Nov. 25 2019

Advances in Pathogen Discovery Are Saving Children’s Lives

In a recent presentation, Ian Lipkin, Columbia Mailman professor and famed “virus hunter,” said recent advances in microbiology had made possible the identification of pathogens responsible for two separate disease outbreaks afflicting children on either side of the globe. 

Lipkin, who spoke at the at the India Today Conclave 2019, detailed the latest success stories and reflected on ways to tackle the spread of another viral phenomenon—vaccine fears, racist hate, and other misinformation that propagates online. Organized by the country’s top news magazine, the two-day conference in Mumbai featured presentations from leading scientists, government ministers, activists, journalists, and other influencers. (Watch Prof. Lipkins presentation here.)

Two years ago, the director of the Indian Council of Medical Research invited Lipkin, director of the Center for Infection and Immunity (CII), to investigate a surge in cases of a mysterious illness killing children in the northeast of the country. Since 1978, as many as 25,000 Indian children have died from periodic outbreaks of encephalitis. In 2016, the disease claimed the lives of 125 children in a single hospital in the city of Gorakhpur.

The pathogen responsible for the outbreaks was widely thought to be a virus—Japanese encephalitis or dengue—but the CII study, which focused on Gorakhpur, uncovered evidence that children were in fact infected by two specific bacteria. This was good news because “each of these targets can be treated with tetracycline [antibiotics], which are very inexpensive drugs,” Lipkin explained. This year, India has seen far fewer cases of encephalitis.

The technology used in the Gorakhpur study was developed by CII researchers to quickly and affordably identify pathogens with a high degree of confidence. While most pathogen discovery relies on genetic material, a new suite of CII tests target the molecular and antibody “footprints” left by infections after the pathogen has cleared the body. The tests are designed to screen for any known human virus or bacterium, as well as whether the bacterium is resistant to antibiotics.

Recently, Lipkin and his colleagues at CII used the new technologies to identify the pathogen behind another outbreak affecting children—acute flaccid myelitis (AFM), a polio-like disease responsible for partially paralyzing nearly 600 children in the United States since 2014. Physicians and scientists have long suspected that enteroviruses, the family of viruses responsible for polio, were behind AFM, but the evidence was scant. The CII study implicated a specific enterovirus called EV-D68. Based on this insight, the National Institutes of Health is proceeding with follow-up studies that could lead to a drug therapy or vaccine.

Since the 1980s, Lipkin has developed techniques that have helped identify more than 1,500 viruses and other infectious agents. He has been on the front-lines of numerous outbreaks—notably, in 2003, he worked with the Chinese government to stem the spread of SARS, and more recently with Saudi Arabia on MERS. He told the conference audience that India would benefit from investing in the latest generation of pathogen discovery technology. “If you have the ability to rapidly diagnose infectious agents in an outbreak then we can prioritize treatment and find ways to prevent disease,” Lipkin said.

Malicious Memes

Done correctly, science advances knowledge; done poorly, it spreads inaccuracies and mistruths. Case in point, Andrew Wakefield’s 1998 faulty research purporting to link the measles, mumps, and rubella vaccine to autism. Yet even after Wakefield’s study was retracted and conclusively disproven in a study by CII researchers, the falsehood lives on. As a result, vaccination rates have declined, leading to a spate of unnecessary measles outbreaks.

Whether it’s the anti-vax movement, climate change denialism, or racist hatred, mistruths spread in viral fashion on the Internet—not least of all, on platforms like YouTube heavily trafficked by young people. Because affected populations are unlikely to read scientific studies or even the lay scientific press, Lipkin told the India Today Conclave audience that it’s important to “inoculate” susceptible groups against falsehoods using popular media. Lipkin has some experience in this area: he was a scientific advisor on the critically-acclaimed film Contagion, as well as for the videogames Plaguing and Three Months; currently, he is consulting for the next James Bond film.

“Virology provides lessons for the digital era,” Lipkin said. “If we’re going to survive as a human race, we are going to have to address infectious diseases, both as we traditionally think of them, but also as viruses that are infecting our social life.”