Q&A With Contagion's Science Advisor (Plus Spoilers!)

Imaginary Superbug Reader: Sweet: Gwyneth Paltrow dies. Is that realistic?

Maryn: After the excesses of GOOP, we can only hope. Kidding! She develops a fever and cough, she goes all neurological, and she dies ugly, in a couple of days. As Lipkin says above, the fictional MEV-1 (the name is never explained, but presumably it stands for MeningoEncephalitis Virus — meningoencephalitis, inflammation of the brain and its covering, can cause fever, tremor and convulsions) is based in part on real-life Nipahvirus, which was identified in 1999. Nipah does cause fever and headache leading to coma, but in 14-16 days, not four.

ISR: Is that really the CDC on-screen?

M: Mostly yes. The deck where (CDC division chief) Laurence Fishburne parks and the stone wall he stands next to while talking to (janitor) John Hawkes are the actual outside of Building 19, which houses the CDC’s Visitor Center. The giant video screens in front of which Fishburne is interrupted by (Department of Homeland Security official) Enrico Colantoni is the actual Bldg. 19 lobby, and the driveway late in the film where Fishburne has to thread his way through a riot is the actual CDC front gate. CDC insiders tell me though that the EOC, where Fishburne meets up with (Rear Admiral Haggerty) Bryan Cranston, is a set that precisely reproduces the actual EOC.

ISR: About that acronym — what’s with the alphabet soup?

M: OK, quick primer:

  • EOC: the CDC’s Emergency Operations Center, its post-SARS war room.
  • BSL-4: “biosafety level” 4 on a scale of 1 to 4 — the highest level of laboratory containment, used for highly infectious organisms for which there is no vaccine or treatment, including the fictional MEV-1.
  • SOHCO: Single Overriding Health Communication Objective, the top-level message that public health people strive to impart in every communication with the public.
  • R-0 (pr. “R-nought”): Shorthand for the “reproductive number,” or number of cases of disease that are caused by a single case; when the reproductive number is determined, the appropriate numeral is subbed out for the 0. As in, I have flu, I give it to you, you have flu: Voila, R-1.
  • EISO: Epidemic Intelligence Service Officer, a member of the CDC’s crack corps of young disease detectives, who serve for two years immediately after finishing medical residency or post-graduate fellowship, or finishing a Ph.D.

ISR: Gwyneth Paltrow’s character brings the illness back to Minneapolis, and then Fishburne sends EISO (ooh, I feel all insidery!) Kate Winslet to work with the Minnesota Department of Health — who seem kind of jerky. Real?

M: Not real — in fact, probably a public-health joke. Minnesota may be the top health department in the country and routinely solves outbreaks on behalf of other, less well-funded states.

ISR: And then Winslet dies on the job. Has that ever happened?

M: Fortunately, not yet. The only EISO to die in the line of duty was Paul Schnitker, who was on assignment to the relief operations for the Biafran famine when his small plane was shot down in 1968. No EISO has ever been fatally infected by an organism he or she was investigating. (If they’ve caught something minor such as a foodborne illness, they’re not fessing up.)

ISR: In the last scenes, we see where MEV-1 came from: Paltrow’s company cleared a forest, disturbing a colony of bats; a bat lands in a palm tree and eats a piece of fruit; it flies away with the fruit and drops it into a pig pen; one of the piglets eats the fruit; and then the piglet ends up being butchered by a chef in the casino where Paltrow is gambling. In the last shot, she shakes hands with him. Real?

M: Very — in fact, matches the field investigations for Nipah virus, except the trees in that scenario were date palms.

ISR: So, bottom line: If this really happened, we’d be fine, right? In the movie, millions of people die, but within about 4 months, a vaccine is being distributed worldwide.

M: And that’s probably the movie’s biggest fictional misfire. In reality, identifying a new virus, formulating a vaccine through 57 separate formulas, mounting human trials, getting it approved by national health authorities and then getting it manufactured, shipped around the world and shot into arms or noses would take much longer. If anything like MEV-1 — or any truly novel organism — ever emerges, the vaccine cavalry will take a long, long time to arrive.


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