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Real-life lessons in Hollywood’s “Contagion”

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Boston, Mass (October, 2011)--The recently released, star-clad thriller Contagion provides a sure-fire nightmare trigger for germophobes worldwide. The portrayal of havoc in the wake of a lethal and rapidly spreading plague is nothing new for Hollywood. But this movie takes a unique – and noteworthy – turn from the Hollywood film mill, one that went unnoticed by most of the critics, but might give restless nights for more than the germ-wary among us.

The film's final minutes take us to the plague's origins. We witness a bulldozer clearing a forest near Hong Kong – an all too realistic scene. Southeast Asian nations have some of the highest deforestation rates in the world, with Cambodia and Vietnam losing more than 1% of their forest cover per year in the past decade. As the trees fall, the camera follows the flight of animals from the plow, including a bat that is tracked traveling to a new resting site: a pig farm. There, its detritus lands on pigs that ultimately end up in a restaurant kitchen where Gwyneth Paltrow's character dines. Fresh from cleaning the swine, the restaurant's chef is asked to meet and greet the American guest and, with a handshake, the pandemic is born.

Implausible? Hardly. For scientists working at the interface of infectious disease and ecology, this movie eerily shadows the events that brought Nipah virus, which first appeared in Malaysia in 1998 and multiple subsequent epidemics in Bangladesh since, from bats into humans. (Unlike the epidemic portrayed in the film, Nipah is transmitted less readily, but was still responsible for hundreds of deaths.) Similar emerging infectious diseases are able to move into humans because ecological barriers that once kept them out of reach have been broken down, opening the door to their entrance to the human stage. Such was the case with SARS, HIV, and others.

There's a long history of infections entering humans from animals. However, the data tell us that untoward cascades, in which seemingly disparate events, such as deforestation and the movement of pathogens from animals into humans, are not only happening but have been occurring ever more frequently over the past 50 years. Many factors contribute to pathogen migration, including increased encounters between people and wildlife that may result from the animals coming to us, as happens in live animal markets, or because we go to the animals, as may happen with logging of pristine forests or populations forced into forests because of conflict or famine. Another major contributor has been the ongoing dismantling of the living world itself, occurring today at a pace unprecedented in human history. Largely as a result of habitat loss, although increasingly due to climate change, species are going extinct at a pace not seen since 65 million years ago when about half of all species went extinct. Today, by our best scientific estimates, the pace of species loss threatens to put another 50% of species on extinction's doorstep by 2100. These extinctions of flora and fauna that makeup in tact ecosystems, lead to more human contact with animals that carry disease, such as the bat in the film.

Although germophobes may want to run for the closet after viewing Contagion, in the movie all of us understand that we can do better when it comes to protecting ourselves from new plagues. As we understand how the risks of cavalier exploitation of nature extend beyond the tragic loss of species to harming us, we can be wiser about how we do business with the biosphere.

Aaron Bernstein, MD, MPH

Aaron Bernstein is the Interim Director of The Center for Climate, Health, and the Global Environment, a pediatrician at Boston Children’s Hospital, and an Assistant Professor of Pediatrics.

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