Running Head: AN EPIDEMIOLOGIAL LOOK AT CONTAGION

An Epidemiological look at Contagion

Kristine Blaker
Northern Arizona University

AN EPIDEMIOLOGIAL LOOK AT CONTAGION

While the main focus of the film Contagion was a modern day race to find a cure and
control a lethal airborne virus, certain epidemiologic elements can be extracted from a critical
analysis of the deeper plotline. The outbreak starts when a woman contracts an unknown disease
in Hong Kong and carries the disease back to the United States, infecting people along the way.
The film implies that with just one touch, youre infected. By the time woman arrives home, her
muscles ache, she has a fever and headache, and by the next day, she seizes and dies. Almost
everyone she came in contact soon after died as well and the virus was spread through the
worlds population in less than a few weeks. The fictional MEV-1, mimicking the real life Nipah
virus, starts off resembling the flu; cough, headache, malaise, fever, and then, the key indicator
the patient dos not have the flu: frothing around the mouth.

Descriptive Epidemiology

In the film, Dr. Mears interviews Beths colleagues and her husband to see who came in
contact with her, tracing back her activities for the entire round trip. Its a complex process and
there are some grey areas of privacy violations, but the deep investigation is considered a vital
tool in outbreak response, especially early on before disease has spread too widely.
These activities performed by Dr. Mears is called Descriptive Epidemiology; when people
investigate when and why people get sick and how the disease is spreading. By watching security
footage of her activities at a casino, Dr. Mears constructed a timeline of when and where Beth
had been, whom she came in contact with, and found that shaking hands with the butcher was the
source of transmission. Using this information she was finally able to develop a comprehensive

AN EPIDEMIOLOGIAL LOOK AT CONTAGION

image of the outbreak by showing its trend over time, its geographic extent (It started in Hong
Kong), and the populations affected by the disease. (United States first, then worldwide.) This
data was then used by Dr. Hextall to form a causal hypotheses about the disease and how to
begin experimenting with a vaccine

The epidemiologic triangle

The epidemiological model states that in order for a disease to spread there must be an
agent, a host, and environment. This forms a triangle that connects during an epidemic or mass
outbreak. In the film, the agent is the MEV-I virus itself and the host and environment were
revealed at the end of the movie when they showed a flashback of how the virus spread to Beth.
An infected bat is shown eating a banana; a piece of the banana drops into a pigpen, the pig eats
the banana and becomes infected. That pig is later butchered. The chef butchering the pig does
not wash his hands before shaking hands with Beth and then spreads the infection to her. Once
Beth contracts the virus, the disease spreads easily via both fomites and airborne routes. A fomite
is an inanimate object, substance or source of disease that can continue to transmit infectious
organisms from one individual to another, thus leading to an outbreak of disease (Tulchinsky &
Varavikova, 2014, p. 153). In Contagion, the means of transmission was respiratory and on
fomites such as bedding, fabric airplane seats and a drinking glass.

Primary, secondary and tertiary levels of prevention

Primary Prevention Strategies to protect healthy people from developing the disease were
to quarantine uninfected persons in their homes to prevent exposure while waiting for the

AN EPIDEMIOLOGIAL LOOK AT CONTAGION

development and administration of the vaccine. People were educated on the symptoms of the
MEV-I virus so that they could sequester themselves to prevent the spread of the disease. People
were also shown using hand sanitizer. Contagion's process of administering the vaccine to health
professionals first and to the rest of the people by lottery, while seemingly fair, doesnt match the
CDCs preferred way of triaging in these situations. In 2009, when the CDC had to distribute
limited amounts of the H1N1 vaccine, it selected a method that made sense and was widely
accepted by the public: it gave preference to those most susceptible to infection and those who
might suffer grave consequences from infection, such as pregnant women. The second-level
preference was given to first responders, nurses, and doctors, and so on (CDC.gov).
Secondary Prevention Strategies happened after people contracted the virus. The goal
was to halt or slow the progress of disease or try to cure it, and the only possible cure, some
thought, was Forsythia. In short, supply, people fought over it, and most people did not get a
dosage. The film later revealed it was ineffective.
The MEV-I virus was especially virulent and did not lend itself to traditional Tertiary
Prevention tactics which are to manage the long-term health problems associated with the
disease and maximize quality of life. The most that could be done for anyone was comfort
measures to reduce fever and dehydration. Most died anyway. The fictional MEV-I virus is
modeled closely to the real Nipah virus, which has a 74.5% mortality rate (Searo.Who.int).

AN EPIDEMIOLOGIAL LOOK AT CONTAGION

Resources:

Cdc.gov,. 'Prevention Strategies For Seasonal Influenza In Healthcare Settings | Health

Professionals | Seasonal Influenza (Flu)'. N.p., 2015. Web.
http://www.cdc.gov/flu/professionals/infectioncontrol/healthcaresettings.htm

Searo.who.int,. 'SEARO | Nipah Virus Outbreaks In The WHO South-East Asia Region'. N.p.,
2015. Web.
http://www.searo.who.int/entity/emerging_diseases/links/nipah_virus_outbreaks_sear/en/

Soderbergh, S., Burns, S. Z., Shamberg, M., Sher, S., Jacobs, G., Winslet, K., Fishburne, L.,
Warner Bros. Entertainment. (2012). Contagion. California: Warner Bros. Entertainment.

Tulchinsky, T. H., & Varavikova, E. (2014). Communicable Diseases. In The new public health
(3rd ed., p. 153). Academic Press.

Who.int,. 'WHO | Nipah Virus (Niv) Infection'. N.p., 2015. Web

http://www.who.int/csr/disease/nipah/en/