Annus Horribilis: 2014 saw Ebola, MERS, Enterovirus D-68, CRE, VRSA … oh and some dusty vials in the attic containing a virus that killed 300 million people in the 20th century

March 18th, 2015

With masterful understatement, Queen Elizabeth the II once confessed as some past year full of calamity burned down like a candle: “[This] is not a year on which I shall look back with undiluted pleasure.”

• The Centers for Disease Control and Prevention, no doubt, will drink to that, as 2014 saw a record outbreak of Ebola virus in West Africa that is still ongoing. The outbreak triggered the largest global effort in CDC history, with 170 staff in the field and more than 700 people fighting the epidemic at any given time. The death toll in Africa is now approaching 7,000 people. The death of a patient and transmission to two nurses in Dallas set off a media frenzy and worker protests, while an asymptomatic doctor in New York was scandalized for going to a bowling alley. Things approached the theatre of the absurd with a quarantine-defying asymptomatic nurse, who returned from the incredibly brave task of fighting Ebola in Africa to find herself a “political” prisoner as the midterm elections neared and common sense was on its death bed.
• A series of stunning lapses and errors occurred in federal research labs working with deadly pathogens and potential bioterror agents like anthrax. Incredibly, live smallpox was found at the NIH, where it had apparently sat forgotten and unguarded for decades. With the vast majority of the world population susceptible to a disfiguring scourge that has been eliminated in the wild, finding unattended viable smallpox is roughly equivalent to the 2007 incident when the U.S. Air Force discovered that a B-52 bomber had been flying over the country on various missions with six inadvertently armed nuclear warheads ready to go.
• The first cases of Middle Eastern Respiratory Syndrome (MERS) coronavirus arrived in the U.S., setting off a wave of near-panic, speculation and blame, which we later realized was a day at the beach compared to Ebola. Further evidence accumulated that MERS has found a reservoir in camels, who were defiantly kissed (on the lips!) by some Saudi owners lest someone even consider a camel cull.
• Vaccine preventable diseases measles and mumps resurged, in part because of the persistent and completely unfounded fear that the MMR vaccine is somehow linked to autism. Vaccine advocate Paul Offit, MD, reminded the anti-vaccine movement that before immunizations were available as many as 20,000 babies a year were born blind, deaf or mentally disabled.
• Antibiotic resistant pathogens marked the year in several ways, as we found in an Illinois outbreak that an upper endoscopy procedure performed on some half million patients annually in the U.S. may pose risk for transmission of the emerging New Delhi variety of carbapenem-resistant Enterobacteriaceae. Researchers in Brazil reported a vancomycin-resistant Staphylococcus aureus (VRSA) strain that they warned is a legitimate threat for emergence and transmission – as opposed to the sporadic cases we have seen thus far in the U.S. Medical researchers in New Jersey showed that it was possible to combine a KPC strain now common in much of the U.S. with a highly virulent isolate from Asia, conferring the multidrug resistance of the former and the killing power of the latter into a new microorganism worthy of nightmare: Hyper-virulent KPC. Thanks, we needed that.

Here's to 2015!

Photo credit: Royal Household/John Swannell.