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Health

I Asked an Expert Which Gross Diseases I Should Panic About

"One of the scariest threats to me is pandemic flu."

Aid workers preparing to enter Ebola treatment unit. Image via CDC​ Global

This article first appeared on VICE UK

​Fear of infection from some form of new super disease or virus seems to come around every couple of years like clockwork. 2002: SARS. 2009: swine flu. 2012: dip-dyed hair. 2014 brought Ebola, and suddenly a whole load of people were googling maps of the world to work out how far Liberia was from their local supermarket.

Of course, when people in the West think their region might be safe from threat, everyone moves on and continues digging their nicotine and fast-food graves. But the tabloid scare around the virus has raised an issue: If it isn't Ebola, what virus is going to kill us?

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We screamed our fears at Benjamin Krishna, a ​Wellcome Trust PhD student currently working on human cytomegalovirus at the Department of Medicine at Cambridge University, and he calmly and sensibly explained the different kinds of viruses that pose a potential threat to mankind.

VICE: Let's cut to the chase: What's going to kill me in the near future?
Benjamin Krishna: There's a lot of viruses that could kill you, but it's never guaranteed. Even the most deadly viruses out there—rabies, untreated HIV, and Ebola—thankfully have their survivors.

Is there any situation in which something considered fairly harmless, like the flu or repeated bouts of gonorrhea, could be deadly?
A lot of viruses become incredibly aggressive for people who have weakened immune systems. Not so much someone on vitamin supplements but HIV patients, transplant patients, and cancer patients, for example, can become susceptible to common viruses that you might not notice. Flu and the ​herpesviridae—a family of viruses related to herpes—are a big threat to these people.

Various viruses from the Herpesviridae family. Photo via Wiki Commons

Let's talk about herpes. Are you saying anyone who's woken up in a strange bed after they've been to a Vodka Revs is a walking time bomb?
Herpes viruses are very common. The family of diseases include oral and genital herpes, glandular fever, and chicken pox. You could get a herpesvirus at the playgroup. Herpes simplex, the viruses that cause oral and genital herpes, are more likely to spread by sexual contact, yes.

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A lot of people have herpes but no symptoms. The incredible thing is, because herpes has evolved with humans and adapted to living in us, its genetic material has a whole toolkit of genes that interact with our immune systems and keep symptoms to a minimum. Unlike the flu, you can be infected and not notice.

So if it's relatively well adapted to humans, why is it so potentially dangerous?
One reason is because they cause such damage to the immunologically weak. Pregnant mothers who become infected with herpesviruses have a risk of passing it on to their fetus, which can mess with development. Cytomegalovirus, which almost nobody has heard of, is the biggest cause of congenital birth defects in the west. Bigger than fetal alcohol syndrome.

About half of people are infected with herpes simplex. But this is why it's a high-priority vaccine—it might be completely asymptomatic, but if you lose your immune system, it's almost certainly a big concern. Additionally, there are rarer issues caused by these viruses, increased risks of cancers, or encephalitis—infections of the brain. About two in a million times, the virus spreads to the brain. About 70 percent die, over 90 percent suffer brain damage.

In the UK, somewhere between 60 to 90 percent of people are infected and, like all herpesviruses, the infection is for life. In less developed countries the prevalence is over 99 percent. It appears to correlate with social background.

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Can you explain the correlation between behavior and infection?
This isn't official data, but we have some trouble finding infected people in Cambridge. Given that it is spread by saliva, it suggests we don't get around much.

So you're saying that if I have a low immune system getting off with Cambridge kids isn't a bad idea?
If you'd just had a transplant, were on immunosuppressives, and just had to get off with someone… it's probably a good bet.

Middle East respiratory syndrome 3-D image. Photo via ​Wiki Commons

Are there any viruses on the horizon we should look out for?
This might sound arrogant, but it doesn't look like anything can get under our radar. We had researchers working on everything from elephant herpes right over to MERS.

MERS—which stands for ​Middle East Respiratory Syndrome—is a respiratory disease, in the same family as SARS and the common cold, which has killed about a third of people it has infected in the Middle East since it was first reported in 2012. We're not entirely sure where it has come, from but I think the current opinion is that it has jumped from camels.

So don't rub yourself on a camel?
I'd suggest that even if they were virus-free. Oddly, camels get camel pox, a version of human small pox. It's a problem in the Middle East, where camels are essentially livestock. Research in Iraq into camel pox was included in the "sexed up" dossier justifying the war in Iraq. I feel sorry for those poor Iraqi vets, whose interest in camel pox was ​linked to biological weapons of mass destruction.

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What other viruses and diseases are a concern?
There's a whole load of mosquito-based diseases which are spreading into Europe due to the warmer temperatures. The mosquitos carry malaria and Dengue fever, which can cause hemorrhagic fever like Ebola.

One of the scariest threats to me is pandemic flu. Unlike Ebola, flu spreads very well at least partly because it is airborne. In 2012 researchers published data in Science magazine showing how many mutations it would take to make H5N1—bird flu—airborne and it was ​just five. Officially, H5N1 kills about 60 percent of those infected, even a fraction of that would be devastating for humanity.

What Ebola looks like up close. Photo via Flickr user NIAID

I thought we'd dealt with bird flu.
​There have been more cases recently  and I think H5N1 vaccines have been developed, but the virus is still only in birds. Influenza is an Influenza is an RNA virus, and the way retroviruses replicate is very mutagenic—so they mutate and evolve rapidly. As each new influenza strain needs a new vaccine, the risk of a rapidly spreading flu—even one with a mediocre mortality rate—is possible and scary.

So even if we do develop a flu vaccine, the virus will have most likely developed past treatment?
A new flu strain would need a new vaccine, which would take time to produce. If the influenza outpaces the scientists then it could cause a lot of deaths before being contained. I think the movie Contagion showed that scenario very well, although I think Contagion features something more like a henipavirus rather than flu.

Will Gwyneth Paltrow die?
I hope not, she's had a rough time recently as it is.

What's the worst virus you've heard of existing today?
Probably the ​Marburg virus. It's similar to Ebola and also causes hemorrhagic fever— burning up, bleeding. The biggest outbreaks saw greater than 80 percent mortality. To make it that bit more terrifying, it's possible that the Soviet Union made a ​good attempt at weaponizing it.

If not that, then rabies. Almost everyone catches it from an animal bite. That's unpleasant. Survival is very low without treatment. The virus travels from your peripheral nervous system up through the spine and into the brain. Symptoms at this point are delusions, terror, fear of water—to me it seems closest to the modern depictions of zombies.

Any other scary facts before I go out this weekend?
If you fancy being further grossed out, Google ​necrotizing fasciitis, ​leishmaniasis, and ​leprosy.