Emerging diseases threaten conservation - Guest Editorial

Environmental Health Perspectives, August, 2003 by Paul R. Epstein, Eric Chivian, Kathleen Frith

In April 2003, severe acute respiratory syndrome (SARS) appeared suddenly, sending shockwaves throughout public health systems and economies worldwide. By July 2003, 8,439 cases had been reported worldwide, with 812 deaths; the economic impacts were estimated to be $50-$100 billion (U.S.) (Newcomb 2003). Although public attention was focused on this explosive pandemic, more than 30 such diseases new to medicine have emerged since 1976 [World Health Organization (WHO) 1996].

Historically, waves of infections have often accompanied periods of social and environmental transition (Epstein 1992). Such upsurges include influenza in the aftermath of World War I and the plague during the Middle Ages. Tuberculosis, smallpox, and cholera appeared in concert among the teeming urban centers of Charles Dickens's 19th-century England.

In the past three decades, previously unknown diseases have surfaced at a pace without precedent in the annals of medicine. Indeed, such a renegotiation of evolutionary agreements between microbes and humans and other species may not have occurred since hunters and gatherers became herders--when domestication of animals triggered such a "spillover" of animal microorganisms (Daszak et al. 2000; McMichael 2001).

Today, human practices, widening social inequities, and changes in ecologic systems and climate are compounding and conspiring to unleash a barrage of emerging diseases that afflict humans, livestock, wildlife, marine organisms, and the very habitat we depend upon. As the climate becomes more unstable, its role increases (Epstein et al. 1998). Having underestimated the rate at which climate would change (Houghton et al. 2001), we are only beginning to understand the responses of biological systems to warming (Walther et al. 2002) and the accompanying intensification of weather extremes (World Meteorological Organization 2003).

The cast of new diseases includes HIV/AIDS, Lyme disease, Legionella infection, Ebola, Nipah virus, hantavirus pulmonary syndrome, toxic Eschericbia coli infection, a new strain of cholera, and infection by a host of antibiotic-resistant organisms [Centers for Disease Control and Prevention (CDC) 1994; Institute of Medicine 1992]. Old diseases such as malaria, cholera, tuberculosis, rabies, and dengue fever are resurging, while others, such as West Nile virus (WNV), have undergone redistribution. SARS, like influenza, probably originated from the genetic reshuffling of animal viruses (Marra et al. 2003) and has now found a reservoir in several species.

Is Nature having her way with us, we might ask, and could the results benefit other species? Unfortunately, the same set of global changes and genetic exchanges are stalking flora and fauna, and diseases themselves now threaten conservation efforts, including those in biological "hot spots" (Myers 2002; Pimm et al. 2001).

Many microorganisms are now jumping from species to species in several directions. For example, in 1998, bats bearing Nipah virus swept onto Malaysian pig farms after fleeing forest fires fueled by intense drought associated with the largest El Nino event of the century (Epstein 1999; Institute on Climate and Planets 2003). As a result of this event, Nipah virus killed more than 100 people and crippled the swine industry (Johnson 2003). In early 2003, Ebola jumped back to primates and killed 600-800 gorillas in the Congo Republic, representing two-thirds of those remaining in the Lossi sanctuary (Morse and Colier 2003).

WNV is playing a particularly sinister role in nature. Following its explosive debut in New York City during the prolonged spring drought and heatwave of 1999 (Epstein and Defilippo 2001), WNV abated and incubated. Then, during the hot, dry summer of 2002, it spread across the nation and was detected in 44 states, Washington, DC, and five Canadian provinces. In 2002, WNV encephalitis afflicted 4,161 people and claimed 284 lives in the largest outbreak of mosquito-borne encephalitis recorded in the Western Hemisphere (CDC 2003). WNV also performed a dazzling array of new tricks, with infection occurring via blood transfusions, organ transplants, pregnancy, and probably breast milk.

Of greatest concern, however, WNV has spread to 230 species of animals, including 138 species of birds. WNV is spreading in the Caribbean and Central America, and is a leading suspect in the recent 10-fold drop of migratory song birds in Costa Rica (Causey D. Personal communication). Raptors have died from WNV, though population-level impacts are unknown. Rodents are consumed by birds of prey, and if unchecked, their legions can become prolific consumers of stored and growing grains and purveyors of pests and pathogens.

Diseases of livestock and crops have been particularly costly. The appearance of bovine spongiform encephalopathy ("mad cow") disease in the United Kingdom in the 1990s and new variant Creutzfeldt-Jakob disease in humans had major health, political, and economic impacts (Newcomb 2003). When followed by foot and mouth disease and large-scale flooding in 2001, the blow to the British economy ($30 billion) and psyche were palpable.