Striking a Familiar Zoonotic Pathogen Chord

International arrivals at Suvarnabhumi International Airport in Bangkok face extra screenings following the outbreak in India. (Suvarnabhumi Airport Office /Handout via Reuters)

"Nipah virus (NiV) is a member of the Henipavirus genus of the Paramyxoviridae family and is a zoonotic virus with a high case fatality rate. Our knowledge of the geographic distribution of NiV and the disease it causes, mode of pathogen transmission, and clinical manifestations of infection, have evolved over time."

"The first recognized human infection was in the Malaysian village of Kampung Sungai Nipah in 1998, initiating a deadly outbreak that lasted through 1999. Smaller sporadic outbreaks have since recurred nearly annually within South Asia with case fatality rates reaching greater than 90%."

National Library of Medicine...National Center for Biotechnology Information 

Black flying fox bats ... World Health Organization

 

Nipah virus infection in humans causes a range of clinical presentations, from asymptomatic infection (subclinical) to acute respiratory infection and fatal encephalitis.

The case fatality rate is estimated at 40% to 75%. This rate can vary by outbreak depending on local capabilities for epidemiological surveillance and clinical management.

Nipah virus can be transmitted to humans from animals (such as bats or pigs), or contaminated foods and can also be transmitted directly from human-to-human.

Fruit bats of the Pteropodidae family are the natural host of Nipah virus.

There is no treatment or vaccine available for either people or animals. The primary treatment for humans is supportive care.

The 2018 annual review of the WHO R&D Blueprint list of priority diseases indicates that there is an urgent need for accelerated research and development for the Nipah virus. WHO 

Confirmation of an outbreak of Nipah virus in West Bengal, India, led to southwest Asia airports placed on alert. Checkpoints for passengers from West Bengal were implemented by Thailand on Sunday, while Taiwan's Centers for Disease Control announced that it planned to list the disease as a Category 5 threat. The Indian Ministry of Health confirmed two cases of the zoonotic infection, with 200 close contacts being monitored and tested. 

 

Nipah has a fatality rate of 40 to 70 percent, according to the Centers for Disease control and Prevention. No vaccine has yet been produced against the virus and there is no cure for Nipah virus. Outbreaks of Nipah occur annually in South Asia, while more broadly global awareness of the virus remains low. Transmitted to people from animals, the virus can be contracted from direct contact with infected animals, primarily flying fox bats and pigs.

Nipah virus has a fatality rate in humans of up to 75 per cent. (Reuters: CK Thanseer)

 

Fruit contaminated by these animals can be a source of infection for the unsuspecting. Raw date palm juice produced with sap contaminated by fruit  bats has been linked to outbreaks in Bangladesh. The virus, once it makes the leap from a contaminated animal's tissues or secretions, can readily spread person-to-person through close physical contact.

Scientists in Bangladesh have previously caught bats to test them for the virus. (Reuters: Mohammad Ponir Hossain, file)

 

A major outbreak among pig farmers in 1999 Malaysia killed over a hundred people, and this was the world's introduction to the presence of the virus,  highly contagious among pigs. Nipah outbreaks occur almost annually in Asia, most frequently in Bangladesh and India. A 'predictable season pattern' has emerged as routine outbreaks in Bangladesh between December and April, a research paper published in the Journal of Infection and Public Health established.

 

That research linked the pattern to peak harvesting season for raw date palm sap, a cultural delicacy and tradition, where fruit bats frequently live among date trees. The Philippines, Singapore and Malaysia have also been host to outbreaks. "This represents a return of Nipah to this area after a long gap, which is concerning from a surveillance standpoint", pointed out Lauren Sauer, director, Special Pathogen Research Network at University of Nebraska Medical Center.

 

Within days of infection symptoms including fever, headache, cough, muscle pain and difficulty breathing emerge. Patients may experience neurological symptoms such as  brain swelling as the infection progresses. Patients who survive brain swelling (encephalitis or brain inflammation) can recover but still face a future life of consequences including seizure disorders.

 

No licensed treatments exist for Nipah, nor are there any available vaccines.  

 

In 2018 the World Health Organization  marked Nipah as a priority pathogen urgently requiring accelerated research and development particular to the virus. 

  

Deciphering A Mystery

"We [in professional vocabulary] call it an accident because that's our terminology [as air accident investigators]. But this is a criminal act. It's not an accident."
"If someone does this intentionally, you can call that suicide. The pilot took his own life and he took the lives of everyone who was on board that aircraft."
"People accuse me of being insensitive to families. I don't mind taking the question, but if someone challenges me, I say, 'I don't need any lessons from you. How many grieving families have you talked to after an airplane accident? I've done it by the hundreds. Don't tell me that I don't have any sympathy. I've had people faint in my arms."
"What they're [searchers for the wreckage of MH370] proving every day they search is that their assumptions were wrong."
"[The Malaysian Airline pilot’s] intention was to make the plane disappear forever, and make it so that no one would ever find it."
Larry Vance, retired Ottawa air accident investigator

"When you start looking at them [identifiable parts of MH370], there's a story in every one of them. And the story is consistent."
"When the airplane is coming in [vertically] at 300 to 600 feet per second, everything is shattering into a million pieces. In a third of a second to half a second, it's gone."
"There's no way you could end up with a piece like this with the leading edge absolutely intact."
"Wreckage analysis is a dying art. They're depending on the recorders [recovered black box]. They tell you what happened -- maybe. But they don't tell you the sequence or why things are happening. You need to be able to do wreckage analysis."
Terry Heaslip, retired Transportation Safety Board investigator

A flaperon from MH370 recovered from the Indian Ocean, showing the intact rounded leading edge that air crash expert Terry Heaslip says proves the plane was ditched at sea and didn’t crash at high speed. AFP/Getty Images

Three investigators with the Transportation Safety Board, a federal Canadian investigative authority, retired to launch their own consulting company into accident disasters, calling it HVS Aviation. Larry Vance, Terry Heaslip and Elaine Summers, all retired, thought their own independent investigation into the mystery of Malaysia Airlines Flight 370 might represent a good joint exercise, whose conclusion might have a twofold purpose; their effort leading to success would give comfort to the grieving families in solving the mystery, and the results would give closure to a puzzle.

Vast sums of funding went into international searches, at first desperate in nature, in hopes of being able to rescue survivors lost at sea awaiting help, or marooned on a remote island somewhere. When the critical  time frame for rescue had passed, it became an international search without anyone knowing precisely where to search in a confused and confusing scenario that placed hope on various areas of vast oceanic searches. Airplane parts were found and  discovered not to be those being looked for, though eventually some pieces did surface and were identified as having come from Flight 370.

That the Boeing 777 had simply vanished with all 239 passengers and crew aboard on March 8, 2014 was a shocking catastrophe. Explanation eluded, and searches were futile. In all of aviation accident history this single flight disaster likely epitomizes the most puzzling. In a later flight of a German airliner in the remote French Alps a brief mystery also puzzled investigators when in March of 2015 Flight 9525 crashed into mountains with the loss of 144 passengers and six crew. Its young co-pilot had carefully planned his own suicide and sacrificed the lives of all aboard to his plan. That conspiracy, however, was solved with the aid of recordings and a successful investigation.


The mystery surrounding the Malaysia Airlines flight is more enduring, however, and it isn't that long ago that the last of a succession of searches was called off with a sense of hopelessness. There were 20 confirmed and identified MHY370 pieces retrieved since the plane and its human cargo vanished. It was some of those pieces that have helped this investigative team who took on this investigation of their own initiative, to solve the seemingly unsolvable. They examined all available data and came to their conclusion.

Mr. Heaslip, an expert on wreckage analysis, who with the Transportation Safety Board was its director of engineering and his partners were convinced the crash resulted from a deliberate action on the part of one of the pilots. Whom they theorize in all probability killed his passengers through depressurizing the plane. And then he deliberately flew toward a remote stretch of the Indian Ocean and ditched the plane to end his life, taking so many others with him, becoming a mass murderer in one fell stroke.

Their theory bears no resemblance to the official story which holds that the plane flew in a straight line until running out of fuel when it plunged vertically into the sea. Quite dissatisfied with the official theory, the Ottawa-based investigators examined wreckage photographs, the flight path maps and schematic drawings of the aircraft. Their investigation transcended a cold analysis of engineering calculations and cockpit procedure, however; their concern also lay with the need of the families to know the truth of what had occurred.

"This is an attempt by us to give some amount of closure by telling them [families of the victims] what happened. Because if people in the end -- I don't care who they are -- if they know the truth it's better in the long run than if they never know what happened."
Larry Vance

And so they zeroed in on pieces that had washed ashore and identified as having belonged to flight MH370; the aircraft's right flap, a part of the wing extended when the plane slows before landing, and the adjacent "flaperon", used to control the plane in low and slow flight. Along with the eight-by twelve foot piece also examined which they knew could not possibly have survived a high-speed vertical impact. Both it and the rounded leading edge of the flap and flaperon were undamaged.

Relying on tried-and-true wreckage analysis; studying stresses and fractures visible on the recovered pieces Heaslip and Vance deduced the forces that tore apart the plane; an exercise that no electronic data of a black box recorder could reveal. Earlier parts of the flight, including the pilot turning off the plane's transponder to make it invisible to radar before reversing direction and flying along the boundary point of two different air traffic control regions to ensure the plane would be missed by controllers, all contributed to their analysis and final conclusion.

The team documented their careful study of all available evidence and their professional analytical methodology, to reach their final, informed conclusion, and it all appears in a book titled MHY370 Mystery Solved which can be ordered online at hvsaviation.com.

MHY370 and ADS-B

00:41, 8 March: Malaysia Airlines Flight MH370 departed from Kuala Lumpur International Airport on Saturday, 8 March (16:41 GMT, 7 March), and was due to arrive in Beijing at 06:30 (22:30 GMT).
Malaysia Airlines says the plane lost contact less than an hour after takeoff. No distress signal or message was sent.
01:07: The plane sent its last ACARS transmission - a service that allows computers aboard the plane to "talk" to computers on the ground. Some time afterwards, it was silenced and the expected 01:37 transmission was not sent.
01:19: The last communication between the plane and Malaysian air traffic control took place about 12 minutes later.

 

The raw horror of the ordinary transformed into a ghoulish tragedy of disappearance, though the 239 souls who mysteriously departed an airport in Malaysia en route to another airport, expecting to arrive at their China destination in a routine flight, lingers still. The anguish of the bereaved families has not diminished, the mystery of the flight's disappearance remains unresolved. It is as though the reality within which we live simply slipped into a time warp, engulfing the plane, its 227 passengers and dozen crew members, allowing time itself to forget all about them.

Seven months later, Malaysia Airlines flight MH370's whereabouts remain undiscovered, the Boeing 777 slipped the sullen bonds of Earth to land in some otherworld unknown to civilization, and where their families hope they may find comfort and security and live on, however impossible it is to visualize. From there, they can continue to visit their loved ones in dreams where they appear as they had before their disappearance, whole, happy and completely natural.

Where they really are, or whatever remains of the airliner and its occupants, is not yet known, and may never be revealed, reflecting the failure up to now, despite the frantic collaboration of many countries lending their most advanced technologies, aircraft and ships to ply the oceans, near and distant, where it was assumed the flight might have ended. If it happened once, it will happen again; it has happened before, and promises repeat performances, but perhaps from this time forward the mystery will be missing.

The southern Indian Ocean pictured at 500 feet above sea level. Photograph: Jason Reed/Reuters

Ottawa-based NavCanada has announced a global emergency tracking system capable of ensuring that the horror that visited the Malaysian Airlines flight will never again result in complete absence of recovery. The tracking system is a service to be offered free to authorized rescue agencies worldwide, to be initiated in 2018. The potential for saving lives is enormous, let alone the agony, time and cost involved in search, rescue and recovery.

NavCanada, a not-for-profit private Ottawa company which manages Canada's commercial airspace has signed up to a joint venture with U.S. Iridium Communications Inc; the venture's purpose: to improve immeasurably the capability of tracking airlines in remote airspace. "The existing gaps in surveillance, particularly in cases of lost aircraft became abundantly clear this past year. The tragic disappearance of MH370 prompted a worldwide urgency to look for solutions. Aireon's response amounts to a global public service offering Aireon ALERT universally and on a no-fee basis", explained John Crichton, president and CEO of NavCanada.

Over 75% of Earth's surface remains invisible to air traffic controllers. The tragedy of MH370, and the 2009 Air France flight 447 crash before it have emphasized the need for a no-fee, global emergency tracking service. Radar coverage fades as flights turn out over oceans and mountain ranges. The use of high-frequency radio for communication -- procedural control, becomes the contact medium for pilots and controllers.

But this mode of contact doesn't permit real-time position tracking, not until the flight reaches airspace where radar-contact can be resumed, closer to land and to radar-tracking stations. An alternative is seen in the use of Automatic Dependent Surveillance-Broadcast (ADS-B) technology where planes equipped with it are capable of determining their positions and can broadcast the data to air traffic ground control stations periodically. But it too has limitations, because it is ground-based.

Enter ADS-B sensors, to be placed aboard low-Earth orbit Iridium satellites, some 66 in total, to enable global, real-time airliner tracking, themselves equipped with operational ADS-B transponders. Aireon will be capable of tracking one thousand active targets within an airspace held to be two thousand nautical miles in diameter. More efficient and precise routing will result, with NavCanada estimating cost savings on North Atlantic routes alone to the value of $125-million a year in fuel.

"The Aireon system solves the problem, there's world-wide coverage. It's a real game-changer", stated Mr. Crichton. Next year, the first of Iridium's second-generation satellites with ADS-B sensor payloads will be launched with the full constellation in place by late 2017, operational the year following. Mystery solved? Not quite. Technology is wonderful, giving humankind various advanced tools to manipulate toward safety and security.

But MH370 had been equipped with an ADS-B transponder Most commercial aircraft flying oceanic routes are, even while such transponders will eventually be mandatory on all commercial airliners in the near future. For some unknown reason, compounding the mystery of its disappearance, the transponder on MH370 had stopped functioning. Most experts in the field feel confident in stating that human intervention was involved; that it was deliberately tampered with.

"That issue is still there. The airlines and the pilots' unions have got to sort that one out. There are solutions to that", said Mr. Crichton. Solutions such as tamper-proofing all transponders in the future. Which still, of necessity leaves the lingering mysteries surrounding that doomed flight: Why? and How? And above all, Where?

Slate

Future Tense

The Citizen's Guide to the Future

March 18 2014 6:03 PM

A “Startlingly Simple Theory” About the Missing Airliner is Sweeping the Internet. It’s Wrong.

By Jeff Wise

Has someone finally solved the MH370 mystery?

Photo by TANG CHHIN SOTHY/AFP/Getty Images

Chris Goodfellow doesn’t have much patience for the uncertainty concerning Malaysia Airlines Flight 370. The instrument-rated Florida pilot found the theories and countertheories mooted on outlets like CNN “almost disturbing.” (I’ve appeared on CNN to discuss Flight 370, but I’ll try not to take Goodfellow’s remarks personally.) So he set about cutting through the clutter, using nothing more than the machete-like incisiveness of his own intellect. “I tend to look for a more simple explanation,” he writes in a Google Plus post that was republished on Wired.

As he read up on the incident, he got to the part where Malaysia military radar detected the aircraft making a 90-degree turn to the left and leaving its planned flight path, just after it had passed the last navigational waypoint in Malaysian territory, and after its transponder and ADS-B (“Automatic dependent surveillance-broadcast”) reporting system had stopped working. His eye followed the track that the airplane made as it headed west, toward the Malay peninsula and to the Andaman Sea beyond. And there, close by the western shore of the peninsula and just a few miles south of the plane’s recorded track, he spotted the island of Langkawi. In a flash, everything made sense.

“Thanks to Google earth I spotted Langkawi in about 30 seconds, zoomed in and saw how long the runway was,” Goodfellow wrote on his Google Plus page on March 14. “I just instinctively knew this pilot knew this airport.”

He knew what the lost pilot and co-pilot had been thinking when they made that turn, and it was something he’d thought himself, while behind the yoke of an aircraft, many times before. “We old pilots were always drilled to always know the closest airport of safe harbor while in cruise,” he wrote. "Airports behind us, airports abeam us and airports ahead of us. Always in our head. Always.”

In the scenario that Goodfellow laid out, MH370 suffered a fire in the cockpit as it climbed to cruise altitude en route to Beijing. Sensing the urgency of the crisis, the flight crew turned toward Langkawi and its 13,000-foot runway, while at the same time pulling circuit breakers to stop the fire. But it was no use. The smoke rendered the men unconscious, and “the flight continued on deep into the south Indian ocean” until it ran out of fuel and crashed.

In a stroke, Goodfellow had solved the mystery of MH370—not only what caused the crash, but where the wreckage would be found. What’s more, his revelation rehabilitated the reputations of the captain and first officer, who have come under an increasing cloud of suspicion. “This pilot,” Goodfellow wrote, “was hero struggling with an impossible situation. … Smart pilot. Just didn’t have time.”

Goodfellow’s posting may be the most (first?) popular thing ever to have come out of Google Plus. After exploding across Twitter, it was reprinted by Wired and praised by James Fallows of the Atlantic, who wrote, “his explanation makes better sense than anything else I've heard so far.”

Goodfellow’s account is emotionally compelling, and it is based on some of the most important facts that have been established so far. And it is simple—to a fault. Take other major findings of the investigation into account, and Goodfellow’s theory falls apart. For one thing, while it’s true that MH370 did turn toward Langkawi and wound up overflying it, whoever was at the controls continued to maneuver after that point as well, turning sharply right at VAMPI waypoint, then left again at GIVAL. Such vigorous navigating would have been impossible for unconscious men.

Goodfellow’s theory fails further when one remembers the electronic ping detected by the Inmarsat satellite at 8:11 on the morning of March 8. According to analysis provided by the Malaysian and United States governments, the pings narrowed the location of MH370 at that moment to one of two arcs, one in Central Asia and the other in the southern Indian Ocean. As MH370 flew from its original course toward Langkawi, it was headed toward neither. Without human intervention—which would go against Goodfellow’s theory—it simply could not have reached the position we know it attained at 8:11 a.m.

To make a good theory, Einstein is said to have asserted, “everything should be kept as simple as possible, but no simpler.” Unfortunately, Christopher Goodfellow’s wildly popular theory errs on the side of too much elegance.

Update, March 18, 2014: This blog post was revised to make consistent which version of Goodfellow's article was used for quotations. The quotes are now all from Goodfellow's Google Plus account, rather than the Wired version.

Future Tense is a partnership of Slate, New America, and Arizona State University.