during Hitler's drive on Stalingrad. However, a shift in the winds also afflicted the Soviets, he said. Nonetheless, the German onslaught was temporarily, and perhaps critically, blunted.

In another instance, Q fever was unleashed on German troops on rest-and-recreation leave in the Crimea, according to a report obtained by Alibek.

In addition, Soviet Laboratory 12 developed numerous toxins and other biological agents
for use in assassinations by the KGB, Alibek said.

During World War II, Alibek reports, Japan dropped porcelain bombs filled with billions of plague-infected fleas over Manchuria. Bacteria cannot pass through certain porcelains (though viruses can).

The Soviet biowar program developed many other such mass casualty weapons, Alibek said.

Numerous virology links
http://www.virology.net/garryfavweb12.html

Emerging Infectious Diseases (CDC journal)
http://www.cdc.gov/ncidod/EID/

Naming viruses
http://www.ictvdb.org/

New math in HIV fight (WSJ)
http://online.wsj.com/article/SB10001424052702303936704576397491582757396.html

Biotech or bioterror: a global dilemma
http://www.angelfire.com/ult/znewz1/bioterror.html  

Biotech, bioterror, emergent disease
http://www.zkea.com/