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New Antiviral May Cure Common Cold
Max Karpiak writes "CNN is reporting on a new antiviral which may cure the common cold as well as many other viral infections. What's especially cool is the way this drug was created: it was designed specifically to counter viruses, not just discovered in a hit-or-miss fashon. Geeks designing molecules to attack viruses? Awesome!" Neat stuff. So, what other "fantastic" science applications are on the verge of actually entering the market?
So?
How many people worldwide in a given year die from Influenza?
In 1996, 3.6 percent of all the deaths in the US were of either Influenza or Pneumonia brought on by Influenza.
That's greater than the number of deaths by AIDS, homicide and suicide put together according to the CDC.
Five deaths? What a horror!
Shanep dun said:
From what I've read, most of the possible increased colon cancer risk isn't so much from the meat itself as from ways of preparation (specifically, grillng meat till it's charred and/or frying it can form nitrosamines, which are potent carcinogens). Most of the other risks of meat-eating come largely from human bungling (there is probably some risk of cancer from the hormones moos and other animals are pumped full of, there is the risk of antibiotic-resistant bacterial infection from people pumping animals fulla antibiotics to fatten them up [one of the side effects of some antibiotics happens to be animals put weight on faster] and if one lives in the EC there is the risk of new-variant Creutzfeld-Jakob disease [which recently was proved to be caused by the same prion that causes mad cow disease] from eating beef because humans made the positively stupid decision to feed cows rendered sheep remains which just happened to have died from scrapie).
There are some cases where people live on a diet almost entirely consisting of meat and don't regularly die of cancer; the Inuit, for one, live almost entirely on meat but don't die of cancer (largely because a lot of their food is eaten raw or boiled) the way we do in the West.
As a minor aside--a lot of colon cancer in the US is actually due to genetic factors that increase the tendency. Most of the genetic errors that have been found in familial colon cancer have directly to do with cell repair farging up (one cancer syndrome points to the P53 oncogene, which when damaged increases the chances of cancer radically; there have been several others found).
Incidentially--I wouldn't count vegetarianism out entirely for risks of cancer, either. Japan and other Asian countries have a drastically higher rate of stomach cancer, which is thought to be possibly related to the fact they eat polished rice as a large part of their diet; it is also suspected by some doctors that the rise in rates of breast and prostate cancer in the US are related to herbicides used on the majority of plants (many of the herbicides used are "estrogen-mimics"; this has had especially bad effects in Florida, where the land is so polluted from agricultural runoff that feminised male alligators and Florida panthers have been found in the Everglades) and some also suspect herbicides to be responsible for the drop in sperm counts in most Western countries.
I will grant, though, that most vegetarians do tend to take care of themselves better than most other folks; probably responsible for your rapid healing. Then again, I consider that part of being smart about one's health anyways (myself, I have to be careful about checkups because of strong family histories of colon cancer and diabetes--so I don't overload on fatty stuff (which is where most nitrosamines are stored as well as cancer-causing pesticides that are still in the food chain), I try to go organic-beef when possible (so the cows aren't pumped full of chemicals--better for you AND the moo), and I eat stuff with antioxidants like broccoli (which can help out a fair amount with beating genetic problems with cell repair such as those that cause familial colon cancer).
Going to EITHER extreme (total carnivore or total herbivore) prolly isn't real healthy, though; humans are obligate omnivores (there are some vitamins we do require from animal foods, and vegans have to be VERY careful to balance B vitamins for example; we are also obligate fruit-eaters, since we can't synthesize vitamin C like other non-primate animals) and pretty much have been since the ancestors of all apes (including humans and our closest relatives chimps and bonobos) evolved from monkeys. (Chimps and bonobos both share around 98 percent of our DNA and are omnivorous; so was, likely, Australopithecus. Gorillas are really the only apes adapted for a largely herbivorous lifestyle and have a much larger gut than other apes to digest plant matter; maybe in a few million years if a society of humans walls off and goe entirely vegan we'll have gorilla-bellied Homo who can live entirely off plants. :)
Oddly, milk-drinking (and, more to the point, the ability to properly digest milk) is actually a wonderful example of evolution (since the thread is largely on concerns of rhinoviruses and picornaviruses (the targets of Pleconaril) becoming resistant to Pleconaril eventually)...
Most milk-drinking started among people who raised moos in Europe, parts of sub-Saharan Africa, and parts of Asia (specifically India). These populations generally have a high percentage of people who can digest lactose (milk-sugar) after infancy, because they've been drinking milk for so long as a population that there's been enough time and "mutation pressure" that there aren't a lot of lactose-intolerant folks left.
In cultures that generally have not raised moos for milk or have not raised moos at all (largely Native Americans, Australian Aboriginals, much of Asia, parts of Africa where they never raised moos for milk, and people who are descended from those groups) there is a much higher rate of lactose intolerance (enough that in the US, they actually sell lactose-free milk and lactase pills), and folks who don't have the ability to produce lactase after infancy tend to get all bloaty and farty and have diarrhea if they attempt to drink milk or eat non-fermented dairy products (cheese and yogurt are easier for them to eat). They never had the gene selected for, so it's not all that common. (For that matter, a lot of African-Americans and especially Native Americans also lack genes selecting for breakdown of ethyl alcohol and for rapid breakdown of sucrose--because until fairly recently those genes weren't selected for. So Native Americans have a much higher incidence of type II diabetes (sometimes shockingly so--something like ninety percent of the Pima people who are adults have type II diabetes) and problems in drinking alcohol.)
As a minor aside--most animals don't produce lactase after infancy, either. This includes--of all animals--cats, who we feed cream to on occasion. (Cream actually has less lactose in it than milk does.) You really shouldn't feed too much milk to kitties, because if one does kitty WILL get the runs and fart (and trust me, kitty farts are NOT the most pleasant thing in the world). There are kitties on occasion that CAN produce lactase and can handle milk ok (and maybe in a few thousand years most kitties will be able to handle it--it's only the last few hundred years that kitties have been seen more as pets than as gods/demons/the little furry things what eat the mousies), but one does have to be careful about it.
This is not to say I don't agree that we've not been arrogant at times (like with mad cow disease or filling animals fulla chemicals)...I think in a way it's probably been mean how we breed dairy cows, for example (they get so full they can barely walk, the poor things...and then they moo pathetically, as if saying "MILK ME BEFORE I BLOW UUUUP!" as they go from show-ring at the fair to the milking station [they usually show moos with full udders, btw--at cow shows they wanna see the "capacity" of the moo] dripping milk or even streaming sometimes...and the poor moos look SOOOO relieved when the milking starts and they get fifty pounds of milk off of a poor Holstein who looks as if ALL of her feed went straight to her udders). I'm the first to agree that we should live more in balance with our fellow creatures and the planet, and Western civilisation probably eats more meat and milk than it should.
All the same, though...we have been determined enough (or stupid enough, your call) to breed animals to the point that we aren't going to just be able to release them into the wild. With dairy cows, for instance, they now intimately depend on humans to milk them precisely because humans have bred for big-uddered moos that give fifty pounds of milk in a setting (yes, I've actually seen this with a champion Brown Swiss at the Kentucky State Fair--it STILL amazes me that the poor moo can have THAT much milk in her)...if they DON'T get milked, the milk turns infectious and they get mastitis (humans sometimes get it too and it's called "milk fever"--nasty stuff; pus gets in the milk and it turns yellow) and they can well die from it if it's not treated (because it can go into septicemia or gangrene) and at the very least it makes moos VERY ill. Yes, it's the humans' fault for making them basically milk machines, but since we have we've got the responsibility to make sure they don't get sick from it (and maybe in time to breed them to something a little more sensible--there are no wild moos anymore, the closest there are to wild moos are the half-feral pointed cows of Ireland, and I seriously doubt moos would be able to survive in the wild--it's been bred out of them).
Of course, I also think that one has a responsibility to be kind to the cow as one can (making sure it's comfy and treated kindly, and not pumped fulla chemical crap) and to use all of the cow if one must kill it...and to be thankful to the cow and remember that you ARE taking a life or getting a gift from the cow (in the case of milk). (Then again, I have weird morals on that. I think eating meat is ok if one uses all the animal one can and is thankful and one does right by the animal that gave the gift of life so you might survive. I do NOT approve of trophy hunting, and to be honest I don't like the extremes to which some dairy cows have been bred because it looks bloody uncomfortable for the moo in question--but if one is thankful to the moo, I don't see a problem with, say, milking a Jersey and using the milk.)
Now, as for harming the young...the only things I can think of are lactose intolerance and milk allergy. The first is genetically determined, and no, I don't think lactose intolerant folks should have to drink milk. As for milk allergy, that's largely caused by introducing milk too early to kids; realistically, though, ANYTHING can cause a food allergy if fed too early to a kid. (In a lot of non-Western cultures, kids are regularly breast-fed all the way to the age of two or even later, and parents MIGHT start introducing solid food at age one or when the kid starts showing interest. In Western cultures, kids are often bottle-fed and solid food introduced as early as three or four months of age...sometimes I wonder if this is the cause of increases in food allergies, as most maternal antibodies start going away at three or four months if kids aren't breast-fed and this is when kids' immune systems start really kicking in; this is why baby shots also typically start around 3-4 months).
Then again, an issue could well be made over parents bottle-feeding kids period. :) (I understand there are some cases where one has to--like if a baby has a rare metabolic disorder like PKU or maple-syrup urine disease, or if a mother CAN'T give milk [me and my sis were bottle-fed for this reason--my mother had polycystic breast disease, where there are hardly any milk glands to GIVE milk in the first place]. But if one can, breast-feeding really IS best; babies handle it much better, it gives stuff like antibodies and other substances like colostrum that babies need. A lot of the ire at pharmaceutical companies in fact involves them donating formula to third-world countries (humans tend to dry up if their babies don't regularly nurse, and this gets them "hooked" on formula; also, most water supplies in third-world countries would put one at risk of Moctezuma's Revenge at best, and it's thought that dirty water used in making formula contributes to thousands, if not millions, of babies dying from diarrhea and dehydration from the runs in third-world countries; it's also been proven that breast-feeding as traditionally practiced in these cultures (up to the age of two-three, very slow introduction of solid food) actually has a protective effect against severe infant diarrhea)...that's probably for another thread, though.
-Windigo The Feral (NYAR!)
JohnL dun said:
Well...actually...we HAVE seen some epidemics of drug-resistant microorganisms both here and in the third world. Specifically, there have been many cases of strep resistant to several of the commonly used drugs to treat it, and there have been several cases in hospitals of strep and staph that are resistant to even the last-line (not in clinical trials) drug, vancomycin...there is a new drug that was recently approved specifically to deal with this, and the FDA now has antibiotics specifically on the "fast track" to deal with antibiotic resistance.
This isn't restricted to staph and strep, btw; multidrug-resistant TB is becoming a major problem in larger cities, with some TB strains literally resistant to every approved drug to treat TB; they've had to go to the idea of setting up "sanitarium wards" in hospitals and sending public health workers directly to homes to make sure people take their TB medicine (which often runs over a year in treatment). From what I have read, it is also a fairly major problem in Russia and the third world...to the point that multidrug-resistant TB, strep and staph are considered emerging infectious diseases.
The problem isn't restricted to antibiotics, btw; antiviral resistance has been documented (there are strains of HIV that are resistant to zidovudine [AZT] and cases of multidrug-resistant HIV have been found--this is why HIV patients are typically given a cocktail of upwards of three or four different antivirals, each with different mechanisms of action...there are also some cases of acyclovir-resistant herpes infections, which is why there are so many herpes drugs), as well as antifungal (strains of Candida (yeast infections) are known that are resistant to literally every drug short of amphotericin B and drugs still in experimental trials such as nikkomycin Z; amphotericin B is literally so toxic that one must typically be hospitalised for treatment, and until nikkomycin Z is approved it is possible that Candida strains may arise that are resistant to ALL known antifungals, azoles and amphotericin B alike), and especially antimalarial drugs (chloroquine resistance is common throughout Africa, Asia and South America, many of the malaria strains (including falciparum malaria, which is really the worst kind of malaria you can get) in Southeast Asia are resistant to mefloquine, most of these are becoming resistant or are already resistant to quinine, and some strains from Thailand and Vietnam are literally resistant to every antimalarial drug not in clinical trials for safety including doxycycline). (Multidrug-resistant malaria is an especially serious problem, as malaria is still one of the largest killers (around two million a year), there is no real vaccine for it, and pretty much the only way to keep from getting malaria other than killing every mosquito on the planet [good luck!] is to take antimalarial drugs...most of which are also used to treat malaria, alas :P).
As a minor aside...some epidemics that are indirectly antibiotic-related are the epidemics of food poisoning that regularly occur in the US now. What with the rise of antibiotics in feed, often as much to fatten animals up as to be able to crowd more animals into factory-farming arrangements (which are ripe for breeding disease; animals tend not to be quite so hygenic, especially livestock), both farms and meat processign plants have been increasingly lax in enforcing standards meant to keep food from being contaminated. (This is especially bad in chickens, who are often put in buildings five and six cages high and bred for the maximum number of chickens in a room; they are often altered (beaks blunted, large amounts of antibiotics fed both for increased weight gain and to keep the chickens from dying of infections from the obviously unhygenic conditions). I think we all know of the risks of salmonella as a result [one must be EXTREMELY careful to make sure the chicken is completely done, anything using raw eggs is a no-no, and many doctors recommend to folks with HIV not to eat eggs at all because of the risk of salmonella]. For that matter, same deal with ground beef and E. coli infections.)
-Windigo The Feral (NYAR!)
Yeah, it's interesting to think of us (humanity) as an ecosystem that other creatures live in.
What makes us a bigger target (so to speak) for virus and harmful bacteria is simply our sucess at propagating. As I recall, our biomass (number of individuals times average weight) is now greater than any other vertebrate species (mammals, birds, reptiles, fish). Combine that with our habit of living in large, crowded cities, and you've got a recipe for disaster.
The only thing saving us currently (until more anti-virals and antibiotics come along) is good hygine. So wash your hands after you've gone to the bathroom, dammit!
If you're interested in the evolutionary biology view on all this, I recommend Laurie Garrett's "The Coming Plague".
As I tend to mention in just about all of my posts, I'm in Brazil. I'm just wondering whether this drug will ever get here. The thought of a horribly healthy North-American population conquering and enslaving the drug-ridden Third World comes to mind.
:)
Oh wait, that already happened. Sorry
To the editors: your English is as bad as your Perl. Please go back to grade school.
I think we'll need to be cautious about these new drugs. Why, just the other day I saw a rerun of ``Bewitched'' where Dr. Bombay came up with a cure for the common cold. The side effects when used on humans, however, were horrendous!
(Score: -1, Oh...my...god!)
With the advent of a vaccine or cure to any given case of the flu, we can completely circumvent a pandemic instance of influenza. But the side effects of wide-spread population usage of any particular high-concentration drug could have drastic long-term effects on a population that we simply cannot forsee. We might all grow wings, I honestly don't know, but I would suggest that something added to the "living equilibrium", such as a (relatively) spontaneously created medication, has the potential to unbalance many of the delicate chemical systems we need to live a healthy, darwinian fit, happy life.
We must then weigh, should a pandemic influenza arise, the benefits of a cure versus the benefits of not using a cure. But if a cure exists, and people are dying, they will desire said cure, side effects be damned. At least, I would desire said cure.
Nature tends to "find a way" to create balance (often through chaos and destruction) in the world's systems of life. As has happened with many other kinds of virii and bacteria, when we find a "cure" for one strain, another strain emerges that is resistent to our medicine, and is often stronger and more effective.
Curing the common cold is great, but I'm scared that the common cold as we know it may then become a disease that gives us much more to worry about than a few days home in bed.
Just FYI, you have in essence defined an antibiotic (though this isn't an antibiotic, it's an antiviral). Most antibiotics work by "gumming up" the bacteria's reproductive ability. Actually, ALL the ones I can think of work this way.
On a slight tangent, next time anyone wonders why we should keep our "basic science" research budget, I saw a talk on this very subject by Dr. Michael Rossman of Purdue University. In 1992. I specifically remember the "comfort index" slide, where they measured grams of snot blown out of patient's noses with and without the drug. Yum.
Which leads to my next even more off subject rant, the fact that they "designed this from scratch." The truth is, no drugs have yet to enter the market that way, even this one. Don't get me wrong, this is an extremely powerful technique, and being an x-ray crystallographer, I'm very glad the drug companies are interested in protein structure and dynamics.
That being said the way it really works is this:
- Solve the structure of the virus or protein of interest which you hypothesize is causing the disease or symptoms of the disease.
- Using the structure of the protein, try to figure out the mechanism of "how it works," and localize it to a particular area of the protein.
- Try to find "pockets" in the protein near this area where you could design a drug to bind which would then disrupt the function of the protein
- Ask your theoreticians (computer geeks with doctorates in physics or chemistry who look like the "pulsing head" aliens in the old Star Trek) to design a drug to fit in the pocket.
- If you are CNN, you have a drug, viola! If you are in the real world, here is where the real work begins.
- Through an iterative process, design the drug, find out it doesn't bind quite the way you thought it should, or with a viable affinity, and turn it back over to the chemists, who then stick every chemical group known to humankind on it to try to get it to bind tighter. You then reassay it's activity, solve the structure again, but this time bound to the new drug, and see how the changes you made affected how well it binds to the protein, and try to correlate these changes to the difference in affinity you observe.
- If you are lucky, you find one that binds with a suitable affinity and specificity (doesn't help if it binds the viral protein but also binds proteins in the body needed to reproduce).
- Years later, your drug passes clinical trials (actually, in most cases it doesn't, because your designs don't take things like toxicity into account, only how well it binds the protein of interest) and you are now the proud parent of an antiviral, or in most cases making the news lately, an HIV protease inhibitor.
Also keep in mind when I say "you," I mean a large team of scientists with an incredible array of backgrounds.
Jerm
Oh, you're not a real doctor, are you?
Jerm
Oh, you're not a real doctor, are you?
My uninformed opinion, from what I read in the article, is that this isn't an antibiotic. It doesn't kill the virus, it just gums up it's reproductive abilities. I'm no biologist, I don't know if the viruses will be able to evolve a new "groove" that this drug doesn't fit into, but if they do, it seems quite possible that the people who designed this drug could just redesign it to fit the new groove. I don't see how viruses can become permanently immune.
Of course I'm probably wrong, in which case there's no real reason to correct me. I know I'm an idiot.
"Help make the world a better place. Kill a moron."
Yes as far as i know viruses do evolve and become stronger/different etc. That is the reason we keep getting colds, it is a different cold all the time. However the way this drug works, is by blocking a general mechanism, one that the virus is going to have to do considerable evolving to get around. Not that this capacity is beyond viruses - they can do many wierd and wonderful things. So this drug may indeed help in that regard, however like all biological systems, viruses will eveltually find a way to get around it. Although there is a sense you can create a drug so devastating that evolution is not possible. Probably unlikely tho. In related news, scientists have found that a virus may well be the cause of the motor-neuron disease that Stephen Hawking and a friend of mine have! link is here exe
The promise of carefully designed drugs is that we can keep pace with evolution better. Much drug development is still done with a shotgun.
That's part of the significance of this type of drug, that it was specifically designed based on knowledge of the 3D structure of a viral protein. Resistance mutations will obviously occur, but these mutations can only go so far. If the drug is intelligently designed and binds to a part of the protein that is critical for its proper function, for example, resistance mutations will give rise to defective viruses. I read a while ago that this had been observed by people developing neuraminidase inhibitors; I'm not sure if this new drug might be one of those (I'll have to read the paper).
In terms of resistance mutations, it's also important not to confuse viruses with bacteria, which are much more complex and become resistant in different ways.
As the articles says, however, the cold is not the most exciting application. This will certainly do a lot of people a lot of good.
One thought, though... Who would pay $50-$100 to get rid of a cold three or four days sooner?!!? I can certainly understand painful meningitis, but a cold? Come on!
OTOH, it certainly is great to see the hardworking medical geeks finally getting some recognition!
--
We have fought the AC's, and they have won.
Hmm...
Norton AntiVirus (Organic Edition)
Peter Norton's guide to Home Health.
# shiver # - No thanks.
-- Give him Head? Be a Beacon?
-- Give him Head? Be a Beacon? :P)
(If you can't figure out how to E-Mail me, Don't.
The cold is just one of the many diseases this can supposedly stop. The article says "Pleconaril (prounounced plah-CONN-ah-rill) is the latest in a short list of medicines that kill viruses. This drug, in fact, blocks an entire category of them, a collection of 169 distinctly different nasties that together cause more human disease than any other."
This sounds like it could be a very big deal for developing nations, not just "the cushy part of the world". The problem is the price -- the company wants $50-100 for a single treatment. I wonder what their costs actually are, and if they'll lower prices once they've paid for development.
--
This space unintentionally left unblank.
A problem we're currently seeing with bacteria and common antibiotics and anti-bacterial products in the house is that you're enforcing natural selection rather rigorously and the bacteria that survive do so because they're naturally resistant to the drug. You end up getting antibiotic immune superbacteria. Any chance this could happen with the virii too? How many virus molecules do you get in a given cold? How prone are they to evolve a defense for this stuff? Though I suppose it doesn't matter since there's no way to cure them now anyway...
I'm trying to teach myself to set people on fire with my mind... Is it hot in here?
Don't try to outsmart yourself with Latin. The correct plural is "viruses".
Natural selection happens. It will happen with this drug. It will happen without this drug. It will happen on a train. It will happen on a plane. It is impossible (or nearly so) to stop. Unless biology changes drastically, evolution will keep going until every strain of every organism is obliterated.
Good biologists laugh, cry and bang their heads in frustration when people worry about whether resistance against some deadly substance will happen. The evolution of many organisms is hard to track because we do not notice great survival pressures bearing down on them. Provide enough pressure, and the organisms will evolve. If a drug, pesticide or herbicide is good enough, it will provide selective pressure. Evolution will happen. It happened against superpesticides that farmers thought would work forever. It happened against our miracle drugs.
The smart doctors and farmers have stopped thinking ridiculous thoughts such as, "Will evolution happen this time?" They know that, somehow, it will. Even if they drive one species to extinction, another one can take its place. They concentrate on finding methods that make their weapons as effective as possible for as long as possible.
Viruses are not living according to the biologists I know. They probably would not call them organisms. Many viruses carry DNA, just as living organisms do. Some carry RNA, and it functions similarly. All DNA and RNA molecules are subject to damage and to errors in base pairing. Mutation is going to happen. When mutation happens, evolution can and will happen.
The promise of carefully designed drugs is that we can keep pace with evolution better. Much drug development is still done with a shotgun. Researchers expose the bugs to chemicals and pick out the effective ones. We do not understand how many antimicrobials work. We just know that they do work and that they are not too toxic. By understanding disease mechanisms, more drugs can be designed and not just discovered. Even when a new bug appears, researchers will be able to discover how it works and to design chemicals that interfere.
What's especially cool is the way this drug was created: it was designed specifically to counter viruses, not just discovered in a hit-or-miss fashon.
It's not just cool. We're going to need this capability.
In some ways you can view viruses such as influenza or hantavirus as a kind of natural defense. They live for generations in natural populations of birds and rodents with little or no ill effects, and in some cases have been incorporated into the genese of the hosts. Humans probably have hundreds, if not thousands of viruses that are passed down through our stem cells. When an immunolgically naive population tries to muscle in on the terrirtory -- blamm! They're infected,like they were hit by a biological land mine. Disrupting a natural ecosystem can cause a species, for example deer, to explode, with their endemic diseases like Lyme disease to explode.
People are moving places they didn't go before (because of what we used to call "pestilence"), peturbing the natural ecology there, and moving with unprecedented speed across the globe. This means that completely novel viruses like Ebola or can be uncovered. Also, disease once endemic to limited areas such as West Nile encephelitis can be spread rapidly to new areas such as the Northeast US. It's no different from Kudzu or Zebra mussels except that it's on the microscopic scale and the ecosystem being colonized is us.
While there is at least a little doubt about global warming, what is clear is that climate is warming around inhabited parts of the planet. This increases, or at least changes the range of disease carrying organisms like certain mosquito species in places where they come into proximity with people. Mexico city is protected by its altitude from Malaria, but as the city expands and the region warms, the vertical range of Malaria bearing mosquitoes is increasing.
We don't take this very seriously, but a disease like Yellow Fever can kill thousands. At the end of the 18th century, Philidelphia almost collapsed because of a Yellow Fever epidemic. In the 1890s ten percent of the population of Jacksonville and something like half the population of the city fled. This led to the start of mosquito control programs in Florida; however it's not clear whether we've just had blind luck so far that it hasn't happened again. Historically, Yellow Fever has struck as far North as New York City.
Also, increasing population makes more aggressive "tactics" work better for these infectious agents. Remember the Volterra predator prey equation in Diff EQ? It's a microbe's banquet out there.
We either have to develop the ability to quickly tailor medicines to completely novel infectious agents, perhaps combined with vector control, OR we have to radically change our civilization to reduce population growth, restrict population movements into virgin territory (especially tropical), reduce our impact on environment, and generally reduce the level of global travel. These things might be worth doing in themselves, but speaking as someone who has at least a bit of a leaning towards environmentalism, I'm not optimistic about our ability to set the direction of our civilization out of our own volition.
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