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Fri June 15, 2012
Virus Hunter Recalls Discovery Of Ebola And HIV
IRA FLATOW, HOST:
This is SCIENCE FRIDAY; I'm Ira Flatow. Imagine a cargo plane dropping you off in a remote corner of the African jungle. The area you've just entered is under quarantine for a mysterious plague. Nobody knows how many people it has killed, but all who have fallen sick die within eight days, first high fever, headache, hallucinations, then usually bleeding to death.
Oh, and no one knows what's causing this sickness or how it spreads, and you've been dropped into this, and it's your job to find out. This Hollywood scenario is a true story as told in my next guest's new book. The author and the protagonist of that sci-fi scenario is the virus hunter Peter Piot, who was sent to the Democratic Republic of Congo in 1976 to solve this real-life deadly mystery, and he ended up discovering the Ebola virus.
And he went on to investigate early outbreaks of HIV in Africa and spent 14 years leading UNAIDS. Peter Piot is the author of "No Time to Lose: A Life in Pursuit of Deadly Viruses." He's also director of the London School of Hygiene and Tropical Medicine. He joins us from the BBC. Welcome to SCIENCE FRIDAY, Dr. Piot.
PETER PIOT: Hello.
FLATOW: Hey there. You open the book with this scene of a flask arriving in your lab from Zaire, and inside it is blood infected with an unknown pathogen. Better you than me, I would have to say.
FLATOW: This sounds pretty scary. What - I mean, all this blood arrives, and you're there, you don't know what's in IT or what's happening?
PIOT: That's right. I mean, we were a lab in Antwerp that was certified to investigate yellow fever, and you can vaccinate yourself against yellow fever, very effective vaccine. And so we got these blood samples from a Flemish nun who had died in what was then called Zaire, now the Democratic Republic of Congo, with some mysterious diseases, particularly with yellow fever.
So we did all the routine for yellow fever, and it was indeed a blue, shiny flask, Thermos, and the vial with the blood, one of the vials, was broken. So there was ice full of blood, in addition to that. And then we...
FLATOW: And what's your feeling when you see this? Oh, this is exciting, or uh-oh, I'm in trouble?
PIOT: No, no, this is exciting in the first place because: One, we didn't know that it would be - what would come out of it. You know, it's unknown. And - but we took some precautions, of course, you know, wearing gloves and some. But if we would have known that this were Ebola or something of that category, of course we would not have handled it because we were not equipped for it.
But you do your job. And then we found a virus that was unlike any other except one type, and that was a virus called Marburg after the town in Germany where workers who are making vaccines got contaminated from monkey kidneys.
And so you do your job, and then at some point you say my God, this is new, and that's really a combination of the excitement of discovery, but also pretty scary, and you want to know more about it. And that's how it started. So it's in the one - one hand, it's anything can happen, it's, you know, coincidence, but on the other hand, you've got to be prepared to deal with that kind of situations.
FLATOW: What kind of preparation can you do? Is it a mental state, that I'm going to work on this even though it's a scary thing, but it needs to be done?
PIOT: There are two things. One, mental state, yes, but also that you really have all the skills to do it, you're well-trained, that you know how to protect yourself. And this was at a time, let's not forget it and something that my students have a hard time understanding this, there was no Internet. Even cell phones didn't exist. So communication was very, very limited.
And so all we got was a small piece of paper with diagnosis yellow fever question mark. But, you know, it's fairly straightforward how to protect yourself from viruses. I mean, we know in general how they're transmitted, and in the lab, you protect your, you know, your hands, your mouth, your eyes and so on. So that's possible.
FLATOW: So now you've gotten this broken vial in your laboratory. You've figured out what it is, and now you have to go find it. And you go, you get dropped into Africa to search for it.
PIOT: Well, first of all I should say - give credit to the Centers for Disease Control in Atlanta, who could positively say that this was a new virus because we thought it may be like this Marburg virus, but they could prove beyond doubt that it was something new, So - which was then afterwards called Ebola after a river in Zaire.
Yeah, and then, you know, then of course you want to know how is this transmitted, who is getting it, how many people are being infected and dying. And so indeed that's how I went with a group of people from - particularly from Centers for Disease Control in Atlanta and some colleagues from Zaire to the epidemic zone, which is really in the middle of nowhere, in the heart of the forest.
You know, Joseph Conrad's book, for those who have read it, "The Heart of Darkness," and that's where there was this Catholic mission. And the first thing you want to know is, you know, are there still people dying, are there still people infected and - or is this a rumor because there were so many rumors flying around, pilots who dropped us there, and they never stopped the engine.
They said get out of here, and then they left because the rumors said that hundreds of people had died, there were cadavers in the streets, even the birds flying over this area, which is called the Umbugu(ph), they came down with this virus. And so you want to know what's going on.
And frankly, the three things you try to find out is who is affected, how many people, where are they, and, you know, when did it start. And you plot all that in terms of curve, so what we call - try to define it in terms of time, place and person. And that gives you already a bit of information.
The scary thing, though, was that it sounds like nobody survived, until we found two nurses who had survived. And secondly that we had no clue how this virus was transmitted. Was it, you know, airborne, through food, water, sex, coughing, you know, shaking hands, mosquitoes, you know, the classic ways? And that took a while before we found out.
FLATOW: And so you must have thought at one point you were going to come down with this, if you had no idea how it was transmitted, and there are corpses all around you.
PIOT: Yeah, at some point. Yeah, well, first of all, I was only 27. So I was so excited. It was also my first time in Africa - or in Central Africa. And it's - the excitement of discovery is a bit like a drug, you know, and everything was new, and you also want to solve the problem because people were still dying.
So there is an enormous urgency. It's really - and I told myself, you know, we can't lose any time, no time to lose because we need to stop this epidemic. So that takes the, you know, precedence over your own angst basically, but then at some point I developed a bit of fever and a bit of diarrhea, and I said oh my God, I've got it. But fortunately, after 24 hours, it was over.
FLATOW: Talking with Peter Piot, who is author of "No Time to Lose: A Life in Pursuit of Deadly Viruses." Our number, 1-800-989-8255. You can also tweet us, @scifri, and also leave messages on our Facebook. Do you think if you had been a lot of older and wiser then you would not have undertaken this scary sort of mission?
PIOT: I think I would have still have done it, and I would love to do it again. But I, you know, I'm 63 now. But I think I would be - make sure that I had better communication and a better safety net and so on. But I would still go for it, yes.
FLATOW: Have you been called the Indiana Jones of viruses?
PIOT: No, no, and that's - I'm not a high-risk type of person, but it's just - it's also the fact that when you see a disaster like that, you know, it's our job to stop it. That's why, you know, I went into medicine and epidemiology. And if everybody just looks at it and doesn't take up the responsibility, you know, then more people will die.
But it's also - to be honest, it's a mixture of scientific curiosity and also the call to save lives.
FLATOW: You write that one of your professors actually told you at the beginning of your career, quote: There's no future in infectious diseases, they've all been solved.
PIOT: Yeah, right. Yeah, that was a prevailing opinion in the '70s. You know, we have antibiotics, we have vaccines, and so it's done. Why waste your time in a career in infectious diseases? But I'm pretty stubborn. Plus I really developed a big interest in microbes and in people. And so - and in my short life, you know, we've seen Ebola virus, many new viruses that emerged, the mad cow disease, and then, of course, there was AIDS a few years later.
And our team, again, together with colleagues from Centers for Disease Control and now also from the National Institutes of Health and then our Congolese colleagues, we could demonstrate that there was this unknown but big heterosexual epidemic of AIDS in Africa. And that was in '83 at a time when, you know, AIDS didn't even exist as a name, and it was called a gay-related immune deficiency syndrome.
FLATOW: GRIDS, I remember. Yeah.
PIOT: They're talking about - GRIDS, yeah, exactly. And I could never understand why a virus would care about the sexual orientation of its human host. It's not very romantic. But from the perspective of a virus, you know, sex between humans is just an opportunity to jump from one cell to the other, from one host to another, and so to perpetuate your own life.
And so we found this big heterosexual epidemic. It was in the very same hospitals that I had visited in '76 in Kinshasa. And then I understood that we were in deep trouble, because we had no clue in the early '80s whether AIDS would become a very big epidemic, worldwide, or would be confined to, you know, either to the gay population or will die out spontaneously. We had no clue. We didn't even know what the cause was then. The virus hasn't been isolated. So that was another excitement. But here, I immediately saw that this was very much unlike Ebola.
As you said, in Ebola, you're dead after, you know, two weeks basically after infection. One week after infection, you get ill, and then a week later, you're dead. Here in the case of AIDS, it was young people, in these days, my age, and, you know, it seems that this really protracted disease. We didn't know yet if you could be asymptomatic, be a carrier of the virus for like 10 years and be perfectly healthy, in other words, transmitted. And what was so special also then is that we found that the majority of people with HIV or, well, with AIDS then, came down with AIDS, were actually women. And that was also very, very new. In the West, we, you know, it was gay men or people who have received blood transfusion or have hemophilia.
FLATOW: Mm-hmm. And it's interesting that you had - you talked about you had blood samples, old blood samples of Ebola. And you went to look back into them and you found AIDS in those blood samples, your HIV virus in the sample?
PIOT: That's right. In '86, when we had enough kits to tests antibodies for HIV, so that you can see whether someone was infected or not, what we did is we went back to the samples that we had collected in '76 during the Ebola outbreak. So 10 years before and when nobody had ever heard of AIDS, because the first cases of AIDS were reported from the U.S. in June 1981. And so we found antibodies that was less than one percent of the population in that zone where we had found Ebola virus were already HIV positive. So that was the first indication that HIV had been around for longer than '81, also that it had been in Africa for probably quite a while.
And today, we know it's about - probably it started maybe 100 years old or a bit more recent and that HIV jumped from chimpanzees, to probably hunters or so, in Africa, and then the virus slowly, slowly spread for many years. Because what we found is that in - 10 years later, in '86, the same percentage of people were HIV positive. So in other words, the virus had not spread that fast in that very remote region, but the people who were positive in '76 had died. So...
FLATOW: Mm-hmm. Let me...
FLATOW: Let me just interrupt to say - remind everybody that this is SCIENCE FRIDAY from NPR. I'm Ira Flatow with Peter Piot, author of "No Time to Lose: A Life in Pursuit of Deadly Viruses."
Fascinating story about AIDS. So you're saying that AIDS was - has been around much longer than we thought it was.
PIOT: Yes, absolutely. And it took a while to figure that out - one, because we had no test. You know, the antibody test only came on the market in '85 and then the priority was to make sure that no blood would be transfused that is HIV positive, as a priority.
And then when it became more widely available, we could test old samples, like the ones that we had collected in '76 in Zaire during the Ebola outbreaks. And then there were an old sample of the '59 from Leopoldville, which was then the name of the capital of Congo. And then through analysis of the genome of the, you know, the genetic makeup of the virus, we could see that in Africa, particularly Central Africa, that these viruses were far more diverse genetically than what we find in the U.S., for example.
And then, through a combination of genetics and mathematics, one can find out when the, let's say, the mother virus must have emerged. And that's probably the beginning of the 20th century. And in the meantime, also, my team found that in - from chimpanzees in Gabon, and then from the zoo in Antwerp, the town that I was working, that some chimpanzees carry a virus that is very, very similar to the one that we find in people. And so - and then putting all that together told us the story, basically, that for probably a long time HIV or an HIV - ancestor of HIV was infecting chimpanzees with not necessarily a lot of problems. And then at some point, it jumped over to, yeah, to some hunter, probably.
FLATOW: Wow. 1-800-989-8255 is our number. We're talking with Peter Piot who is author of "No Time to Lose: A Life in Pursuit of Deadly Viruses." He's director of London School of Hygiene and Tropical Medicine. You can also tweet us, @scifri, and also send us a message on our website at sciencefriday.com. Join the conversation there. We'll take more of your calls. We haven't - Peter has been so mesmerizing. We haven't had any phone calls, but I'm happy to talk more with him, and we will. We'll see if we can get you in on the conversation. 1-800-989-8255. Stay with us. We'll be right back after this break. I'm Ira Flatow. This is SCIENCE FRIDAY from NPR.
(SOUNDBITE OF MUSIC)
FLATOW: This is SCIENCE FRIDAY. I am Ira Flatow.
(SOUNDBITE OF SONG, "ATTENTION NA SIDA")
FRANCO LUAMBO: (Singing in foreign language)
FLATOW: That was Congolese musician Franco Luambo with his 1987 track, "Attention Na SIDA." SIDA means AIDS in French. My guest is Peter Piot, author of "No Time to Lose: A Life in Pursuit of Deadly Viruses." Peter, you talk about that song in your book and how music was key to raising awareness about AIDS and HIV.
PIOT: Yeah, well, first of all, I love Congolese music, and Franco has been one of the greatest musicians. And by the way, he died from AIDS himself. But, you know, when you - what do you with AIDS, what you do against it, particularly before there was any treatment, it was education, making people aware and you need to - you can go with a billboard saying, AIDS kills. You know, that doesn't work very well. So you need to really use the media that people like. Is it music? It's in the churches. It's theater. Radio can be very important, and that's what Franco did. And in his song, he said, you know, be faithful, use a condom, and it was very straightforward. But people were dancing it at the same time.
FLATOW: You write in your book about meeting Thabo Mbeki, Nelson Mandela's successor as president of South Africa and how he did not believe. I remember he used to say, I don't believe there is a connection between HIV and AIDS. What was it like working with these world leaders who were AIDS deniers at those times?
PIOT: Yeah, after, you know, I'm a scientist by background, and still am one. And so in the beginning, I thought, OK, we've got the facts. We've got the epidemiology, and, you know, there's this disaster, so that's enough. And when people see that and politicians, the ones who hold the person, they will act. But that was very naive. And we only made serious progress when the powerful of this world were taking on AIDS. And, you know, and that's changed around the millennium, 2000. 2001 was really a tipping point when, at the United Nations, over 40 heads of state, heads of government came together and said, we've got to do something about AIDS, and particularly African president who, you know, broke the silence.
And then in 2003, PEPFAR, the President's Emergency Plan for AIDS Relief, was created by President Bush, and here we went but there were also others. And particularly in the '80s, many denied that there was AIDS in their country. And one of the worst was Thabo Mbeki because here we've got South Africa, one of the worst affected countries in the world in terms of AIDS. Out of a population of 45 million, there were then four to five million people infected. And he said, no, this is not AIDS. This is poverty. He didn't believe that HIV was causing it.
And, you know, and he was really slowing down access to lifesaving treatment, which had come on the market in '96 and which was saving - literally, saving the lives of people with HIV in Western countries. The price was too high in these days. That's true. But when the price came down of these drugs, even then Thabo Mbeki didn't believe it, so that was very tough. And another example is in Russia. Russia were - which has the - still growing AIDS epidemic. It's driven by injecting drug use and the government is still not ready to go for so-called harm reduction in drug uses. In other words, providing them with clean needles and so on and methadone, so that they don't inject drugs and spread HIV.
That was tough part of my job, but it was also - I saw many things. It's thanks to the unique combination of the right politics and the science, the scientific discovery and programs on the ground. When you have that, when these stars are aligned, you can move mountains. And I think that's what we're seeing now, huge achievements and millions of lives saved.
FLATOW: You also spent an evening chatting with Fidel Castro at his presidential palace and, if I read it correctly, might have changed his mind a little bit.
PIOT: Yeah, originally, Cuba would, you know, lock up people with HIV. Cuba had lots of troops in Africa in these days and some returned with HIV. And they were all tested, and when they were HIV positive, they were basically put in a so-called sanitarium, which was kind of a prison and (unintelligible) with the - although they were getting good food and song. And - but in the meantime, HIV was present in the community in Cuba. And so, yeah, I told Fidel, you don't talk about human rights with Fidel Castro. You know, it's - said it's too expensive. It doesn't work. And also, what happened afterwards is that the sanatoria were opened, and people with HIV were trained to become educators talking about prevention, going to schools and some so turning it around in a positive way.
FLATOW: Mm-hmm. Moving back to Ebola, this week, a study came out in which researchers cured monkeys of Ebola.
FLATOW: You know about that, using a cocktail of antibodies. Do you think that a human vaccine might be on the horizon?
PIOT: Well, the - this is - investigators in Winnipeg in Canada who found that by giving very specific combination, a cocktail of very specific antibodies, could cure monkeys. Now, there's still a long way to go, whether this can be used in people. Also, I think because in most people, the disease develops in a very (unintelligible) way. And so you have basically a collapse of your blood coagulation system, so that's why you start bleeding all over. But it's a breakthrough, and it's a very important development. So - and so often, there will be then a lot of incremental steps that have to be taken before it can be, you know, be applied in people.
FLATOW: Did you see the movie "Contagion"?
PIOT: Yes, I did. Yes.
FLATOW: What did you think about its accuracy and the message it had there?
PIOT: Oh, I think it's great that, first of all, that such a movie was made. And it's, you know, it was scientifically certainly very accurate. They had very good also scientific consultants from Columbia University and CDC. And these things could happen. But, of course, it's - to make it a movie, it's - it shows the more spectacular side of the world because when you investigate an epidemic, an outbreak like Ebola or AIDS, a lot of the time, it's not very sexy and that. But, no, and I think it's great.
FLATOW: Yeah. It shows what a lot of hard work, and actually scientists are heroes in that film where as opposed to being villains.
FLATOW: Are there other viruses that we don't know of, terrible viruses lurking out there?
PIOT: Well, definitely. I mean, basically, all the time, new viruses are being discovered, particularly in animals. We've got also the flu. You know, it's absolutely certain that one day we'll have a big flu epidemic in the world. And we also have old viruses which are still there. Polio virus, which was such a terrible, you know, plague in the U.S. in the '50s and then with - thanks to the vaccine was wiped out, is still there in countries like Pakistan and Afghanistan or parts of Nigeria. So there are the old problems. They haven't gone away yet, although we should do everything we can to eliminate polio. But then, you know, there will be - new viruses will emerge all the time. It's viruses coming from animals and in contact with human beings.
And in the case of Ebola, these are fairly self-contained, relatively small epidemics, killing a few hundred people, particularly if people are hospitalized and not, you know, in not very hygienic circumstances. And then, you know, there will be also through our food chain, I think, food supply, which is being globalized and with massive production of food, that we could also see some big outbreaks as we have seen in Europe recently. And, you know, in the old days when your chicken got the salmonella infection in your backyard, that would infect a few other chickens who will die, and maybe the family came down and some but that's it.
But today, you've got chicken farm, so there are a million chickens and who are shipped all over the country or all over the world. And so making sure that our food supply is absolutely safe is one of the big challenges of this globalizing, you know, food production. And we saw it also with mad cow disease in Europe where cattle was fed with other cattle and then in that sense, you know, became infected and infected a few people.
FLATOW: In our last moments here, what's on the horizon for you? What are you going to be up to now?
PIOT: Well I am to return to academia. I'm now the director of the London School of Hygiene and Tropical Medicine which is a fantastic place. It's the premier, you know, school in the world for public health and to train the new generation of leaders so that they will be prepared for new epidemics of infectious diseases but also the largest epidemic at the moment is a truth tsunami of chronic diseases - diabetes, obesity. I mean, the U.S. is affected by it, but also we're seeing now it's taken over Asia, Latin America, the Caribbean, the Middle East. And we've got to work on that as well. So it's not only new viruses but it's also, you know, through lifestyle, through unhealthy food, lack of, you know, movement and smoking that we - that's killing now more people than anything else in the world.
FLATOW: Well, good luck to you, Peter. And thank you for taking time to be with us today. And it's a fantastic book. Congratulations to you.
PIOT: Thank you, Ira. Thank you.
FLATOW: Peter Piot is the author of "No Time to Lose: A Life in Pursuit of Deadly Viruses," and he's also director of the London School of Hygiene and Tropical Medicine and former executive director of U.N. AIDS. And as I say, it's a great book. It's well within your time to have a read. Transcript provided by NPR, Copyright National Public Radio.