It’s not like a major theme, usually, but writers of near future science fiction usually have one or two major disease outbreaks as one of the plot devices, even if it isn’t a major factor in the story. It’s always fun to speculate on the future, and it’s a good bet that there will be something along the lines of the Kansas City Flu, or the Helsinki Virus, both of which have figured in someone’s novel. Or it could have been the Kansas City Virus and the Helsinki flu. It’s fun to make up catastrophic disease names, and it’s so easy—pick a location, any location, really, and put it in front of the words “flu” or “virus”, and suddenly you’ve got a plausible near-future event. Hey, look, the Seattle flu wiped out one third of humanity. Who knew? But it wasn’t nearly as deadly as the Capetown virus, which took out the other two-thirds.
All good speculative fun, in its own weird way. The problem is that life often has a tendency to imitate art. So now we have this new form of e. coli bacteria (technically, Escherichia coli O104:H4 (STEC O104:H4)) that has killed a number of people in Germany and elsewhere (17 dead, and over 1,600 ill so far, and counting). And, contrary to earlier reports, it appears that the bacteria did not come from cucumbers in Spain. In fact, no one seems to know where it does come from. The German health minister has said that the origin may never be traced. The one thing that seems clear is that it’s related to consuming fresh vegetables, but whether it’s from where and how they’re grown, harvested, stored or distributed is still anyone’s guess. But it keeps killing people, and even in the survivors causes extensive kidney damage–470 people with kidney failure at this point, and who knows where this levels off. And it’s contagious, apparently. And it has now reached the US. This looks like the worst e. coli outbreak ever, in terms of the severity of the reactions, and no one knows where it came from, or how it got to where it is now. Or what happens next, apparently. Science writer Christine Gorman, who writes about this stuff over at Scientific American’s blog, is worried. No, make that scared.
(And just today, here in Britain, and presumably purely by coincidence, a new strain of the MRSA superbug has been found in milk on farms around the country. Great.)
The response thus far has not really been a surprise, although there’s always some other levels of interest to this sort of thing—Russia has banned raw imports of vegetables from the European Union, following on an earlier ban of vegetables just from Germany and Spain. Spain, ruffled by the initial accusations from Germany about the quality of Spanish cucumbers, is now seeking compensation from Germany for lost sales of €200 million a week. In the US, where a couple of cases have been reported, the CDC is in “monitoring” mode.
All of this has a number of implications. If you’re a Public Health person, you have to be wondering how you respond to outbreaks of disease that have never appeared before? It may be that the World Health Organization over-reacted a couple of years ago when it looks as if a new strain of swine flu might take off—it looked pretty deadly at the time. As it turned out, it wasn’t, but governments around the world spent hundreds of millions on flu vaccines anyway (including one with possible dodgy side-effects), enriching as number of pharmaceutical companies further. But it’s not clear to me, anyway, just as a concerned citizen who is not involved in the decision-making on any of this, that the line between justified and unjustified caution isn’t pretty darn blurry. This isn’t clear-cut by any means, as opposed to the hysterical nonsense over the concerns about a possible (but never, ever scientifically validated) link between autism and the MMR vaccine.
Then there’s the general issue of the sprawling and increasingly-difficult-to-monitor food production and distribution network we’re saddled with, a network that, on the positive side, manages to deliver generally safe (and often even healthy) food to an extraordinary number of people on a daily bases. Offsetting this is the increasing difficulty governments and regulatory authorities have in monitoring this network, even in places where governments and regulators actually want to do a good job in this regard (like Europe, as opposed to the US, which seems to have largely given up). And incidents like this one are on the increase. While the overall number of outbreaks appears to be lower than in the 1990s, they still appear with depressing regularity. And—wildly speculating here—there seems to be no question but that these are associated with practices at factory farms. These now dominate US agriculture, and are increasingly common in Europe. Anyone who has read Eric Schlosser’s Fast Food Nation, to take a popular example among many books on the food industry these days, knows the grisly history of regulatory capture of regulators and Congress by the processed meat industry in the US. And since it now appears more likely than not that the current strain comes from cows, that’s where investigators will be looking. Does this mean that factory farms in Europe are the likely culprits here? It’s too soon to tell, clearly—how does factory farm anything relating to cattle somehow get intertwined with vegetable distribution?
So do we look forward to a future where the increased industrialization of agriculture inevitably is accompanied by increasingly virulent disease outbreaks? This seems plausible, and worrying. Up to now, at least, there’s little evidence that these outbreaks won’t keep occurring. What has worked reasonably well up to now (although not perfectly, obviously) has been the regulations under which food safety inspectors operate under. In the US, of course, these have been under pressure for years, and were rolled back significantly under the previous administration—and Obama’s attempts to strengthen them have run into bitter Republican opposition. In Europe, there has been reasonable success in harmonizing the regulations governing all of this, although the issue remains complicated by national borders and domestic agricultural issues.
Once again, there’s that vague sense of helplessness that arises in the face of the corporatization of everything. But there’s reason for optimism—here in the UK, at least, I’m in a position to actually know where my meat and vegetables come from, which is next to impossible to do in the US. And this is still the case in much of Europe, and in those parts of the globe where industrial agriculture has not yet taken root. As Wendell Berry and Wes Jackson and the folks over at Front Porch Republic keep reminding us, we need more localism than we have now, and we need to figure out how to get it back in those areas where it’s been lost. In Britain, at least, that’s still possible in a number of domains, including food, and this remains true in many parts of Europe as well. What this most recent outbreak shows as that the international intertwining of the food system is far enough advanced to provide instant global infection in the right circumstances pretty much anywhere—Germany has some of the most effective food inspection regimes out there.
It’s not the Kansas City flu yet. But unless we figure out a way to get a sensible combination of localism and globalization than we have now, the odds are not moving in our favor. There are reasonable justifications for both processes to continue, but the trend at present remains more global than local, and we need to reverse that somehow. The harder part for most people, in the US anyway, particularly in urban areas, will be to reconnect to the local. Unless we can do that, the risks of a real Kansas City flu outbreak along the lines of an even more sever e. coli outbreak will continue to hang over us. Maybe it’s just assumed that this is a price we’re willing to pay for the relative efficiencies (and environmental consequences) of the modern industrial agricultural system that generates an increasing proportion of our food. But I don’t remember being asked.