Contagion: Fiction or Reality?

So, last weekend I spent some quality time with my brother. Both movie fans we decided to check out "Contagion." I recently heard that this new bio-thriller was actually the #1 movie in the box office in its opening weekend.  Apparently people found the movie genuinely scary because the monster of the movie isn't anything that can be seen with the naked eye. It was a good representation of a viral pandemic so I won't spoil the movie for those of you that want to see (I highly suggest it because it is pretty awesome), but I thought the idea behind the movie was worth examining. Can such a situation really happen? How real is the threat of a vial pandemic? A million people have written similar things on this topic but I would like to let everyone know that my explanation is best! (I'm joking, but seriously...) Let's turn to some history and science for the answers.


The movie follows the outbreak of a virus as it spreads throughout the human population. The key here is that the virus was new. Throughout history the appearance of novel viruses has resulted in pandemics. For example, the Spanish Influenza pandemic of 1918 was a novel type of flu and the result was the worst pandemic in the history of the world. A dramatic phrase, but true nonetheless. What makes novel virus outbreaks so debilitating to humans is the simple fact that the human body have never experienced the virus, therefore the body has no way of figuring out what to do. The Spanish Influenza (which deserves its own post at a later time) had surface antigens that the body could not recognize and the result was a quick spreading outbreak that swept around the world.

The 1918 pandemic influenza was not the only time a novel virus has emerged which threw the CDC into a frenzy. Remember SARS? Well, the onset of SARS was a bigger deal than we actually know. It started in one hotel in Hong Kong and within a week it was in Canada knocking on our door. This is a perfect representation of how technological advances have acted as a double-edged sword when it comes to viral epidemics. All it takes is one infected person to board a plane and infect a group of people at an airport and then the virus could be world wide in no time. The end result of SARS was nearly 9000 individuals infected and 900 deaths.



A key component of "Contagion" is the work of doctors to track down the path of the virus. This is also based on fact. The CDC has a special branch called the Epidemic Intelligence Service (EIS) whose job is to travel abroad and see outbreaks first-hand, interview patients, and uncover the epidemiology of the disease. On a side-note, my goal is to one day work for the EIS because they are basically the most BA doctors in the world! The single goal of these "virus hunters," as they call themselves, is to find out any information they can that can lead to the containment and possible treatment of the disease. This includes the pathways by which the virus is spread, the amount of people that can potentially be infected from one contagious individual (a term called the R-naught which is referred to many times in "Contagion"), and to find out if the virus is on its way to the US.


These guys also have had a huge role in some serious biological incidences, one of the most notable involving a novel virus in the mid seventies that began an epidemic in Zaire. Those infected displayed a horrific hemorrhagic pathology and the virus was given the name "Ebola." Another involved a mysterious viral outbreak in New Mexico that resulted in similar symptoms to Ebola. This one was more related to a virus called Hantavirus only this particular strain of Hantavirus caused renal failure in its victims. The EIS doctors discovered that the virus which they called "Sin Nombre" was spread like other Hantviruses, through the urine of mice and by getting rid of the mice the virus outbreak ended. The EIS doctors come face-to-face with the worst types of viruses with scant regard for their own safety. If an outbreak of a virus on the scale of "Contagion" were to occur these investigative doctors would be the first to the scene. They're awesome!

So the CDC is just overreacting right? In "Contagion" the media makes the point that most people believe the CDC overreacts to such threats. The truth is that they do, but with good reason. I think that it highlights a serious flaw in our own philosophy. People don't think epidemics abroad can effect them. Individually they are probably right, but the more people that hold this view, the less prepared we are to face it when a threat emerges. If an entire town doesn't vaccinate their children then the result can be the recurrence of disease such as Whopping Cough which was reported in California last year. The problem isn't only for your own safety. It is....but the CDC has more important reasons for you to get vaccinated. By reducing the amount of people susceptible to disease, you can cut off the route of a potential epidemic quicker. It's a statistical thing. So when the CDC freaks out and says to get your vaccine even if you're healthy what they're really asking is for you to help reduce the threat of an epidemic.

What should trouble is how the virus acts. As I've mentioned before viruses want to spread. It's all they care about. They wait for millions of years until one susceptible host comes along and triggers a cascade of biochemical events that ultimately lead to replication of the virus. They can mutate their genome and give slight changes to their surface which could allow them to infect new species or evade an immune response. This was what happened with novel H1N1. A bird harboring the virus gave it to a pig which itself was infected with another virus. The pig acting like a mixing vessel then generates a new virus capable of infecting a human and...bang, the gun goes off and it's off to the races.

Should a pandemic ensue I think the most powerful driving force would be fear. Assuming people recognize the virus as a very real threat, fear will become its own plague. The media propagates stories about the virus and people start to freak out. The novel H1N1 pandemic of 2009 showed that. Every day I heard stories about how new people were infected and more people died.  With images like these constantly bombarding the public it's easy to see why a virus with very real effects could transform the American public through fear. "Contagion" obtains maximum effect from this field!

Imagine hearing a town next to yours now has the virus. You're walking down the street not knowing if your town is still safe and if anyone is infected with a lethal virus. Every cough, sneeze, and sniffle would make you wonder if the person next to you is infected and if its possible that the agent has breached your city walls. There would be a palpable fear. So strong was this kind of fear that in the 14th century towns literally gated themselves off from one another to prevent the entrance of Plague. This was also the case in Poe's short story "Masque of the Red Death" but not even closed doors could stop the Red Death from gaining entrance to the castle... The movie very accurately portrayed the social aspect of a pandemic in that people will become restless and hostile. Seeking the well being for one's own family becomes priority and people would achieve this by any means necessary including force. It's at this point that the military intervenes and cities start to look more like a scene from "Outbreak."

Hendra and Nipah virus, two very
unfriendly looking pathogens

The viruses that can cause such an event do exist even if we aren't fully aware of them. These agents are termed Emerging Infectious Diseases and these are the ones that are downright scary. These are viruses that are new to the human population even though they may have been circulating in the wild for a long time. Nipah, Hendra, Ebola, Lassa Fever, and Hanta Virus are a few of this class and all cause a horrific display of symptoms ranging from encephalitis to renal failure and hemorrhaging (all very bad things). Worse, these agents have no treatment and no cure. Given that these viruses aren't endemic to the US there is no need for alarm. However, the director of the CDC said in an interview with CBS that a new pathogen is discovered everyday so it looks like the odds of an outbreak occurring is higher than we expect and it may only be a matter of time before luck runs out and one poor individual harboring a new virus boards a plane and crosses boarders.

So is "Contagion" more real than fiction? In truth, it is. This is why the movie creates fear. Whether or not we want to admit it, there is something frightening about the human race being overwhelmed by an enemy that can't be seen, smelled, heard, or felt. Worse, "Contagion" holds very true to the events that would commence once the outbreak began. The science of the movie, although ambiguous in parts, is pretty good in explaining the course of viral infection and why it is easy to lose control over the situation unless it is handled immediately. All in all, it is a very good and exciting movie that is sure to make you pause when the person next to you sneezes.