Contagion Movie Assessment
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Contagion Movie Assessment
Roxanne Evans
Concordia University Nebraska
Contagion Movie Assessment
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The movie Contagion, released in 2011, depicts a global pandemic that involves a highly
infectious virus that attacks the central nervous system of humans. This movie shows a possible
beginning, middle and end a pandemic of highly pathogenic disease could take. This outbreak is
depicted from the emergence of a new disease through to vaccination and prevention techniques,
highlighting each step of investigation to determine the cause, spread, and control of the
pandemic.
The initial spread of the disease isn't truly established until the end of the movie. We find out that
pigs used for human consumption are located on a farm close to a forest that is being cut down,
assumingly for lumber. As the trees fall, we see bats that were once housed in those trees seek
shelter in the pigs barns. Likely these bats are defecating onto the pigs, onto the pigs bedding
and/or onto the pigs' food. One avenue of transmission of disease is fecal contamination and is
very common among different infections.
One example most people can relate to, of this exposure process, is the fecal contamination of
beef with Escherichia coli. This bacteria can make people very ill after ingesting under cooked
meat. E.coli, which is a normal commensal of the cows gastrointestinal tract, is extremely
pathogenic to humans who ingest it. Ingestion of E.coli, specifically the strain known as
O157:H7, causes severe diarrhea and other gastrointestinal symptoms which can even lead to
death. (Food Poisoning, 2012)
A less known example of disease spread by fecal material of one species to another is
Cryptococcus neoformans. This fungus is typically spread to humans through the fecal material
from pigeons or other birds. This fungus enters the body by the inhalation of spores, and affects
the nervous system. (CDC, 2014
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Diseases that can cross species such as E.coli and C.neoformans usually are more pathogenic to
the new host, as seen in the two examples given. These pathogens, able to move from other
species to humans, or vice versa, are known as zoonotic diseases. Some zoonotic diseases can
even go on to be spread from person to person, like with E.coli. Adversely, as seen with
C.neoformans, human hosts cannot infect ether humans with disease. When this occurs it is
referred to as a dead-end host, where the pathogenic disease is halted from spreading to others.
(Faria, Suchard, Rambaut, Streicker, & Lemey, 2013)
IN the movie, they are implying that the bats are the reservoir host of the infect. An infection that
may or may not cause disease in the bats, but clearly did outside of the bat species. This is a well
documented scenario. Bats are well know carriers of several pathogenic zoonotic diseases.
One disease in particular, the Nipah Virus, could have been the basis of the movie. In fact, in
1998, there was an outbreak of this disease in people from pigs acting as an intermediate host.
Symptoms experienced by infected people included fatal encephalitis and acute respiratory
syndrome. In addition, human to human transmission was also seen. (Nipah Virus Infection,
2014) This makes their storyline of the film very plausible, in the sense of the infectious agent
involved. Especially since we see a female business woman (Gwyneth Paltrow) in Hong Kong
shaking hands with a restaurant chef that did not wash his hands after handling raw pig meat that
was in contact with bat droppings.
This virus in movie, called Meningoencephalitis Virus One (MEV-1), appears to be spread by
fomites to human and was shown to be an newly emerging disease to the human race, a disease
not recognized before. Fomites, objects or things that carry infectious agents are a real concern
when dealing with disease outbreaks. (Soderbergh, 2011) If a pathogen is capable to remain
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infectious for long periods of time on fomites, they are able to infect more people, than if they
were rendered inactive or died outside of a host quickly. Rabies virus, for example, is extremely
unstable outside of a host and transmission by fomites is extremely rare. The virus is inactivated
by many means, including heat, ultraviolet light, and a vast number of cleaning agents or other
chemicals. (Scheld, Whitley, & Marra, 2004)
Another avenue that increased the number of people that are infected are diseases with short
incubation periods, or incubation periods that are shorter than when clinical symptoms starts.
This allows for disease to be spread before people have an opportunity to implement preventative
measures, since those sick can’t easily be identified. (Nishiura, 2007)
Fomites and a short incubation period can rapidly spread disease, making it extremely
contagious. If the disease is also highly pathogenic, as depicted in the film, the following
transmission rates seen are also high. This reproductive number or growth number is known as
the R0, which describes how easily a pathogen with spread or better described, how many people
can be infected by a single sick person. (Chowell et al, 2004) For example, the R0 value for
Measles is 12 to 18, where Ebola is 1 to 4. The large difference in the number of people infected
it likely that Measles is an airborn diseaes , where the spread of Ebola relies on contact of
infected body fluids. (Basic Repoduction Number, 2014)
In the movie the MEV-1 has a R0 of 2 initially, but the virus then is described as mutating and
the R0 increases to 12. This supports the highly contagious nature described in the film. In
addition to being a highly contagious disease, it is also has a high mortality rate of 25 to 30%.
And by then end of the pandemic there are roughly 26 million people who had died from MEV1. (Soderbergh, 2011)
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This movie depicts a very realistic outcome of such a highly infectious and highly virulent
pathogen. A similar pandemic would be the Spanish Flu of 1918. The resevior of Spanish Flu
was determined to wild bird until the virus cross species to humans. The R0 of Spanish Flu was 3
to 11 and the mortality rate was 10 to 20%. An estimated 50 to 100 million people died from the
disease. (Taubenberger & Morens, 2006) I would have expected, however, base on how
devastating the Spanish flu was, in a time where there was fewer means of transportation, that
the MEV-1 virus would have killed more than the 26 million with todays aviation and
transportation achievements. Especially considering that the population of the world has since
dramitically increased.
One other major aspect of fighting diseases that has evolved since 1918 is medical care and other
medical advancements. This may have contributed to an increased surivial rate among those
infected I the movie. In addition, there are public health measures that would likely be instituted
to prevent disease spread. Like confinement to people's homes. This is actually being seen now
in Sierra Leone where the 2014 Ebola epidemic is taking place. To avoid further spread of
disase, people are being ordered to stay in their homes. (Nossiter, 2014)
In addition, another similarity from Ebola to the MEV-1 virus is that there was no vaccine
available for protection. We see a doctor in the movie make a vaccine and try it on herself
without going through the typical vaccine testing protocls. This has also been recently done with
Ebola, not a vaccine, but a new drug derived from the blood of Ebola surviviors. Making this
senerio very viable, that in despert times people take desperate measures. (Ebola (Ebola Virus
Disease), 2014)
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I do believe that this scenario has the potential to occur. Humans are constantly changing animal
-human interactions by increasing human territories, demonstrated in the film. The CDC would
be intimately involved to determine cause, identify the agent responsible, and institute protected
and curative measures. In the movie they had a woman from the CDC who was an "EIS" officer
(Kate Winslet). The EIS office is a Epidemic Intelligence Service officer and they are sent to
determine connectivity to the affected and also determine who else might have been in contact
with a particular individual, contagion, or chemical that could cause disease or illness. (Epidemic
Intelligence Service, 2013)
The CDC also has numerous protocols established for specific emergencies. These emergencies
include bioterrorism, radiation, chemical, natural disaster, and infectious diseases, just to name a
few. (Emergeny Preparedness and Response, 2014) They would be responsible for, in this case,
overseeing all laboratory works and making sure all labs have the necessary equipment needed to
functions, this allows then a high level of involvement, so that they are always in the loop of
information.
The only parts of the film I question are "The vaccine lottery" and the rapid quarantine of the
different towns and cities. The idea of a vaccine lottery is wonderful, but I do wonder if that is
truly plausible. Also I wonder if people would have the means to continue to remain confined in
their homes until they were able to get the vaccine if they were last on the list. The movie also
doesn’t get into herd immunity. Would there be a dates when the majority of people are expected
to be protected and therefore it is safer to be out even though they are protected themselves.
The quarantines implemented in the U.S. happened very rapidly. I would be concerned that this
is not likely the case, given that there have only been a handful of individual cases of quarantines
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being issues on a non-voluntary basis. It would be more likely that they would first issue a
"Shelter in Place" or "Home Confinement". This again can be reflected in the current Ebola
outbreak, where this particular epidemic has been going on since December of 2013 and only
recently have any quarantines or home confinements been issued. (Ebola (Ebola Virus Disease),
2014)
Overall, this movie has an eerie realist undertone and insight into a major pandemic. Most of it
reflects previous outbreaks such as Spanish Flu, but set in modern day. In addition, the mode of
transmission of disease is similar to other know diseases, specifically Nipah Virus, which bats
are the reservoir host for, pigs are the intermediate host, and people are infected by a virus that
can go to the nervous system. The CDC will also be highly involved in determining cause and
instituting protocol for prevention and treatment. Hopefully this movie will remain fiction, but
given there are newly emerging or mutating pathogens constantly being discovered, this could
rapidly be seen as things to come.
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References
Basic Repoduction Number. (2014, September 12). Retrieved from Wikipeida:
http://en.wikipedia.org/wiki/Basic_reproduction_number
Chowell, G., Hengartner, N., Castillo-Chavez, C., Fenimore, P., & Hyman, J. (2004, July 7). The basic
repoductive number of Ebola and the effects of public health measures: the cases of Congo and
Uganda. Journal of Theoretical Biology, 229(1), 119-126. Retrieved Septmeber 13, 2014, from
http://math.lanl.gov/~mac/papers/bio/CHCFH05.pdf
Ebola (Ebola Virus Disease). (2014, August 29). Retrieved September 13, 2014, from Centers for Disease
Control and Prevention: http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa-experimentaltreatments.html
Emergeny Preparedness and Response. (2014, May 6). Retrieved September 12, 2014, from Centers for
Disease Control and Prevention: http://www.bt.cdc.gov/planning/
Epidemic Intelligence Service. (2013, April 17). Retrieved September 12, 2014, from Centers for Disease
Control and Prevention: http://www.cdc.gov/eis/
Faria, N., Suchard, M., Rambaut, A., Streicker, D., & Lemey, P. (2013, February 4). Simultaneously
reconstructing viral cross-species tranmission history and identifying the underlying constrains.
Philosophical Transactions of the Royal Society B- Biological Sciences, 368(1614), 20120296.
doi:10.1098/rstb.2012.0196
Food Poisoning - E.coli. (2012, March 14). Retrieved September 12, 2014, from FoodSafety.Gov:
http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/ecoli/
Nipah Virus Infection. (2014). Retrieved September 12, 2014, from World Health Organization:
http://www.who.int/csr/disease/nipah/en/
Nishiura, H. (2007, May 11). Early efforts in modeling the incubation period of infectious diseases with
an acute course of illness. Emerging Themes in Epidemiology, 4(2). doi:10.1186/1742-7622-4-2
Nossiter, A. (2014, September 6). The New York Times. Retrieved September 13, 2014, from Sierra Leone
to Impose 3-Day Ebola Quarantine: http://www.nytimes.com/2014/09/07/world/africa/sierraleone-to-impose-widespread-ebola-quarantine.html?_r=0
Scheld, W. M., Whitley, R. J., & Marra, C. M. (2004). Infections of the Central Nervous System (3rd ed.).
Lippincott Williams & Wilkins.
Soderbergh, S. (Director). (2011). Contagion [Motion Picture].
Contagion Movie Assessment
Sources of Crytococcosis - How is someone infected with Cryptococcus neofomans? (2014, February 13).
Retrieved September 12, 2014, from Centers for Disease Control and Prevention:
http://www.cdc.gov/fungal/diseases/cryptococcosis-neoformans/causes.html
Staples, M. (2011, April 24). Canadian woman battling crippling disease caused by pigeon poop. The
Canadian Press. Fredericton, Canada. Retrieved September 12, 2014, from The Globe and Mail:
http://www.theglobeandmail.com/news/national/canadian-woman-battling-crippling-diseasecaused-by-pigeon-poop/article577526/
Taubenberger, J. K., & Morens, D. M. (2006). 1918 Influenza: the Mother of All Pandemics. Emerging
Infectios Disease, 12(1), 15-22. Retrieved September 13, 2014, from
http://wwwnc.cdc.gov/eid/article/12/1/pdfs/05-0979.pdf
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