In 1964 there was a typhoid outbreak in Aberdeen caused by contaminated corned beef from Argentina. Opinion among older Aberdonians is sharply divided about Ian MacQueen, the local medical officer of health. Some say he saved the city. Others say he did more damage than good. Dr MacQueen ran daily press conferences. At the beginning he said the outbreak was under control and the number of cases would be small. Then, as case numbers continued to rise, he started doom-laden talk about a second wave, and predicted as many as 40,000 possible cases. But as case numbers fell, his waves turned into a series of wavelets. At the end of the outbreak, 507 cases had been diagnosed. There were no waves, or even wavelets. Three people died, none of typhoid.
Pharmacopoeia raiders are busy, looking for Covid-19 remedies that might be hiding in the long list of tried, tested and safe drugs. I did this for smallpox a long time ago, when it was discovered that the antibiotic rifampicin blocked its growth. It turned out that the effective dose was far too high to be useful. The smallpox strain I used in this work was called Butler. It had been isolated in Rochdale during a big outbreak in 1952. Most of the 138 cases had never been vaccinated. Nobody died, because the causative virus was variola minor, very closely related genetically to classical smallpox – variola major – but very different in its clinical effects: v. minor with a case fatality rate in the unvaccinated of less than 1 per cent and v. major with a rate higher than 20 per cent.
Covid-19 has made A&E departments very quiet. I worked in the one at St Thomas’s Hospital when it was called Casualty. Undressing a homeless patient once caused the centrifugal escape from his clothes of a shimmering sheen of lice, hundreds of them. Sister Cas was called. She rolled up her sleeves and said: ‘This reminds me of Dunkirk!’ Most lousy people have only a handful. The best quantitative study of lousiness was done by Alexander Peacock, an RAMC entomologist, in the trenches on the Western Front in the First World War. He found that 95 per cent of the soldiers were infested, more than 60 per cent with 20 lice or fewer, but 2.8 per cent – he called them ‘horrible examples’ – had more than 350 on their trousers and shirts. This pattern of distribution, in which most of a human population’s parasites are concentrated in only a few individuals, is very common. Statisticians call it ‘overdispersion’.
More than sixty years ago, puffing on an untipped Senior Service (we were allowed to smoke in those days) to cover up the reek in a dissecting room at St Thomas’s Hospital, I was struck down by a pandemic virus that had recently evolved in China. By the time I fell ill (its onset was very sudden) the virus had already killed more than 20,000 people in the UK, with 1150 dying every week at its peak, and 80,000 in the US. In the first UK wave, more than half the deaths occurred in the under-55s. It went for the elderly later, in its second wave. It killed quickly: nearly 20 per cent of its younger victims died before getting to hospital and two-thirds were dead within 48 hours of admission. But it has been airbrushed out of history, despite being by far the most lethal pandemic to affect Britain at any time in the hundred years after the ‘Spanish’ flu pandemic at the end of the First World War.
The emergence of a new coronavirus in Wuhan at the end of 2019 has not been a virological surprise. New coronaviruses causing respiratory infections have been detected from time to time since SARS (which was a surprise) in 2002-3; MERS came in 2012. How ‘new’ these viruses are is debatable.
In 2004 I described the basis of attacks on the MMR vaccine as ‘unsubstantiated speculation masquerading as science’, and finished the piece: ‘I despair.’ Measles is now busier in Europe than it was fifteen years ago.
‘Chlorinated chicken’ is pejorative. Chlorine gas doesn’t come into it. The meat isn’t bleached. Poultry carcasses are washed with dissolved antimicrobials such as sodium chlorite, chlorine dioxide and trisodium phosphate. The EU banned it in 1997, not because the washes leave the meat dangerous to eat but because it might incentivise poultry producers and processors to give hygiene a lower priority. This argument was used in the 1930s by opponents of milk pasteurisation.
A recent review by scientists in Australia of 73 historical studies of insect decline concluded that insect biodiversity is threatened worldwide, and 40 per cent of insect species are threatened with extinction over the next few decades. But there is a puzzle. The classes that are declining fastest are butterflies, bees and dung beetles. No one is going out of their way to eliminate them. Other insects that we attack deliberately and for which extinction would be a cause for celebration are doing well.
Romaine lettuce in the US is currently under the cosh of a Food Safety Alert: don’t eat it, whether head or heart or baby; don’t sell it; and don’t eat ready-mixed Caesar salad, which contains it. Contamination with E. coli O157:H7 is the reason. An outbreak started in October, with 50 cases across 11 states, as well as in Ontario and Quebec, with 13 in the US admitted to hospital. The lettuce may have been grown in California, unlike the produce that caused the first romaine outbreak this year, which was grown in Yuma, Arizona. That outbreak lasted from March to June, and was the biggest E. coli O157:H7 outbreak in the US for many years, with 201 cases (96 hospitalised) and five deaths.
The UK has the highest incidence in the world of poisonings caused by the toxins produced by E.coli O157:H7. It killed 17 people in the outbreak centred on Wishaw in central Scotland in 1996, still a world record for lethality. My involvement in attempts to stop a repeat led to an invitation to visit the Defence Science and Technology Laboratory at Porton Down. Security was impressive. The heavily armed welcome at the gate left an abiding memory. It is reasonable to guess that the Russian chemical warfare facility at Shikhany is as well guarded. The notion that nasty substances of high purity could leave it without some kind of authorisation seems highly unlikely.