What is Contagion ?

hi

Nearly every aspect of the science within the film was realistic, even the rapidity at which viruses can kill after one is exposed, and the existence of receptors on the respiratory cells that link up with the virus.

I did, however, question one thing about the scientific accuracy: the virus was said to mutate very quickly, which is fine and typical of viruses that use RNA as their genetic material. However, the activity of the human population seemed to bounce back very quickly in the film once a vaccine was found and administered.

This is why finding solutions to combat HIV/AIDS has been so difficult; HIV is quite good at evolving and evading our efforts to control it. As for the overall impact of the virus on the human population, numbers used in Contagion (~26 million) were very realistic.

Just for comparison, approximately 40 million people died from the Spanish flu (1918/1919), in fact, more soldiers died from the flu during World War I than they did from combat. Some have predicted that there will be 100 million deaths from the avian flu, if it ever takes hold in the human population.

The film’s description of how quickly the disease spread around the globe was certainly not exaggerated. In 2003, SARS spread from the Guongdong Province in China to many countries in very short order. Even in the 14th century, Black Death (the plague; a bacterial disease) moved relatively quickly by ship and by land to kill nearly 25% of the people in Europe.

I also believe Contagion conveyed the human response to the contagious disease fairly well, though at times the individuals seemed a bit too calm given the circumstances.

The Department of Health and Human Services, including the Centers for Disease Control and Prevention (CDC), will need to play their cards carefully if we have a real Contagion (e.g., avian flu that is easily transmitted from human to human) in the future. A rapid spread of hysteria would seriously undermine efforts to control the disease.

Nevertheless, there are generally some positives you can take from even the most dire circumstances. Although the 14th century plague epidemic killed one out of every four individuals, it is believed that the Renaissance emerged because of it. Laborers were in such short supply that creativity and design (e.g., printing press) had to come to the rescue. What a 21st century pandemic would bring, only time will tell.

Alan B. Hale, Ph.D., Professor of Biology and Director of the Global Diseases Program at Cedar Crest College. His laboratory research is focused on the use of viruses in combating pathogenic bacteria, especially those that cause intestinal diseases in humans. He is currently teaching a course entitled, Outbreak Investigations: Case Studies in Epidemiology. Next spring he will be teaching two courses: Bioterrorism & Emerging Infectious Diseases and Multidisciplinary Solutions for Global Diseases.

An innocent cough launches a deadly pandemic in Contagion, the new thriller directed by Steven Soderbergh. Critics and scientists alike have touted the movie as a more realistic depiction of disease transmission—no movie stars turn into flesh-eating zombies, and the previously unknown disease does not kill every person it encounters.

In the movie, Gwyneth Paltrow’s character, a Minnesota executive named Beth Emhoff, falls ill with a cough on a company trip to Hong Kong. She infects several other unfortunate people on two continents. Soon, places as remote as Durbin South Africa and San Francisco are overrun with the disease, a Paramyxovirus dubbed MEV-1, which contains bat and pig DNA.

Along the way, widespread chaos ensues, several A-list actors have chances to be both tragic and heroic, and the world is saved in the end by intrepid scientists who whip up a vaccine in less than six months.

Yet the least plausible part of the scenario is the very beginning, said Bill Hanage, an epidemiologist at Harvard University. “I’m not entirely sure why it would be Gwyneth Paltrow who would be so important other than the fact that she’s a movie star,” he says. “In reality, something that would have been that infectious, you would expect there to be rumblings in local populations.” A factory worker at the pig farm, for instance, would be a more likely patient zero than a jet-setting Western business executive.

MEV-1 is based on a real pathogen, called Nipah virus, which causes respiratory symptoms, encephalitis, seizures, and kills 45 to 90 percent of its victims. Nipah has a reservoir in bats and has sickened hundreds of people in Malaysia and Bangaldesh. But it usually doesn’t transmit between humans very well, says Pramila Walpita, a virologist at the University of Texas Medical Branch at Galveston, who is developing a vaccine for Nipah.

In comparison to Nipah virus, MEV-1 is rather restrained, killing only one out of every four of the people it infects and spreading to two people for every one who gets the disease, a very realistic transmission profile, Hanage says.

At the end of Contagion, viewers see a flashback that explains where the fictional MEV-1 came from. A native bats’ habitat is razed to build a factory, and a bat flies into a pig farm, where a fruit dropped from its mouth mingles with food eaten by the pigs. One of the slaughtered pigs is prepared in a swanky Hong Kong restaurant where Emhoff shakes hands with the chef—who presumably has some of the new virus on his hands—and Voila! Global pandemic.

That pathway from animals to humans is very realistic, says Barbara Reynolds, a crisis communications specialist at the Centers for Disease Control in Atlanta. Close interactions between humans and animals have caused pandemics, like the morphing of a bird flu into the 1918 Spanish influenza.

“We know about 75 percent of the threats we face come from animals and insects. The idea that as we interact with our natural environment there’s a potential for a virus to mutate and be transmitted to humans is very plausible,” Reynolds notes.

At Argonne National Laboratory, emergency preparedness analysts like Dan Walsh work with public health departments to make sure they could quickly respond to a Contagion-like outbreak.

But the fact that it spread from the chef to Emhoff with no prior history of infecting anyone else, ever, is unlikely, Hanage agrees. “That suggests a very rapid process of suddenly becoming fully transmissible in human.” In reality, the disease would mostly live in animals and be transmitted from animals to humans for a while, gradually becoming more easily transmitted from human to human, he says.

Sure, a killer virus set on destroying humanity makes a good pitch for a movie. But whether the audience is on the edge of their seats or rolling in the aisles depends entirely on how the movie balances fact and science fiction. 2011’s Contagion, however, proved that a thriller can be creative without compromising scientific integrity.

Walpita thinks that such a dramatic transmission may not be realistic “at this minute,” but that a similar level of infection could one day emerge in Nipah or other paramyxoviruses, because they are RNA viruses, which don’t employ the same genetic proofreading used by DNA viruses. As a result, they mutate very quickly and can become much more infectious; the annual outbreaks of Nipah in Bangladesh are often different strains, she said.

At Argonne National Laboratory, emergency preparedness analysts like Dan Walsh work with public health departments to make sure they could quickly respond to a Contagion-like outbreak. We asked Walsh what he thought of the portrayals in the movie.

While the virus in Contagion is completely unknown on day zero, intrepid scientists culture it in just 12 days, and a vaccine is ready about 4 months later. That’s a stretch, Walpita says.