Uncategorized — November 9, 2009 at 5:13 pm

New Thriller Highlights Public Health & National Security Connection

By Mat Trachok, HLS 2012 NSJ Staff Writer

According to surgeon and best-selling author Robin Cook, the world is at risk from an imminent, serious pandemic.  Cook has written a new medical thriller entitled Plague, which he hopes will raise consciousness about this potential threat.  In his recent article “Plague: A New Thriller of the Coming Pandemic,” Cook explains the science behind the novel.

According to Cook, the world is currently under threat from two relatively benign strains of the influenza A virus:  H1N1 (known commonly as swine flu) and H5N1 (the strain of avian flu that appeared in 2006 and has slowly been spreading its way out of Southeast Asia).  H1N1 has a high human-to-human transmissibility but it is not especially virulent—for the most part it causes a relatively mild illness.  In contrast, H5N1 has low human-to-human transmissibility but a very high lethality—60% of those who have contracted H5N1 within the last three years have died.

The problem, according to Cook, is that influenza A is exceptionally good at incorporating new genetic material.  Therefore, he writes, it is easy to imagine a scenario in which H1N1 and H5N1 come into contact and recombine with one another.  In such a scenario, H5N1 could give its virulence to H1N1, or H1N1 could give its transmissibility to H5N1.  Either way, writes Cook, the result will be a pandemic to rival the Black Death or the Spanish Flu of 1918.

Looking to historical pandemics as a guideline, Cook argues that a truly serious pandemic could lead to widespread fear, chaos, and violence; disruption of the social infrastructure; famine; an increase in fanaticism; and war.  If such a threat does indeed exist, it raises difficult questions for U.S. policy makers.  For example, would policy makers withdraw U.S. forces from abroad?  Would they use those forces to close down the United States’ borders?  Would they instead use U.S. forces to try to keep peace in areas of strategic interest?  How would they keep peace within the United States?  Would they force the many Americans who distrust vaccinations to be vaccinated?

Cook’s book and subsequent article urge policy makers and the public to take the threat of a modern pandemic seriously.  By preparing to deal with a potential pandemic now, Cook says, the United States may be able to avert its worst effects.

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