Dr. Anthony Fauci, the retired head of the National Institute of Allergy and Infectious Diseases, has West Nile Virus. He was at risk because of where he lives, rather than because of any particular activity or lifestyle. He suspects that he was given the virus by a mosquito that bit him while he was sitting outside his home near Washington, D.C. Whatever the mechanism for his acquiring this potentially lethal disease, the implication is that none of us is safe. This physician knew how to safeguard himself against this and innumerable other viral infections, and yet he still fell victim to a disease that may yet kill or cripple him. It is an indication of how vulnerable we all are to this and other infectious diseases and how indiscriminate viruses, bacteria, and parasites are in acquiring targets.
Viruses, unlike bacteria and parasites, are not living organisms: they are bits of information packed in a delivery system. They injure or destroy cells by hijacking their internal machinery to make copies of themselves that are disseminated to other cells. They usually target a specific type of cell. A viral assault on heart muscle may produce heart failure. A viral assault on nervous system tissue may produce brain inflammation, also known as encephalitis.
A few weeks ago, an elderly man living in Oxford, Massachusetts, developed signs and symptoms of encephalitis and proved to have the Eastern Equine virus. Last week, a 41-year-old man living in New Hampshire died from Eastern Equine Encephalitis (EEE). Other cases of EEE have been reported in New Jersey, Wisconsin, and Vermont just during the past year. The emergence of this disease is especially worrisome because it is highly lethal. As many as one out of three victims of the disease die. There is no specific treatment or vaccine. All ages and both sexes are vulnerable, and there are no pre-existing conditions that make an individual more vulnerable to the encephalitis.
Newer testing methods certainly make the identification of lethal viral infections much simpler than was the case fifty years ago, but this is not the reason for the re-emergence of viruses previously identified but rarely seen. Some reasons for outbreaks are self-evident. Wars restricting access to highly effective vaccines, such as the polio vaccine, have allowed the emergence of preventable lethal or crippling diseases in war-torn locations, such as the Gaza strip in the Middle East. The children who survive the bombs and bullets surrounding them are now succumbing to polio and other infectious diseases while “grown-ups” discuss an interruption in the carnage to allow the administration of vaccines.
Threatening the U.S. from the south is a recently detected viral infection called Oropouche. Travelers from the U.S. to countries in northern South America, as well as to Cuba, have acquired this disease from mosquitos and other biting insects, called midges, and have developed febrile illnesses that occasionally involve the brain. Pregnant women are at special risk from this virus because it may infect the fetuses they carry. Within the past few decades, we had experience with a similar virus, called Zika, that also affected human fetuses and led to profound disturbances of brain development, called anencephaly. Climate change is making the environment in the southern United States more hospitable for the insects that carry this disease, but currently there are no habitats in the United States supporting the responsible mosquitos and midges.
Our recent experience with Covid-19 is not reassuring, and the threat of another pandemic from another virus is real. We have been spared to some extent substantial outbreaks of polio, measles, mumps, and rubella by virtue of widespread vaccination programs. This can all change abruptly if the smoldering resistance to vaccinations gains traction and political leaders relax vaccination mandates. Generations of virtual freedom from these terrible diseases have blunted the fear of recurrent epidemics. Any lapse in guarding against these once familiar diseases could result in hundreds of thousands of deaths.
Of course, Covid-19 is still a problem in the U.S., despite the availability of effective vaccines and test kits. As the number of Covid-related deaths decreases, there is an unwarranted lessening of concern. The initial government response to the Covid pandemic was inappropriately relaxed and was most charitably described as blundering. We were assured that this lethal virus would simply “go away.” This assurance was reminiscent of the response by Mayor James Michael Curley of Boston when residents asked what would be done about snow clogging the streets in early twentieth century Boston, and he answered, “God put it there, and God will take it away.” Politicians lack originality. This laissez-faire attitude by the Federal government when Covid first appeared in the U.S. contributed to the deaths of hundreds of thousands of Americans.
What we learned from the Covid pandemic is that men and women, like Dr. Fauci, with expertise in the management of infectious diseases will be mocked and dismissed by sound-bite-hungry politicians and will receive death threats from human lemmings who are willing to follow their Beloved Leader over any cliff. Another pandemic is not merely likely: it is inevitable. Clearly we need men and women in leadership positions with intelligence and integrity to protect us from the next pandemic and from the people who tell us to relax, pray, and stock up on bleach.
Dr. Lechtenberg is an Easton resident who graduated from Tufts University and Tufts Medical School in Massachusetts and subsequently trained at The Mount Sinai Hospital and Columbia-Presbyterian Medical Center in Manhattan. He worked as a neurologist at several New York Hospitals, including Kings County and The Long Island College Hospital, while maintaining a private practice, teaching at SUNY Downstate Medical School, and publishing 15 books on a variety of medical topics. He worked in drug development in the U.S., as well as in England, Germany, and France.
