Viral Trade and Global Public Health: All Countries Must Adopt Uniform and Enforceable Public Health Standards to Stop the Spread of Infectious Disease

Article excerpt

In June 2003, some 80 people in three Midwestern states were stricken with monkeypox. Until then, the disease--a sometimes fatal viral infection related to smallpox--had never been seen outside Central and West Africa. In the United States, the virus is believed to have spread to humans from pet prairie dogs, which in turn were likely infected by a giant Gambian rat held by a Chicago exotic pet dealer. So far, no one has died. But if the outbreak is confirmed to be an inadvertent byproduct of trade, then it is yet another warning sign of the growing international exchange of viruses.

The increase in viral traffic is the result of two converging trends: Deadly new viruses are appearing at an accelerating rate, and viruses are traveling around the world faster than ever before. During the past several decades, a number of new or changing viruses have emerged, wreaking havoc wherever they strike. The deadly avian influenza virus that hit Hong Kong in 1997-1998 and the Netherlands in 2003, for example, required the mass slaughter of poultry to control the outbreaks. And HIV has decimated much of the working population in sub-Saharan Africa and threatens other parts of the world.

Today, a virus that emerges in one place can quickly find its way to any other place on earth. Witness the discovery of the West Nile virus in New York City in 1999 or the recent global spread of severe acute respiratory syndrome (SARS). SARS illustrates one of the new realities of the global economy: Except for war, terrorism, and natural disasters, nothing stops global trade and travel as effectively as a deadly disease outbreak.

Such outbreaks will become more common unless stringent steps are taken to prevent them. The biggest obstacle to effective control is the unevenness of public health capabilities around the world. Although an individual country might attempt to stem viral outbreaks within its borders, one nation's public health laws and disease control efforts are only as good as those of its neighbors. This is a global problem, and it requires a global solution. The only way to ensure that all countries pull their weight is to allow the World Health Organization (WHO) to establish stringent global public health laws and standards. Although enforcement would be difficult, another global body, the World Trade Organization (WTO), could provide strong incentives by allowing only countries that adhere to these laws and standards to participate fully in global trade. By working together, these two organizations could create effective strategies for preventing and controlling the inadvertent trade of viral infections.

In the battle between humans and viruses, viruses have all the advantages. One reason is the sheer number of viral particles. The oceans alone contain more than 1030 bacterial viruses. That number is larger than the number of stars in the observable universe, and it describes just a small subset of viruses: those that infect only bacteria. And most viruses are completely unknown. According to Lynn Enquist, a virologist at Princeton University, scientists have identified only 1 percent of the viruses on the planet.

An infected person or animal can shed enormous numbers of new viral particles. For example, one 35-ton gray whale, infected with a virus that causes diarrhea, has been estimated to excrete over 1013 new viruses into the ocean each day. This class of virus, the noroviruses, can infect terrestrial hosts, including humans. They have been implicated in outbreaks of illness aboard cruise ships. On a lesser scale, one human with end-stage AIDS can produce a billion new viral particles per day. Given that upward of 40 million people worldwide are estimated have HIV infection or AIDS, one gets an idea of what humans are up against.

Viruses are the most successful life form on the planet, yet they are not even technically alive. Their complex chemical structures consist of a strand or two of DNA or RNA and a protein coat. …