Viral infections and risks in wine and medicine

Nothing is more useful than wine for strengthening the body, and at the same time more harmful to our pleasure if it is lacking in moderation..

Pliny the Elder (Gaius Plinius Secundus), Roman philosopher, a man who had opinions on many things. Figure 1 23 AD – 79 AD.

I am always amazed when well-known wine writers and sources like Wikipedia talk about grapevines having symptoms, when in fact grapevines cannot have symptoms if they cannot speak! Symptoms are what the person complains about and signs are what the observer (usually a healthcare worker) perceives.

Is there any activity in life that is risk-free? Many years ago I flew to Japan for a medical conference. My mother (who has since passed away) called me and said she was very worried and would pray for my safe return. A few weeks later I left for a medical conference, which is statistically a much riskier activity, but she never called me! So despite the inherent risk of some activities, if the benefit seems worth the risk, we go ahead.

Eric Asimov, probably my favorite wine writer, has an interesting article in the New York Times [1] “In defense of wine.” He points out that wine sales are declining and health concerns are increasing. He rightly points out that the 2023 WHO report says there is no alcohol content that is safe for human consumption. [2]. It is difficult to imagine that longitudinal studies of people who drink a few milliliters of wine a day would show any resulting health risk compared to a group of the same age who never drink wine. In vitro data may be convincing, but in vivo data are difficult to imagine. He discusses the many cultural and social benefits of drinking wine while pointing out the dangers of overindulging. Like many of us, he engages in many risky activities such as driving and flying, even though both activities should be restricted according to the “greens” because of their contribution to pollution. This opens up the whole philosophical notion of risk, which is relatively new, having only been popular since the early 1970s. Although risk is a favorite pastime of fund managers and bankers, some people claim that a person's first trip through the birth canal is the riskiest journey of their life!

Returning to the theme of wine drinking and risk, Asimov also says:Good wine invigorates and refreshes. It is an invitation to visit other cultures and worlds, to learn about history and geology, agriculture and environmental protection. Aged wine offers a Journey through timeIt can be a gateway to philosophy and contemplation. Whether you agree or not, it is difficult to imagine a world without wine. But he warns: Yes, wine, like all alcoholic beverages, can be dangerous. Uncontrolled consumption can pose a threat. Societies struggle to balance the benefits and dangers of alcohol in a cycle that ranges from total prohibition to excessive permissiveness..

And what about viruses? Many/some will still remember the times when people reacted to a cold, cough and perhaps a slight rise in fever with the comment:Don't worry, it's probably a virus and should clear up in a few days. Drink plenty of fluids and if the high fever bothers you, take some antipyretic analgesics..' Some may remember Eugene O'Neill's great play 'Long Day's Journey into Night' when a cough and fever were called 'summer colds' when in fact they were tuberculosis.

This was all very well until the first case of Covid-19 infection with SARS-CoV-2 was diagnosed in China in late 2019, and the viral infection began to appear in other countries in early 2020. A pandemic quickly ensued, resulting in many deaths, mostly from respiratory failure. Patients in nursing homes became infected and many succumbed to the disease. This proved particularly distressing for their families, who could not be with them. The response to the pandemic varied in different countries, but the general method of preventing contagion was to impose a curfew. This was remarkably similar to attempts to stop the spread of the “plague” in Florence in the 14th century.^th Century.

The big difference between previous pandemics and the infection caused by SARS-CoV-2 Covid 19 was the rapid development of vaccines. Although the vaccines did not confer lifelong immunity, the severity of the infection was significantly reduced and the number of deaths correspondingly lower. Despite the propaganda of the “anti-vaxxers”, the vaccines have been widely accepted and infection with SARS CoV-2 is no longer feared by health authorities or the general public as it was in the pre-vaccination era.

Unfortunately, however, many teenagers and young adults have suffered from mental health issues during isolation, and many believe that mental health issues are part of the “Long Covid” syndrome. Mental health issues may be more widespread than many doctors and health authorities believe, and the long-term consequences of such outcomes are still unknown.

In addition, many hospitals and isolation wards were overwhelmed and numerous surgical procedures had to be postponed or cancelled. The long-term effects of this are not yet clear. Perhaps we had become complacent? After all, we had virtually eradicated polio, smallpox and measles in many countries through active and successful vaccination programmes and probably did not expect a viral pandemic with such devastating consequences.

In the world of wine I recently learned [3] of a new disease caused by a virus called “red spot disease” (Fig. 2) and the virus that causes it is known as red spot virus (GRBV) (Fig. 3). The virus was first identified in California as a single-stranded circular DNA virus. According to Wikipedia, the virus affects all grape varieties. The leaves of the affected vines have red or pale yellow spots, which leads to a loss of grape juice. The vector is the three-edged alfalfa bushhopper (TCAH) (Spissistilus festinus). Unfortunately, according to Jancis Robinson, it is currently [4]the only cure seems to be to pull out the infected plants, which means a loss of income for the winegrower. Winegrowers have to worry not only about viral infections, but also other infections. In Tuscany, this year's spring was wet and cool, creating a climate conducive to fungal diseases in vines. According to Barbara Widmer of La Brancaia (personal communication), 'powdery mildew' is a particular problem and organic anti-fungal sprays are often used. Fortunately, red spot disease has not yet been detected in Italy. So planting a vine involves risks: will the clone be the best, will the weather be conducive to good grape development, will there be hailstorms in July, which can be particularly dangerous for ripening grapes?

A healthy vine (left) next to a vine infected with red spot virus. From: A guide to grapevine diseases and their impact on global wine production. PhysOrg, November 14^th 2023.

Adapted from the International Committee on Taxonomy of Viruses.

Whatever you think about the dangers of wine, there is no doubt that moderate consumption, usually with food, can be a satisfying experience. Overindulgence, especially during pregnancy [5] can have disastrous consequences. No matter how risky crossing the street, driving a car, riding a bike or drinking a glass of wine is, make up your own mind about the risks and benefits.

I am grateful to Professor Robert P. Gale for bringing Asimov's article to my attention.