The Viral Frontier

We’ll make a lot more progress against chronic illness in this century once we decide we actually want to understand what we’re dealing with.

Good news! COVID is over and you can breathe easy without a mask or any mitigation measures because everything is back to normal now and unless you’re an important person at the World Economic Forum you don’t need to think or talk about SARS COV-2 ever again!

Not sure if all other viruses have also been banished from existence now as well wink wink but if we are still believing they exist, I’m curious, which of the following options have you been most surprised to discover can be triggered by viral infection?

1) Multiple Sclerosis

Scientists had long suspected a link between viral infection and the development of multiple sclerosis, a crippling disease that affects nearly 1 million Americans. In January 2022, researchers at Stanford Medicine were finally able to prove the connection, showing how the Epstein-Barr virus mimics a protein made in the brain and spinal cord, leading the immune system to attack the body’s own nerve cells, triggering MS. Quite the journey for an illness that at the turn of the last century was referred to as the “faker’s disease,” before the advent of MRI technology in the late 1980s made the brain lesions visible. But perhaps cold comfort for the MS sufferers who had once been confined to mental institutions.

2) Alzheimer’s disease

Using data from Finland’s FinnGen and the UK Biobank, containing biological samples from hundreds of thousands of patients, researchers identified 45 viral exposures significantly associated with increased risk of neurodegenerative disease. Their study, published in Neuron, found the largest association between viral encephalitis (brain swelling and inflammation) and Alzheimer’s disease. Some of these exposures are associated with an increased risk of neurodegeneration up to 15 years after infection.

According the Alz.org, An estimated 6.5 million Americans are affected by Alzheimer’s disease today and they estimate the number could grow to 12.7 million by 2050 “barring the development of medical breakthroughs to prevent, slow or cure Alzheimer’s disease.” Maybe a society actually interested in mitigating viral infection might help.

3) Parkinson’s disease

For decades, studies kept finding a sharp increase in Parkinson’s cases after the 1918 influenza pandemic, so neurologists had suspected a link between Parkinson’s Disease, which affects nearly one million people in the United States, and the flu. In October 2021, a study published in JAMA Neurology looking at over 60,000 people, found that those who had had the flu, since as far back as 1977, had a 70% higher risk of developing Parkinson’s 10 years later, and a 90% higher risk after 15 years.

4) Diabetes

While it’s well known that bad choices and moral failings are to blame for endocrine disorders, according to a January 2021 study in Diabetes Research and Clinical Practice, “Virus-induced activation of the immune system increases risk of development of T2D [Type 2 diabetes].” It turns out that “pro-inflammatory cytokines of an anti-viral Type-I profile promote insulin resistance” whoops. Recent research has also uncovered some of the underlying molecular mechanisms of these processes, and can offer important new avenues for future anti-diabetic therapies.

Given that Type 2 diabetes has also been shown to increase the risk and severity of viral infection, the researchers note that “there is a reciprocal, detrimental interaction between the immune and endocrine system in the context of T2D. Why these two systems would interact at all long remained unclear.”

Yes, why would parts of an integrated body ecosystem interact at all? It’s a mystery.

5) Cancer

Finally, some real good news! As Bloomberg reports, a new analysis by the American Cancer Society found that “Cervical cancer rates dropped by 65% during the period between 2012 and 2019 among women in their early 20s. Those women were the first group to be eligible for vaccination against human papillomavirus (HPV), the leading cause of cervical cancer.”

Indeed, the viral infection — cancer link is pervasive. As BU School of Public Health epidemiologist Dr Ellie Murray, lists: H. pylori can cause Stomach cancer, Hepatitis B and C can cause liver cancer, herpes virus 8 can cause Kaposi sarcoma, schistosomiasis can cause bladder cancer, onchoceriasis can cause bile duct cancer, and for fun, blindness. According to Infectious Agents and Cancer, prevalence of Epstein Barr virus in breast cancer tissue is 5 times higher than in normal and benign controls.

So much for good news.

6) Schizophrenia

“Associations between influenza infection and psychosis have been reported since the eighteenth century,” researchers from King’s College London and John’s Hopkins write in Frontiers in Psychiatry. “In the late 20th century, reports of a season-of-birth effect in schizophrenia were supported by large-scale ecological and sero-epidemiological studies suggesting that maternal influenza infection increases the risk of psychosis in offspring. Maternal immune activation models implicate placental dysfunction, disruption of cytokine networks, and subsequent microglial activation as potentially important pathogenic processes. More recent neuroimmunological advances focusing on neuronal autoimmunity following infection provide the basis for a model of infection-induced psychosis, potentially implicating autoimmunity to schizophrenia-relevant protein targets including the N-methyl-D-aspartate receptor.”

In an interesting turn of events, the 1918 flu pandemic resulted in a lot of disability among survivors and much higher rates of children who developed schizophrenia and other serious mental disorders afterwards. Not coincidentally, when the Nazis came to power 20 years later they were *obsessed* with creating a genetically superior “master race,” free of disease and mental illness. In 1939, still years before the first concentration camp crematorium, Hitler signed Aktion T4 into effect. It was a decree for German doctors to euthanize disabled and mentally ill adults and children. They were the first group the Nazis systematically went after, a “Psychiatric Genocide,” and once they succeeded there, they knew they could wipe out entire groups of people and no one would stop them.

Out of sight, out of mind, though, right? “What’s the point” of even talking about post-viral illness, anyway? Which is why, luckily for us and our need for everything to be “normal” all of the time, most of our doctors don’t! As Time reported, in 2018 fewer than 1 out of 3 medical schools in the U.S. taught students about post-infectious conditions such as ME/CFS. Arguably the quintessential post-viral illness, Myalgic Encephalomyelitis/Chronic Fatigue Syndrome is a debilitating, chronic, multisystem disease characterized by extreme exhaustion after physical or mental exertion, problems with memory and cognition, and muscle or joint pain, with onset that typically follows a viral infection. In 2019 it was estimated to affect 1 — 2.5 million Americans, but that was before some things happened. ME/CFS has no widely accepted biomarkers and no approved treatment, but it does have a disease burden double that of HIV/AIDS and more than half that of breast cancer while also being the most underfunded for research by the NIH.

What’s the likelihood your doctor understands that Multiple Sclerosis, Alzheimer’s, Parkinson’s, Diabetes, Cancer, Schizophrenia can all stem from a viral infection sometimes a decade or more in the past? Even if they did know, do you think they would tell you now, when it might make a difference, when “It’s just a cold. It’s mild. Everyone’s gonna get it; what are you gonna do?” are the dulcet tones of defeatism a public hooked on learned helplessness demands to hear?

The past 150 years of public health progress have made us feel entitled to expect to survive acute infection, and yet we are plagued with chronic illnesses afterwards FOR SOME REASON. And so, society goes about whack-a-moling “mysterious” conditions once they’ve progressed to the point of diagnosability, pin-balling from one specialist to another, each one focused on an isolated subdivision, never recognizing the full picture (why would they interact?), all the while sucking up viral infections like hungry, hungry hippos. Gobble, gobble, normal, normal. Let’s check back in 15 years and see how we did!

Many, many “it’s just a flu” viruses destroy the brain, disrupt endocrine processes, suborn the immune system to turn against the body, and sabotage plenty of other organs over extended periods of time. This kind of long-term, cold war, sleeper agent is arguably the true nature of what a virus is.

We will be able to make unprecedented progress in treating and preventing some of the most intractable diseases of our time once we as a society decide we actually want to know the truth of what we’re dealing with.

But you’d have to learn to live with some bad news first.