The Ecology of Disease
By JIM ROBBINS
THERE’S a term biologists and economists use these days — ecosystem services — which refers to the many ways nature supports the human endeavor. Forests filter the water we drink, for example, and birds and bees pollinate crops, both of which have substantial economic as well as biological value.
If we fail to understand and take care of the natural world, it can cause a breakdown of these systems and come back to haunt us in ways we know little about. A critical example is a developing model of infectious disease that shows that most epidemics — AIDS, Ebola, West Nile, SARS, Lyme disease and hundreds more that have occurred over the last several decades — don’t just happen. They are a result of things people do to nature.
Disease, it turns out, is largely an environmental issue. Sixty percent of emerging infectious diseases that affect humans are zoonotic — they originate in animals. And more than two-thirds of those originate in wildlife.
Teams of veterinarians and conservation biologists are in the midst of a global effort with medical doctors and epidemiologists to understand the “ecology of disease.” It is part of a project called Predict, which is financed by the United States Agency for International Development. Experts are trying to figure out, based on how people alter the landscape — with a new farm or road, for example — where the next diseases are likely to spill over into humans and how to spot them when they do emerge, before they can spread. They are gathering blood, saliva and other samples from high-risk wildlife species to create a library of viruses so that if one does infect humans, it can be more quickly identified. And they are studying ways of managing forests, wildlife and livestock to prevent diseases from leaving the woods and becoming the next pandemic.
It isn’t only a public health issue, but an economic one. The World Bank has estimated that a severe influenza pandemic, for example, could cost the world economy $3 trillion.
The problem is exacerbated by how livestock are kept in poor countries, which can magnify diseases borne by wild animals. A study released earlier this month by the International Livestock Research Institute found that more than two million people a year are killed by diseases that spread to humans from wild and domestic animals.
The Nipah virus in South Asia, and the closely related Hendra virus in Australia, both in the genus of henipah viruses, are the most urgent examples of how disrupting an ecosystem can cause disease. The viruses originated with flying foxes, Pteropus vampyrus, also known as fruit bats. They are messy eaters, no small matter in this scenario. They often hang upside down, looking like Dracula wrapped tightly in their membranous wings, and eat fruit by masticating the pulp and then spitting out the juices and seeds.
The bats have evolved with henipah over millions of years, and because of this co-evolution, they experience little more from it than the fruit bat equivalent of a cold. But once the virus breaks out of the bats and into species that haven’t evolved with it, a horror show can occur, as one did in 1999 in rural Malaysia. It is likely that a bat dropped a piece of chewed fruit into a piggery in a forest. The pigs became infected with the virus, and amplified it, and it jumped to humans. It was startling in its lethality. Out of 276 people infected in Malaysia, 106 died, and many others suffered permanent and crippling neurological disorders. There is no cure or vaccine. Since then there have been 12 smaller outbreaks in South Asia.
In Australia, where four people and dozens of horses have died of Hendra, the scenario was different: suburbanization lured infected bats that were once forest-dwellers into backyards and pastures. If a henipah virus evolves to be transmitted readily through casual contact, the concern is that it could leave the jungle and spread throughout Asia or the world. “Nipah is spilling over, and we are observing these small clusters of cases — and it’s a matter of time that the right strain will come along and efficiently spread among people,” says Jonathan Epstein, a veterinarian with EcoHealth Alliance, a New York-based organization that studies the ecological causes of disease.
That’s why experts say it’s critical to understand underlying causes. “Any emerging disease in the last 30 or 40 years has come about as a result of encroachment into wild lands and changes in demography,” says Peter Daszak, a disease ecologist and the president of EcoHealth.
Emerging infectious diseases are either new types of pathogens or old ones that have mutated to become novel, as the flu does every year. AIDS, for example, crossed into humans from chimpanzees in the 1920s when bush-meat hunters in Africa killed and butchered them.
Diseases have always come out of the woods and wildlife and found their way into human populations — the plague and malaria are two examples. But emerging diseases have quadrupled in the last half-century, experts say, largely because of increasing human encroachment into habitat, especially in disease “hot spots” around the globe, mostly in tropical regions. And with modern air travel and a robust market in wildlife trafficking, the potential for a serious outbreak in large population centers is enormous.