GOING VIRAL

Of Bats and Pigs and the CDC

Contagion is the new virus thriller from director Steven Soderbergh about MEV-1, a vicious, spanking-new hybrid virus—part bat, part pig—that spreads worldwide like the flu and is often fatal within a few days, usually after the victims spike a high fever, then experience seizures and, finally, frothing at the mouth. The film spans more than four months, and once the virus invades the HIV/AIDS population, it becomes even more virulent. 

The fast-paced movie makes coughing scarier than Kathy Bates in Misery and sports a great cast.  Gwyneth Paltrow is pale, wan patient zero in the U.S., having been infected on a business trip to Hong Kong; Matt Damon is well cast as her beleaguered husband; Kate Winslet and Marion Cotillard portray dedicated epidemiologists; Laurence Fishburne imbues his role of the hardworking Centers for Disease Control deputy director with gravitas; Jennifer Ehle plays a fearless CDC vaccine researcher and the film’s number-one heroine; Elliott Gould has fun as an intrepid non-government scientist defying CDC orders; and Jude Law sinks his teeth into the juicy role of an unscrupulous blogger who sets the world into an early panic and screams “Print media is dying” to a newspaper editor who won’t give him an assignment. Later, when the number of unique visitors to "Truth Serum Now"—his doom-and-gloom blog of fake cures and misinformation—exceeds the mounting death toll, he becomes positively gleeful.

As MEV-1 and panic spread, food becomes scarce, stores are looted and fires set, streets and airports empty out, and undertakers won’t bury the dead as Earth morphs into a gigantic ghost town. To increase their chances of survival, people don masks and gloves and practice what’s called “social distancing” while CDC scientists risk their lives in a race to come up with an effective vaccine.  Oddly no politicians weigh in during the movie, and the President is soon whisked to a secure underground bunker; that's the last time he's mentioned.  Contagion is all about weary scientists who spout phrases like "chimeric," "revert to wild type" and "attenuated."

The film’s only obvious misstep is the disappearance of Marion Cotillard’s character.  She's kidnapped by Chinese who claim first dibs on a vaccine for their nearly wiped-out village—and use her for collateral.  But so much is happening round the globe that when the film finally pivots back to Cotillard, someone in the audience called out:  “I thought she was dead already.” 

Contagion effectively pieces together the casual connections of the first victims.  Even more satisfying is witnessing how the two virus halves first met.  Both are the most gratifying and eerie aha! moments since the critical instant in The Sixth Sense when you realize that Bruce Willis’s character has been dead for most of the movie.  

Why am I giving a mini review of Contagion on CFS Central?  

1. Is it because I snickered and threw popcorn at the screen every time another brave government official appeared?

2. Is it because I wondered how the CDC’s Beth Unger would fare in the role Jennifer Ehle played? See photos, below.

3. Is it because another worldwide plague is already here and it’s not MEV-1, but rather ME?

4. Is it because I’m wondering where the heck are all the intrepid non-government researchers like Elliott Gould’s character, who’d defy government orders for the sake of mankind?

5. Is it because the film gives bloggers a bad name?

6. Is it because the scientist that Kate Winslet portrays believably utters the word “fomite”?

7. Is it because a frightened big brown bat flew inside my house during hurricane Irene, and I had bacon in the refrigerator? 

8. Is it because what’s missing in the film is a cameo from British psychiatrist Simon Wessely in which he’d call MEV-1 a biosocial construct and complain that MEV-afflicted patients were sending him nasty emails and trying to breathe on him?

9. Is it because the film mentions Dr. Barry Marshall, who drank a Petri dish of H. pylori in 1984 because he was convinced the bacterium caused ulcers, but nobody believed him?

10. Is it because Jude Law’s character, Alan Krumwiede—pronounced “Crum-weedy,” in the most hyperbolic illustration of nominative determinism ever—bemoans the pathetic lack of information on the CDC website? 

All of the above are true, except for number one: I don’t like popcorn.

Postscript: Patient advocate Lilly Meeham emailed that virus hunter Dr. Ian Lipkin, who's overseeing the big XMRV study, served as an adviser to Contagion.  In fact, Elliott Gould's character is based on Lipkin!  Thank you, Lilly.  Lipkin explained in an interview that MEV-1 is not that big a stretch from the truth and is similar to the Nipah virus, which was discovered during an encephalitis outbreak in Malaysia among Chinese pig farmers. "The pigs had been infected by bats," Lipkin said.  "In outbreaks in Bangladesh where people don't farm pigs, the virus went directly from bats to man via palm sap collected in trees and sold as a beverage. What was different in Bangladesh is that there were reports of human-to-human transmission."

            Ehle                                   Unger

DOCTOR, DOCTOR, GIVE ME THE NEWS

The International ME Association (IMEA) and patient advocate and IMEA member Keith Baker have nominated Dr. Joan Grobstein, a neonatologist with ME, to sit on the Chronic Fatigue Syndrome Advisory Committee (CFSAC).  A graduate of Harvard College and University of California at Davis Medical School, Grobstein was serving as a neonatologist at Children’s Hospital of Philadelphia and the University of Pennsylvania when she became ill with ME more than a decade ago.  She has testified before the CFSAC committee several times, most recently last spring (see clip at the bottom of this post).

Baker says that Grobstein’s experience both as a patient and a medical doctor is a good blend of attributes that no one else on the committee has.  “And that’s a perspective that the committee needs,” he says.

Grobstein says she decided she wanted to join CFSAC because the current government response has been “inadequate. Access to care is extremely limited, and there is little funding for research into the causes and potential therapies for the disease,” Grobstein explains. “Patients have waited far too long for progress.”

The deadline for CFSAC nominations is August 17^th. A former high-ranking government worker told CFS Central last spring that in his experience what gets the government’s attention is Facebook. In his view, the government has learned to ignore phone calls, faxes and emails. But Facebook campaigns, he said, “panic” them because they’re viral, embarrassing, and leave an indelible footprint.  Ideally, a campaign endorsing Grobstein’s bid could be started today.

BREAKING THE CODES

 Blood Working Group 

Results Expected in a Month

Dr. Michael P. Busch, director of the Blood Systems Research Institute, said today in a telephone interview with CFS Central that his institute began this week to break the codes for the Phase III study of the XMRV Blood Working Group.  “We expect in the next month to preliminarily disseminate the findings,” Busch said.  The Phase III study is evaluating the specificity and sensitivity of different assays in detecting the retrovirus XMRV, first discovered in ME/CFS patients in October 2009 by the Whittemore Peterson Institute.

How the Blood Working Group plans to publicize the results will be determined later this month, when the Blood Working Group scientists have their next phone conference.  Busch offered three possible ways of publicizing the preliminary findings:  in a peer-reviewed journal; at a conference; or in a press release.

“The Working Group will have to decide whether we put out a general public announcement summarizing the findings [making sure] that it would not undermine the scientific, peer-reviewed publication. Major journals are careful about embargoing findings. We’re working on a paper, pending the findings, so that we can plug them in and submit the paper.”

However, “definitive” dissemination will be through publication in a major journal, Bush clarified.

Researchers have examined whole blood, PBMC’s (peripheral blood mononuclear cells, which are cells with a nucleus, key players in the immune response), and serology (antibody testing).  Several labs participated, including those at the Whittemore Peterson Institute, the Food and Drug Administration, National Cancer Institute, and Centers for Disease Control, plus the commercial labs Abbott and Gen-Probe. 

The scientists examined the blood of ME/CFS patients who were positive in the Lombardi and Lo papers, as well as pedigreed negative control donor samples and spiked positives.  Several samples from about 70 different subjects were tested using at least 15 different assays.

“Our Phase IV and other planned studies of donor and recipient infection are contingent on results from Phase III documenting reproducible and specific detection of virus/antibody,” Busch said.