Doctors raise alarm about ancient virus

An ancient virus infecting residents across Australia's Northern Territory is leaving death and despair in its path, and doctors are now calling for greater efforts to stop the spread of infections. CNN's Elizabeth Cohen reports.

Posted: May 8, 2018 2:29 PM
Updated: May 8, 2018 2:34 PM

An ancient virus infecting residents across Australia's Northern Territory is leaving death and despair in its path, and doctors are now calling for greater efforts to stop the spread of infections.

The rates of human T-cell leukemia virus type 1, or HTLV-1, infection are exceeding 40% among adults in remote regions of central Australia, with indigenous communities being the hardest hit, especially in the town of Alice Springs.

Many doctors -- including the man who discovered the virus nearly four decades ago -- are raising the alarm about how little has been done to prevent, test for and treat HTLV-1, which can cause leukemia and lymphoma.

"The prevalence is off the charts" in Australia, said Dr. Robert Gallo, co-founder and director of the Institute of Human Virology at the University of Maryland School of Medicine, whose laboratory was the first to detect HTLV-1 in 1979 and publish the finding in 1980.

Yet "nobody that I know of in the world has done anything about trying to treat this disease before," said Gallo, who is also co-founder and scientific director of the Global Virus Network and chairs the network's HTLV-1 Task Force.

"There's little to almost no vaccine efforts, outside of some Japanese research," he said. "So prevention by vaccine is wide open for research."

HTLV-1 -- an ancient virus whose DNA can be found in 1,500-year-old Andean mummies -- can spread from mother to child, particularly through breastfeeding; between sexual partners, through unprotected sex; and by blood contact, such as through transfusions. Because it can be transmitted through sex, it's considered a sexually transmitted infection, or STI.

The virus is associated with myriad serious health problems, such as diseases of the nervous system and a lung-damaging condition called bronchiectasis, and it weakens the immune system. HTLV-1 is sometimes called a cousin of the human immunodeficiency virus, HIV.

An 'extraordinary' prevalence in remote Australia

The focus has come about now because of the high prevalence among indigenous Australians, "which is probably the highest-ever reported prevalence in any population," said Dr. Graham Taylor, a clinician and professor at Imperial College London who runs the United Kingdom's HTLV clinical service based at St. Mary's Hospital.

"But if we look globally, we know about HTLV-1 in a number of countries," he added.

HTLV-1 is present throughout the world, but there are certain areas where it is highly endemic, such as the rare isolated cluster in central Australia.

The main highly endemic areas are the southwestern part of Japan; some parts of the Caribbean; areas in South America including parts of Brazil, Peru, Colombia and French Guyana; some areas of intertropical Africa, such as south Gabon; some areas in the Middle East, such as the Mashhad region in Iran; a region in Romania; and a rare isolated cluster in Melanesia, according to the European Centre for Disease Prevention and Control.

Elsewhere in the world, such as in the United States and the UK, prevalence remains low.

"The interesting thing about central Australia, of course, is you can go back 25 years, and the high rates of HTLV-1 were published 25 years ago in that community," Taylor said.

Indeed, a study published in the Medical Journal of Australia in 1993 found that HTLV-1 was endemic among natives in inland Australia, with a high 13.9% prevalence in the Alice Springs area.

It's unclear whether the sample in that old study was of the same population currently experiencing a higher prevalence rate, and it's unclear whether that previous rate was measured with similar methods used to assess prevalence today.

Nonetheless, the current prevalence rate, exceeding 40%, is "extraordinary," Taylor said.

"It's causing a problem of bronchiectasis. People are dying of bronchiectasis in association with HTLV-1 infection, and what is the response? If you can't see a response, then you might say it's neglected," he said. "The virus is neglected, and the diseases that it causes are neglected."

The reason why HTLV-1 prevalence in an already endemic area is exceeding 40% remains something of a mystery, Gallo said.

While musing on possible reasons, he questioned whether the HTLV-1 seen among indigenous communities in central Australia could be a variant that transmits more easily.

"Nobody knows that either," he said. "That's possible."

However, he added, there is no reason for the rest of the world to be concerned about the virus spreading more widely.

Likely, "this virus, I don't care what the variation is, will not transmit casually," Gallo said.

"In short, I would not be afraid to use towels, drink out of the same glass, be part of the family, et cetera," of an HTLV-1 positive person, he said. But he added that the virus certainly can transmit through breastfeeding, blood contact and sex.

'We have to make up for what we didn't do before'

On the other hand, why the HTLV-1 virus has been neglected in certain regions -- especially Australia's indigenous communities -- appears to be not as mysterious.

Many regions around the world impacted by HTLV-1 are poorer communities that often go overlooked by the medical establishment and don't have as many health care resources, Gallo said.

Around the world, there appear to be not many efforts to screen for HTLV-1, Taylor said. For instance, few countries have antenatal screening programs for it.

"The only country which has a national antenatal screening program is Japan," he said. Screening and recommendations of formula feeding have been practiced in Nagasaki, Japan, since about 1987 and are being discussed in other parts of the world, including England and Jamaica.

"Then, you have the situation where blood which is infected with HTLV-1 can be given to a recipient, an organ can be given to a recipient," he said. "So there are public health issues."

In the United States, Australia and some other countries, donated tissues and donated blood often are tested for HTLV.

Additionally, just a few years after HTLV-1 was discovered, HIV was identified for the first time. Between HTLV-1 and HIV, the latter got the most attention, Gallo said, partly because HIV is more efficient at transmitting.

Now, "we have to make up for what we didn't do before," he said. "We have to get attention to HTLV-1 quick."

In other words, the high prevalence of HTLV-1 in central Australia has become something of a wakeup call for the world to do more to prevent and reduce infections from the virus.

"There's a lack of knowledge about HTLV-1," Taylor said.

Terre Haute
Broken Clouds
59° wxIcon
Hi: 65° Lo: 39°
Feels Like: 59°
Robinson
Broken Clouds
61° wxIcon
Hi: 67° Lo: 37°
Feels Like: 61°
Indianapolis
Broken Clouds
63° wxIcon
Hi: 61° Lo: 41°
Feels Like: 63°
Rockville
Scattered Clouds
61° wxIcon
Hi: 63° Lo: 38°
Feels Like: 61°
Casey
Broken Clouds
54° wxIcon
Hi: 62° Lo: 39°
Feels Like: 54°
Brazil
Broken Clouds
59° wxIcon
Hi: 64° Lo: 38°
Feels Like: 59°
Marshall
Broken Clouds
59° wxIcon
Hi: 65° Lo: 38°
Feels Like: 59°
Turning Cooler
WTHI Planner
WTHI Temps
WTHI Radar

WTHI Events

 

Illinois Coronavirus Cases

(Widget updates once daily at 7 p.m. CT)

Confirmed Cases: 295720

Reported Deaths: 8916
CountyConfirmedDeaths
Cook1454625225
DuPage17786563
Lake17151488
Will14239382
Kane13285326
St. Clair6747192
Winnebago6300151
Madison5828143
Champaign481821
McHenry4653118
Peoria355552
McLean332523
Rock Island307177
Kankakee277677
Unassigned2562244
Sangamon247945
Kendall205425
Tazewell180927
LaSalle175857
Macon163645
DeKalb162239
Coles150831
Williamson142649
Jackson127625
Clinton122221
Adams119910
Boone115323
Randolph95811
Effingham8833
Vermilion8304
Whiteside78421
Ogle7486
Knox7043
Monroe69016
Grundy6876
Henry6795
Morgan67423
Bureau67112
Jefferson64138
Marion5732
Macoupin5677
Christian56511
Franklin5523
Stephenson5486
Union52424
McDonough49015
Logan4691
Crawford4664
Fayette4376
Woodford4327
Livingston4086
Shelby4084
Cass40411
Jersey39817
Lee3941
Montgomery38913
Iroquois36819
Saline3624
Perry35815
Bond3426
Warren3342
Douglas3187
Wayne3005
Jo Daviess2752
Lawrence2633
Carroll2386
Greene23513
Hancock2283
Moultrie2224
Richland2206
Cumberland2195
Washington2191
Jasper21210
Fulton1900
Clark1833
Pulaski1831
White1760
Johnson1630
Wabash1623
Mason1611
Clay1590
Piatt1430
Mercer1415
Pike1391
De Witt1292
Menard1281
Massac1172
Edgar1168
Marshall1110
Ford1085
Alexander851
Scott800
Gallatin752
Hamilton742
Henderson710
Brown690
Edwards680
Putnam630
Calhoun620
Stark562
Schuyler500
Hardin390
Pope301
Out of IL30

Indiana Coronavirus Cases

(Widget updates once daily at 8 p.m. ET)

Confirmed Cases: 120019

Reported Deaths: 3632
CountyConfirmedDeaths
Marion21671768
Lake10772325
St. Joseph6763116
Elkhart6755112
Allen6411206
Hamilton4997110
Vanderburgh390632
Hendricks2789125
Monroe270837
Tippecanoe265213
Johnson2383126
Clark229357
Porter223347
Delaware204162
Cass19619
Vigo190628
Madison173575
LaPorte153241
Warrick142847
Floyd142064
Howard134164
Kosciusko130117
Bartholomew120357
Marshall102924
Dubois102119
Boone100346
Grant97237
Hancock95143
Noble93532
Henry83027
Wayne78115
Jackson77910
Morgan73940
Shelby68929
Daviess68429
Dearborn67928
LaGrange65111
Clinton64414
Harrison60124
Putnam59211
Gibson5606
Knox54410
Lawrence53029
Montgomery51222
DeKalb50111
White49114
Decatur46339
Miami4394
Greene43236
Fayette42314
Jasper4032
Steuben3997
Scott39611
Posey3712
Sullivan33912
Jennings31812
Clay3155
Franklin31525
Ripley3098
Whitley2956
Orange28924
Adams2833
Carroll28313
Wabash2758
Starke2747
Wells2734
Washington2702
Spencer2693
Huntington2543
Jefferson2543
Fulton2472
Tipton23323
Randolph2308
Perry22613
Jay1931
Pike1771
Newton17511
Owen1721
Martin1690
Rush1584
Vermillion1330
Fountain1302
Blackford1243
Pulaski1141
Crawford1110
Parke1112
Brown1023
Benton870
Ohio797
Union790
Switzerland680
Warren411
Unassigned0227