Is the UK vulnerable to emerging viruses?

“Universities have a vital role to play in training clinicians to recognise the abnormal in the context of emerging disease”

Hide

The recent Ebola epidemic in West Africa and the growing concerns about Zika virus infections in the Americas serve to vividly illustrate the vulnerability of even the most economically advanced societies to what is often referred to as emerging disease. With this in mind the House of Commons Select Committee in Science and Technology has recently highlighted the woeful inadequacy in the UK’s vaccine development capability as a weakness in the national capacity to respond to such unforeseen events. However, to claim that the UK is vulnerable to Ebola because we lack vaccine development capabilities misunderstands the reality of the Ebola outbreak in West Africa. The disease was able to spread due to a lack of information, and sometimes misinformation, about how the virus is passed between people. Furthermore, local healthcare systems were already struggling with a chronic lack of resources, leading frontline healthcare workers to risk their lives without protective equipment, as well as forcing people to care for their sick friends and relatives, a situation unlikely to occur in the UK. We also have a different cultural traditions with regard to burial: the African tradition of washing the dead body before burial was shown to increase the spread of virus.

Timeliness in recognising a disease outbreak and in mounting an effective response is a challenge to any society, requiring a range of multi-disciplinary skills spanning clinical acumen in the face of the unusual, through laboratory and field analyses, to handling the world’s press and media. These skills are rarely integrated, and even where they are, for example the SARS epidemic in Hong Kong in 2003, valuable time is lost in sharing information, samples and reagents across national borders. Critical time was also lost in the UK’s response to the Ebola oubreak as there was an insufficiently large cohort of laboratory and other workers with the specialised training in the handling of highly dangerous specimens and patient material.

Universities have a vital role to play in training clinicians to recognise the abnormal in the context of emerging disease as well as providing postgraduate training for clinicians, laboratory scientists and veterinarians alike to form a national skills base. Clinical training should include key skill components in disease recognition, but unfortunately many medical courses have cut training in infectious diseases over the past decade. Consequently the tropical disease base has withered to individual student electives, and those with experience of tropical diseases are no longer available to call upon.

In the last three decades over 30 new disease threats have appeared that have had a serious impact, either locally or internationally, on health-care resources. Most are the result of crossing the species barrier from animals to humans, especially from wildlife reservoirs and domesticated animals. The situation is even more complex when arthropod vectors are involved, and adaptation of viruses and bacteria to new ecosystems becomes a mounting possibility as a result of climate changes. Every populated continent has experienced new diseases, regardless of their economic status. Dengue, a distant relative of Zika virus, is an excellent case in point. Prior to 1970, epidemics were restricted to as few as nine countries. A generation later, over 55 countries now see regular outbreaks, due largely to the rapid spread of the principal arthropod vector, Aedes aegypti. However the absence of Aedes species in the UK should not allow complacency, as occasional cases of malaria occur in hot and humid summers around London’s airports due to mosquito escapes from arriving aircraft: in 1865 in Swansea there was a yellow fever outbreak. Insect vectors for other disease threats have yet to be fully evaluated but a body of opinion holds that conditions are conducive for diseases such as Rift Valley fever, a disease of both humans and cattle, to establish itself in the UK if our climate continues to change. The serious lack of support for medical entomology in the UK, however, may impact disastrously on the vital monitoring of vector competence and the likelihood of transmission to indigenous arthropod species.

Returning to the issue of vaccine development, the vaccine industry is a global business and it is unlikely that any private company would invest in production facilities to serve only the limited population the UK represents. Newer technologies such as bioengineered proteins make potential immunogens easy and rapid to produce, but scale up is costly and the regulatory issues equally complex. The UK biotechnology sector has sought to develop commercially viable vaccines but these have largely floundered on cost: an excellent example is the gas-delivered particle technology developed by Powderject in the 1990s. Even major companies have run into difficulties when producing vaccines against well-recognised threats, such as dengue. The reality is that we still do not know enough as to what actually confers protection in the vaccinated individual.

Although the availability of an Ebola vaccine is of global importance, the need for it in the UK is limited. It was not only ‘a combination of hard work and chance’ that stopped Ebola spreading beyond West Africa, but knowledge of viral dissemination routes that are easily disrupted with the right resources. Such knowledge was instrumental in determining that the UK was fully prepared to allow our healthcare workers with Ebola to return here, under 24 hour care and in full containment.

We can help prevent future outbreaks of Ebola by increasing such resources in those countries most likely to be affected, but whilst public health awareness is maintained in the UK we do not believe that we are are at great risk from this disease. We believe that prioritising inter-disciplinary research and training in emerging diseases is the highest priority to ensure the UK is ready for the ‘unexpected’ in years to come.

Elizabeth Benedikz and Colin Howard, Centre for Human Virology, University of Birmingham

Have your say...

Feedback
  • 88952634
    External
    1. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    2. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    3. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    4. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    5. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    6. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    7. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    8. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    9. At 10:57AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    10. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    11. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    12. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    13. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    14. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    15. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    16. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    17. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    18. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    19. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    20. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    21. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    22. At 10:58AM on 11 December 2016, wrote

    88952634

  • 88952634'`"(
    External
    23. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634-0
    External
    24. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634s3
    External
    25. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634'+'
    External
    26. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634'
    External
    27. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634'||'
    External
    28. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634'
    External
    29. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    30. At 10:59AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    31. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    32. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    33. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    34. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    35. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    36. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    37. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    38. At 11:00AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    39. At 11:01AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    40. At 11:01AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    41. At 11:01AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    42. At 11:01AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    43. At 11:01AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    44. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    45. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    46. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    47. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    48. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    49. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    50. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    51. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    52. At 11:02AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    53. At 11:03AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    54. At 11:03AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    55. At 11:03AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    56. At 11:03AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    57. At 11:03AM on 11 December 2016, wrote

    88952634

  • 88952634
    External
    58. At 11:03AM on 11 December 2016, wrote

    88952634'`"(

  • 88952634
    External
    59. At 11:03AM on 11 December 2016, wrote

    88952634-0

  • 88952634
    External
    60. At 11:03AM on 11 December 2016, wrote

    88952634s3

  • 88952634
    External
    61. At 11:04AM on 11 December 2016, wrote

    88952634'

  • 88952634
    External
    62. At 11:04AM on 11 December 2016, wrote

    88952634'||'

  • 88952634
    External
    63. At 11:04AM on 11 December 2016, wrote

    88952634'

  • 88952634
    External
    64. At 12:15PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    65. At 12:15PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    66. At 12:16PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    67. At 12:16PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    68. At 12:16PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    69. At 12:16PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    70. At 12:17PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    71. At 12:17PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    72. At 12:17PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    73. At 12:18PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    74. At 12:18PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    75. At 12:19PM on 13 May 2017, wrote

    88952634

  • 88952634'`"(
    External
    76. At 12:19PM on 13 May 2017, wrote

    88952634

  • 88952634s3
    External
    77. At 12:20PM on 13 May 2017, wrote

    88952634

  • 88952634'+'
    External
    78. At 12:20PM on 13 May 2017, wrote

    88952634

  • 88952634'
    External
    79. At 12:21PM on 13 May 2017, wrote

    88952634

  • 88952634'||'
    External
    80. At 12:21PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    81. At 12:24PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    82. At 12:24PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    83. At 12:24PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    84. At 12:24PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    85. At 12:25PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    86. At 12:25PM on 13 May 2017, wrote

    88952634

  • 88952634
    External
    87. At 12:26PM on 13 May 2017, wrote

    88952634'`"(

  • 88952634
    External
    88. At 12:27PM on 13 May 2017, wrote

    88952634s3

  • 88952634
    External
    89. At 12:27PM on 13 May 2017, wrote

    88952634'+'

  • 88952634
    External
    90. At 12:27PM on 13 May 2017, wrote

    88952634'

  • 88952634
    External
    91. At 12:27PM on 13 May 2017, wrote

    88952634'||'

  • 88952634
    External
    92. At 12:27PM on 13 May 2017, wrote

    88952634'

  • 88952634
    External
    93. At 2:58PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    94. At 2:58PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    95. At 2:58PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    96. At 2:59PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    97. At 3:00PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    98. At 3:01PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    99. At 3:02PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    100. At 3:03PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    101. At 3:03PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    102. At 3:04PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    103. At 3:04PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    104. At 3:04PM on 02 August 2017, wrote

    88952634

  • 88952634s3
    External
    105. At 3:06PM on 02 August 2017, wrote

    88952634

  • 88952634'+'
    External
    106. At 3:06PM on 02 August 2017, wrote

    88952634

  • 88952634'
    External
    107. At 3:07PM on 02 August 2017, wrote

    88952634

  • 88952634'||'
    External
    108. At 3:07PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    109. At 3:11PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    110. At 3:12PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    111. At 3:12PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    112. At 3:13PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    113. At 3:13PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    114. At 3:14PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    115. At 3:14PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    116. At 3:14PM on 02 August 2017, wrote

    88952634

  • 88952634
    External
    117. At 3:15PM on 02 August 2017, wrote

    88952634'`"(

  • 88952634
    External
    118. At 3:15PM on 02 August 2017, wrote

    88952634-0

  • 88952634
    External
    119. At 3:15PM on 02 August 2017, wrote

    88952634s3

  • 88952634
    External
    120. At 3:15PM on 02 August 2017, wrote

    88952634'+'

  • 88952634
    External
    121. At 3:16PM on 02 August 2017, wrote

    88952634'

  • 88952634
    External
    122. At 3:16PM on 02 August 2017, wrote

    88952634'||'

  • 88952634
    External
    123. At 3:16PM on 02 August 2017, wrote

    88952634'

Add Your Feedback