The Ethics behind a The Ethics behind a Country’s Response and Country’s Response and

Responsibility to Dealing with Responsibility to Dealing with Emerging DiseasesEmerging Diseases

Wolf, StevenWolf, StevenAP BiologyAP BiologyPeriod 3Period 3June 11June 11

Emerging DiseasesEmerging Diseases

• Def: a disease that has appeared in a Def: a disease that has appeared in a population for the first time, or that population for the first time, or that may have existed previously but is may have existed previously but is rapidly increasing in incidence or rapidly increasing in incidence or geographic range (“Emerging geographic range (“Emerging Diseases,” World Health Diseases,” World Health Organization).Organization).

• Examples: AIDS/HIV, Ebola, Avian FluExamples: AIDS/HIV, Ebola, Avian Flu

AIDS/HIVAIDS/HIV

• HIV (human immunodeficiency HIV (human immunodeficiency virus)virus)

• Targets and destroys Helper T Targets and destroys Helper T cells and CD4 cells cells and CD4 cells (immunodeficiency)(immunodeficiency)

• AIDS (acquired immunodeficiency AIDS (acquired immunodeficiency syndrome) - syndrome) - final stage of HIVfinal stage of HIV

• All over the worldAll over the world• sexually transmitted infection sexually transmitted infection

(STI)(STI)• Hard to treat because rapidly Hard to treat because rapidly

mutatingmutating• Prevent transmissionPrevent transmission

– AbstinenceAbstinence– CondomsCondoms– HIV TestsHIV Tests– Medication to stop transmission Medication to stop transmission

across the placentaacross the placenta

EbolaEbola

• Common name for severe Common name for severe hemorrhagic fever hemorrhagic fever

• Caused by a filovirus- loopCaused by a filovirus- loop• Extremely fatal (up to 90%) Extremely fatal (up to 90%)

fatalityfatality• Causes sever hemorrhagic Causes sever hemorrhagic

bleeding bleeding • Transmission: by blood in humansTransmission: by blood in humans• Disease spreads quickly in poor Disease spreads quickly in poor

African countries where they African countries where they reuse needlesreuse needles

• Treatment Treatment – Isolation (barrier nursing Isolation (barrier nursing

techniques) techniques) – proper hydration & nutritionproper hydration & nutrition– watch blood pressurewatch blood pressure– no known vaccine/cure no known vaccine/cure

• Several types, could still be Several types, could still be mutating (ex: Zaire, Reston)mutating (ex: Zaire, Reston)

Avian FluAvian Flu

• formally known as avian influenza, may formally known as avian influenza, may hear “bird flu”hear “bird flu”

• in domestic birds, ex: chickens, turkey, in domestic birds, ex: chickens, turkey, duck, may cause sickness and death duck, may cause sickness and death

• Transmission in birds, contact with: Transmission in birds, contact with: – feces feces – SheddingShedding– SalivaSaliva– Other excretionsOther excretions

• sometimes low fatality, but could reach sometimes low fatality, but could reach 90-100 percent in 48 hours90-100 percent in 48 hours

• H5N1 most deadly of avian influenza H5N1 most deadly of avian influenza viruses in birdsviruses in birds

• There have been cases of transmission to There have been cases of transmission to humans through close contact with humans through close contact with contaminated specimens or birdscontaminated specimens or birds

• Inefficient spread from human to human Inefficient spread from human to human • More than half of people infected with More than half of people infected with

disease have died, because little immune disease have died, because little immune responseresponse

• currently there is a vaccine approved by currently there is a vaccine approved by FDA for one type of H5N1 virus FDA for one type of H5N1 virus

– added to US stockpile, not to public added to US stockpile, not to public – will be distributed in case of pandemic will be distributed in case of pandemic

Question 1: What responsibility does a Question 1: What responsibility does a country have to find a cure for an emerging country have to find a cure for an emerging

disease?disease? • Medical testing on animalsMedical testing on animals

– Pro:Pro:• Humans don’t get harmedHumans don’t get harmed• Testing on living being over time advantage over Testing on living being over time advantage over

computer simulationscomputer simulations– Con:Con:

• Do not show similarities between humans and Do not show similarities between humans and animals because differences are to great (ex: Phen animals because differences are to great (ex: Phen Fen)Fen)

• Computer programs are good alternativesComputer programs are good alternatives– Pro: Because best to save human lives (comps. Pro: Because best to save human lives (comps.

are not a replacement for living specimens; are not a replacement for living specimens; living specimens code comps.)living specimens code comps.)

Question 1: What responsibility does a Question 1: What responsibility does a country have to find a cure for an emerging country have to find a cure for an emerging disease?disease?

• Medical Testing on Humans Medical Testing on Humans – Pro:Pro:

•Rigid testing procedureRigid testing procedure

•Humans show side effects after long term useHumans show side effects after long term use

• Informed consentInformed consent

– ConCon•The size of reward to finding cure often The size of reward to finding cure often

makes researchers ignore human subjects makes researchers ignore human subjects (ex: Tuskegee Syphilis Study, 1932-1972)(ex: Tuskegee Syphilis Study, 1932-1972)

Question 2: Once a cure is found, should it Question 2: Once a cure is found, should it be given to other countries?be given to other countries?

• Pro:Pro:– Gain information on spread of disease and effectiveness of Gain information on spread of disease and effectiveness of

cure cure – Strengthen diplomatic tiesStrengthen diplomatic ties– Supporters:Supporters:

• MeMe

• ConCon– May run out of treatment for own countryMay run out of treatment for own country– carrying capacity acting on population growth, don’t carrying capacity acting on population growth, don’t

interfere w/ nature interfere w/ nature – Its up to them to make there own stockpile of drugs Its up to them to make there own stockpile of drugs – Supporters:Supporters:

• Mr. FazioMr. Fazio

Question 3: What responsibility does a Question 3: What responsibility does a country has to help its own country ?country has to help its own country ?

• South African inmates South African inmates hunger strikehunger strike– do they need to provide do they need to provide

HIV testing and treatmentHIV testing and treatment– Criminals vs. citizensCriminals vs. citizens

• Myanmar refuses help Myanmar refuses help from other countriesfrom other countries– May 2 cyclone devastates May 2 cyclone devastates

Irrawaddy Delta Irrawaddy Delta – Until May 26, 2008, Until May 26, 2008,

military Junta refused military Junta refused helphelp

– Would they accept help in Would they accept help in an epidemic? an epidemic?