In recent years, scientists have been paying a lot of attention to a striking development: the number of infectious diseases has increased considerably. That rise was not just one or two more diseases each year. In fact, over the last 100 years, the number of new infectious diseases discovered each year has quadrupled and outbreaks have tripled. What explains this dramatic increase in new infectious diseases? Read on to find out the answer to this question, how scientists are working to fight diseases, and what the consequences could be if we continue along this same trajectory.

Infectious Disease on the Rise

To begin to understand the rising levels of infectious disease, it is first imperative to understand the common terminology. Four terms, in particular, are used very frequently and require clarification. These terms are outbreaks, epidemics, pandemics, and endemic. An outbreak occurs when the number of cases of a specific disease in a specific community rises above what would normally be expected. Epidemics are, “a widespread increase in the observed rates of disease in a given population.” Pandemics are basically the multinational form of epidemics in that they encompass worldwide outbreaks beyond a particular population. Endemic is decidedly different than the other terms and essentially means a rate of disease that is consistently higher within a given group. These definitions are particularly important for the people treating an outbreak on the ground, as it helps them tune their methods to the reality of the situation. The following video gives an overview of how disease spreads:

Although that rise sounds troubling it is not all doom and gloom. While individual outbreaks are increasing, they are affecting fewer people now than before. Additionally, only a small variety of infectious diseases are responsible for the majority of outbreaks. Furthermore, of these strands, a little over half are zoonosis–diseases that are passed from animals to humans. Even among zoonosis, there are only a few zoonotic diseases that cause most outbreaks. In other words, outbreaks are on the rise but a decreasing number of diseases–passed from animals to humans–account for that rise. The question then becomes, what is leading to the rise in outbreaks?

Factors Leading to the Rise of Infectious Diseases

There are several reasons for this increase, but it starts with us and the actions we take. Many of the recent outbreaks are not new diseases, only new to us as a species. They have been incubating and traveling all across areas like rainforests for tens of thousands of years. However, with human encroachment in the form of farming, mining, housing, etc. people are starting to come into contact with these diseases more often and the results are not always good.

Other human manipulations of the environment are also leading to the rise of infectious diseases. These include seemingly benign activities such as reforestation, animal farming, and even flooding rice patties. Sometimes it can be a combination of human activity and environmental factors, such as when milder winters that are the result of global warming fail to kill off the usual number of pests. In fact, rising temperatures have the potential to be one of the greatest contributors to the continued rise of infectious diseases in the coming years, while ailments such as Malaria, which prosper in warmer climates, may become much more virulent. The video below details how global warming can increase the risk of infectious disease:

Other trends, like urbanization, may also contribute to the rise of infectious diseases. By clumping closer together, the chances of an infection spreading quickly are much higher. This is particularly true when urbanization occurs in poorer countries without effective public health monitoring and preventions systems. Similarly, more travel between countries and regions can introduce infections to places that have never seen them before and it can increase the likelihood that an epidemic becomes a pandemic. Even technology and modern supply chains can present a risk, as processing consolidation may increase the likelihood that contamination spreads.

Resistance to antibiotics and resulting superbugs are additional issues leading to the rising number of infectious diseases. However, this is also a problem for viral infections for many of the same reasons, including over prescription of certain medicines and prescribing the wrong medication for a specific disease. Viruses are especially problematic because they can evolve so quickly that it is impossible to stay ahead of them. The clearest example of this is influenza or the flu which changes from year to year. Along with antibiotics, many sanitation systems are also proving less useful than before. In this case, the issue has more to do with the lack of upkeep in existing public health systems that has led to outbreaks of old diseases such as cholera.

Efforts to Fight Outbreaks

Given this trend, what is being done to stem the tide? Actually, governments began addressing the rise of infectious diseases several years ago. A response was prompted back in 2014, following the outbreaks of MERS and bird flu. That year, the United States, along with dozens of countries and organizations, announced a plan to respond and treat new outbreaks where they start.

Currently, efforts to fight infectious disease in the United States fall under the authority of the Centers for Disease Control, or CDC. Specifically, many of those efforts are housed in the National Center for Emerging and Zoonotic Infectious Diseases or NCEZID. NCEZID focuses on reducing both illnesses and deaths that are associated with infectious diseases. It also strives to be proactive in protecting against the spread of infectious diseases.

At the international level, there is the World Health Organization (WHO). Much like the CDC in the United States, the WHO also focuses on reacting to and fighting epidemics. The WHO acts more like a clearinghouse encouraging individual countries to improve their own existing systems and work to integrate them internationally so a crisis in one country can be handled as effectively by its neighbor if it crosses international borders. When it comes to the spread of infectious disease, the WHO serves as an international monitor to identify and coordinate a response to outbreaks.

Conclusion

Foreseeing and preventing all outbreaks of infectious disease would be impossible. Just last year, for instance, several people in Russia were infected with Anthrax when frozen strains of the disease were released when permafrost melted. While this could easily lead to discussions about global warming, the truth is that it just as clearly exemplifies that it is impossible to anticipate everything. In fact, in some cases, efforts are even seen as misguided or unwanted.

Many recent efforts have focused on identifying and understanding new diseases, like those deep in the rainforest. However, such methods have also been criticized for spending scarce funding to search out new diseases when funds could instead be used for treating known maladies. Although it seems odd to criticize people for being proactive, that might be a fair critique in a world with finite resources. In fact, it might be fair to wonder why people are really that concerned with infectious diseases at all.

This is because non-communicable diseases, like cancer, which cannot be spread from one person to another, kill far more people each year than infectious diseases. However, those diseases also originate within us and frequently have to do with factors that we are less able to control, such as getting older. Conversely, based on the fact that only a few diseases cause most of the outbreaks, infectious disease can be managed and their threat reduced. Thus counteracting the rise of infectious diseases is likely to continue to be a mainstay of health policy both nationally and globally.

Michael Sliwinski

Michael Sliwinski (@MoneyMike4289) is a 2011 graduate of Ohio University in Athens with a Bachelor’s in History, as well as a 2014 graduate of the University of Georgia with a Master’s in International Policy. In his free time he enjoys writing, reading, and outdoor activites, particularly basketball. Contact Michael at staff@LawStreetMedia.com.

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Cancer. Just one little word that sets hypochondriacs everywhere on edge. To some, the word means nothing but certain death. If that seems a little dramatic to you, guess what’s the second most common cause of death in the United States? That’s right, cancer.

What about the word “virus”? Scary…but not nearly as scary as cancer. It’s certainly not a word that evokes hope. But that may change as medical breakthroughs present a compelling question: can we use viruses to treat cancer?

How could we use viruses to cure cancer?

I know what you’re thinking. How can two negatives combine to achieve something as positive as a cure for cancer? The answer lies in your immune system.

Your immune system pinpoints a virus as a foreign invader, and works to eliminate it. Kind of like how our government would react to an alien spaceship entering Earth’s atmosphere.

On the other hand, your immune system has a harder time detecting cancer. Cancer cells share more characteristics with your own harmless cells than viruses. After all, cancer does originate from your own cells. It’s not in your body’s best interest to attack its own cells, so your immune system may overlook cancer as a threat. Kind of like how the government would react to a standard American aircraft filled with aliens. Seeing the aircraft as one if its own, they would leave it alone, and we’d have an invasion.

In summary, your immune system recognizes and fights viruses, but often not cancer.

So where does the cancer treatment part come in?

Our bodies can fight off viruses efficiently. What if we could hijack that fighting spirit and direct it towards cancer cells? What if we could manipulate our marvelous immune systems to fight off cancer?

That is the basis for how we may use viruses to treat cancer in a process known as oncolytic virotherapy.

Let’s go back to our surreptitious alien friends (cancer). They’ve made it into our atmosphere in their inconspicuous plane and are having a lovely joy ride when that alien spaceship (virus) joins them to transfer some of its passengers. Someone is bound to notice this suspicious activity and alert the authorities. Now the government (immune system), is wise to the presence of foreign invaders in both aircrafts and prepares for attack.

In oncolytic virotherapy, a virus infects a cancer cell. Distressed by this turn of events, the tumor cell releases cytokines which are really just messenger proteins. The cytokines raise the inflammation red flag and the immune system dispatches its sniper-like white blood cells to eliminate the source of inflammation–the infected tumor cell.

That was just one cell. What about an entire cancerous tumor? That’s where a virus’s prodigious replicating power is actually a good thing. Viruses don’t reproduce per se, but inject their own genetic material to commandeer host cells and replicate with their help. Replicating is a virus’s raison d’etre, host cells beware. After one cancer cell is successfully infected, the virus uses it as its replication puppet, consequentially infecting more cancer cells. So one transmission of a virus to a patient could cause destruction of many cancer cells and possibly an entire tumor.

To truly understand this process, take a moment to brush up on your viral replication knowledge. This video will help you out:

Will any virus work?

Any virus can infect and destroy a cancer cell, but it can also infect and destroy healthy cells. Successful oncolytic virotherapy requires a more selective virus–an oncolytic virus. The word oncolytic stems from oncolysis, which means the destruction of tumor cells. Oncolytic viruses are specifically attracted to tumor cells and leave your normal, healthy cells alone. This type of virus combats cancer cells without making patients sick.

That’s a new thing, right?

Yes and no. The concepts underlying virotherapy have been recognized for years. Doctors have pondered the use of viruses to treat cancer for more than a century as they discovered tumor remissions after viral episodes. As early as 1904, researchers noted a remission of cervical cancer in a woman given the rabies vaccination. But while early observations were strong, patient tests yielded erratic results. Then, technological breakthroughs took off in the 1940s and transformed oncolytic virotherapy from dream to possibility.

Scientists began studying genetic material in vitro by the 1970s, opening doors for new experiments and tests. The discovery of recombinant DNA technologies in the 1990s sparked an explosion of breakthroughs in genetic engineering. Genetic engineering took oncolytic virotherapy to new levels.

Genetically Engineering a Cancer-Killing Virus

Genetic engineering empowered scientists to devise oncolytic viruses with certain ideal characteristics for safer, more specific, and more effective oncolytic virotherapy. Scientists created viral vectors that target tumors in the body even more specifically than naturally occurring oncolytic viruses by isolating the human genes that code for tumor antigens. This heightened specificity diminished risk of infection in healthy cells and the toxicity witnessed in early murine (family of rats and mice) and human experiments was mitigated.

With engineered super viruses in tow, interest in oncolytic virotherapy soared.

Fear of engineered viruses  

Many find the concept of engineering viruses a bit on the scary side. I Am Legend, both the book and the movie, epitomizes distrust of viral engineering. The story features some possible side effects of tinkering with nature. Spoiler alert: it doesn’t go well for the people in this story.

But fear not, scientists aren’t cooking up a myriad of franken viruses in their labs unchecked. The field is regulated by the Food and Drug Administration with detailed oversight from the Recombinant DNA Advisory Committee reporting through the Office of Biotechnology Activities. To conduct a human study, researchers have to file an investigational new drug application with the FDA. They must provide ample evidence of human safety from prerequisite lab and animal tests. Rest assured they are working hard to prevent a virus induced apocalypse.

Other than oversight…

What other government activities could possibly affect the future on oncolytic virotherapy? Well, if there’s one thing cancer research requires other than brilliant brains, it’s money. In that vein, organizations like the American Society of Clinical Oncology find the stagnant growth in federal funding for cancer research disheartening.

In fact, 75 percent of oncologists in the United States say that current funding slumps impact their ability to conduct cancer research. Check out this infographic from the American Society of Clinical Oncology that sums up the situation.

Even so, proposed legislation to invest in biomedical research, encourage innovation in biotechnology, and fight off the deadliest cancers proves confronting cancer remains a priority for representatives. It looks like the War on Cancer started by the Nixon administration in 1971 is still going strong today.

Does oncolytic virotherapy work?

Mayo Clinic announced a great success in oncolytic virotherapy last May. One nearly hopeless woman saw complete remission of her multiple myeloma after injection with the measles virus – enough to vaccinate 100 million people. Speaking of vaccines, Dr. Mark Federspiel actually came up with the proper concentration of the virus by building up a strain of the measles virus used safely in vaccines. Watch to find out how this success is giving doctors hope for a one-shot cure for cancer:

Hungry for more evidence? Check out Table 1 of this article for a list of published clinical trials in the field of oncolytic virotherapy. One major critique of the therapy is that lab successes often don’t translate to human trials.

What are we waiting for?

There are a few kinks to work out in the field of oncolytic virotherapy before the procedure gains mainstream acceptance.

Here are a few key hurdles:

• The explosion of engineered viruses created by pharmaceutical and biotech companies have presented scientists with more options than they have time or money to test. Furthermore, modifications come so fast, a state of the art engineered virus can quickly become obsolete.
• Treatment toxicities are always possible when using a virus to treat a disease. Healthy cells risk infection as even meticulously engineered viruses have the ability to mutate.
• Finding the right balance of immune suppression and aggression is difficult. The immune system must be weak enough to allow the virus to get to the host, yet also strong enough to combat the infected tumor once the virus has reached it.

Conclusion

A one-shot cure for cancer? Who wouldn’t love that? While it seems like a fairy tale, recent successes are creating buzz that we may be getting closer. Even if one shot doesn’t do it, many believe oncolytic virotherapy can be used synergistically with other cancer therapies to induce tumor remission.

Hope is the most important part of our War on Cancer. Hope drives us to continue fighting in the face of a daunting adversary. Is there reason to hope viruses may be used to treat cancer? Absolutely. Is further research and testing needed? Again, absolutely. The field of oncolytic virotherapy has made incredible progress since the first whispers began over 100 years ago. Surely the next century will bring more advancements than we can possibly imagine today.

Resources

Primary 

Cancer Research Institute: Cancer and the Immune System: The Vital Connection

Journal of Vascular and Interventional Radiology: Oncolytic Virotherapy

Additional

American Cancer Society: Cancer Facts & Figures 2014

Genelux: What is Oncolytic Virotherapy?

BBC: How Does the Body Fight Off a Virus?

American Cancer Society: Immunotherapy

The New York Times: Viruses Recruited as Killers of Tumors

UC San Francisco: Killing Cancer Through the Immune System

Clinical and Translational Oncology: Viruses in Cancer Treatment

Mayo Clinic: Harnessing Viruses to Treat Cancer

Dove Press: Applications of Coxsackievirus A21 in Oncology

Dove Press: Reovirus in Cancer Therapy: an Evidence-Based Review

NIH: Oncolytic virotherapy

Multidisciplinary Digital Publishing Institute: Oncolytic Viruses for Cancer Therapy: Overcoming the Obstacles

BMJ: Fighting Cancer With Oncolytic Viruses

Ashley Bell

Ashley Bell communicates about health and wellness every day as a non-profit Program Manager. She has a Bachelor’s degree in Business and Economics from the College of William and Mary, and loves to investigate what changes in healthy policy and research might mean for the future. Contact Ashley at staff@LawStreetMedia.com.

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