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Mystery 'Disease X' outbreak widens as WHO sends rapid response team to DR Congo (scmp.com)
85 points by throwup238 15 days ago | hide | past | favorite | 36 comments



I recommend the book "Spillover" about zoonotic diseases. Given it was written pre-covid, it was insanely prescient - it expressed, for example, huge concern about bat viruses and RNA viruses.

Aanyway, it writes a lot about how these diseases are investigated, at the frontline in remote African villages. It gives a great idea of just how hard they are to investigate.

By the time researchers get news of an outbreak and arrive, the outbreak might well be over, the patients recovered or, well, dead. No one remembers what they were doing 4-6 weeks prior, when they would have contracted the virus. The village may also also be a site, still, of a medical disaster, with inadequate medical facilities, and you don't know how the germs spread - via air, water, contact, contaminated food? It's like investigating a crime while it is still being committed.

I'm not sure what my point is, other than, kudos to the people who do it. Also, this painstaking work gets to an answer eventually, but it necessarily takes a long time, and probably goes down few dead ends too.


It's incredible the amount of work that goes into protecting the world from dangers it barely understands as a whole.

And the scary thing is, one bumbling loudmouth politician can Duning-Kruger us into a major catastrophe by throwing a wrench in this sort of essential work.

The COVID pandamic did trail by a few years the de-funding of pandemic prevention efforts by Trump in his last presidency.


Thread from a couple days ago, included an epidemiologist with a pointer to some procedural details:

https://news.ycombinator.com/item?id=42333460

The terminology you're seeing from the WHO and from epidemiologists sounds scary, and it might be, but it's the same terminology they'd be using if this were an outbreak of something like malaria, which is always a possibility in remote, underserved areas.


> The first round of test results should come in Friday or this weekend. The longer it goes undiagnosed, the more we tip into categories 2 and 3

The Friday/weekend she referred to is in the past. Although... from a different article:

> On Monday, a WHO spokesperson in Kinshasa told USA TODAY that initial samples collected in Panzi weren't in optimal condition for lab analysis, so medical teams had to collect new samples.

So still no reason to panic.


> The outbreak is centred in a remote rural area of Kwango province, where poor road conditions and heavy rains mean it takes nearly 48 hours to reach from Kinshasa.

> While more than half of the cases involve children under 5, a 50-year-old man hospitalised in Lucca, Italy, is suspected to have recovered from the disease after a business trip to Congo, Il Tempo reported.

These statements don't feel very compatible. Either it would mean that the business trip was to a really hard to reach rural area at a insane time for traveling there, or the disease is already widespread in other areas as well.


The discrepancy I find more interesting is that the Italian traveler doesn't seem like the sort of person to be severely malnourished. Assuming it really is the same disease, it's one small indication that the 'trivial infection, abysmal baseline health status' explanation is not adequate.


I don't know what they meant by "have recovered" but if he has recovered, it shouldn't be that bad. But the phrasing is weird: why hospitalize a patient who has recovered? Is it because he was sick on arrival and got better in the hospital? Because of some after-effects? For analysis? For an unrelated reason?


I would add "quarantine" to that list.

There are diseases that would appear to be cured but are still infectious, especially if little is known about the disease.


Why dont they seem compatible?

While the chance of a given business person going to a remote area is low, it seems reasonable that hard to reach places still get travelers.


Nah, the businessman was probably in a more urban area, and he likely came into contact with a person (or contaminated item) who had recently been in the extremely rural area of outbreak.


Plus helicopters exist and he could, for example, fly out to a mining operation to meet with the site manager.


> All severe cases involve individuals suffering from severe malnutrition

> Malaria is common in the area, and it may be causing or contributing to the cases, the United Nations health agency said.

> Acute pneumonia, influenza, Covid-19, measles and malaria are considered as potential causal factors based on the signs and symptoms of those afflicted



At university, I studied zoonosis (travel of disease from animals to humans) and the introduction of AIDs to the world from Congo. The most likely theory (to me) is that when cities were developed to physically concentrate and economically exploit African people and resources, along with the associated international travel, it was an unhappy accident that contributed to the success of diseases that would otherwise transfer from animal to human and then die out due to the physical separation of populations.


You don’t think Africans would have any incentive to urbanize like the rest of humanity? This didn’t even start in a city. It’s a remote rural place which is why there’re so many malnourished people.


This is not what pcblues is saying.

The OP explains (correctly) that this diseases could have started several times in remote areas just to self-fix later, because remote rural areas aren't connected with other people and because bat viruses were first plant viruses. They are very fragile out of any cell. The presence of cities helps greatly the viruses to spread and survive in human hosts.


That still leaves the descriptive claim about urbanization exploiting Africans as if they'd be better off in their impoverished warfaring rural tribal communities.

You clearly missed the context in this thread. By a mile. Nobody is saying what you think that they are saying.

This article really lacks any context. How common is it for a rapid response team to be deployed? How often do they find something interesting or novel?


Alright how do I bet on this spreading, anything on polymarket?

Seriously there are some perverse incentives for pandemics to occur


Long or short on TP this time around?


Is SCMP a reputable, or otherwise trustworthy news source?


Very reputable and trustworthy historically. After the authoritarianization of Hong Kong in 2020 I trust it less specifically on topics the Beijing regime would have enough propaganda interest in to bother threatening the editorial staff over. The rest overall seems good still, and often with coverage with Asia-Oceania perspective which is not typically found in big North American or European news outlets.

In this instance, as they credit, they're just acting as a repeater for Bloomberg though.


[flagged]


> I wonder if there's an actual upper bound in the frequency of global pandemics. Is it possible that we could even have simultaneous pandemics?

There's literally always a "mystery disease" happening somewhere in the world. Particularly in the third world, where malnutrition and deaths from preventable illnesses are rampant.

Unfortunately, since 2020 it's trivial clickbait for reporters to just repeat this stuff without providing context. At least in this case, if one bothers to read article you see that this is indeed an example of bad health outcomes linked to severe poverty.


Read Spillover[1] - as we encroach further into previously undisturbed habitats we're going to see more fun diseases of zoonotic origin.

[1] https://en.wikipedia.org/wiki/Spillover_(book)


COVID is scary at personal scales and it did deeply traumatize us all, but at statistic scale it had 3.5% or so of mortality rate among unvaccinated humans. That isn't going to put us onto a list of endangered species.


3.5% means it killed 1 in every 29 or so people it infected.


And that's only 1 percent point more than the global infant(<1yo) mortality rate right now. Or 4x less percentages than Soviet losses in WWII(13.7% wtf), or 5x less than French losses in Napoleonic wars(5m out of 30m or so).

It's not worth assuming antivax style denialist attitudes against a COVID-class crisis, but it's also no factor for survival of humans the species. Only damaging to like, medium term economies and profits. We'd grow back just fine so long we'd wear masks, eat well, and get vaccinated as needed in timely manners.


I don't understand people who do the "well we'll survive as a species!" argument.

Like, sure, okay. But if I told you to do something which killed 1 out of every 30 people who attempted it, you wouldn't do it.


We have influenza all the time - just some strains are worse than others.

When you get a vaccine the scientists try to defend you vs the strain they consider the worst (or most expected to spread), not all strains.


[flagged]


Who is "they"in this and why is world population something they care about?


[flagged]


It's the standard placeholder name when they're not sure what it is yet.


Since 2018. In an effort to cause WHO projects to focus their research on broader themes rather than individual strains. I'm not precisely sure how you meant this to be any sort of counterpoint, and this looks _even more_ like terrible public health consciousness to me.


[flagged]


Okay, so what's wrong with slapping a number on a strain name? COVID-19 (COrona VIrus Disease 2019)


Nothing, but they don't know the strain yet.

BTW, COVID-19 is the name of the disease, Coronavirus Disease 2019. The virus is SARS-Cov-2 (Severe acute respiratory syndrome coronavirus).


Only works if you isolate the strain.

Once they discover what the causative agent is for disease X, they will name it something that someone will call racist eventually and we'll be able to reference it directly.




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