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Virtual epidemics may hold scientific promise

Some see the recent plague that ran amok in the online game "World of Warcraft" as a valuable tool for examining how a real pandemic might behave. Images: Deadly virtual outbreak

When Erik Jacobson fell victim to a recent plague that ravaged the online game "World of Warcraft" and caused his character to squirt blood, he and other players laughed it off as a harmless bug that caused some temporary sickness.

The plague, which hit the virtual world in late September, quickly propagated, causing the temporary death of innumerable players and significant damage to large numbers of others. But it didn't have any lasting effect: Those hit by the disease were either healed or quickly reborn.

But to some scientists and educators, virtual reality outbreaks like the one that slammed "World of Warcraft" could prove a valuable tool for studying the spread of infectious diseases--as well as public response to them. The correlation between online and real-world behavior in the face of epidemics, they say, takes on heightened significance in the face of public-health threats like a potential avian flu pandemic.

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Could witnessing players' behavior in online plagues help save real-world lives?

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Some say virtual online worlds--where players' economic and social behavior is often a microcosm of their real-world behavior--are a perfect place to compare real-world infectious diseases with those comprised only of digital ones and zeros.

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"Similar to a natural virus, (which) in its DNA has the information encoded about what it's going to do, in a virtual world, when you have an outbreak, you have a piece of code with instructions about what it's going to do," said Yasmin Kafai, an associate professor of learning and instruction at UCLA's Graduate School of Education and Information Studies.

Kafai and her colleague, Nina Neulight, recently conducted an investigation into "students' understanding of a virtual infectious disease (Word document) in relation to their understanding of natural infectious diseases." To do so, they intentionally spread a disease called Whypox through the online children's game "Whyville."

To Kafai, virtual online worlds--where players' economic and social behavior is often a microcosm of their off-line behavior--are a perfect place to compare real-world infectious diseases with those comprised only of digital ones and zeros. Among other things, she explained, virtual environments can allow researchers to see how social ostracization occurs as a disease spreads and people try to avoid going near the infected.

In her report on the Whypox study, Kafai said that results were mixed. On the one hand, the virtual sickness "capitalized on students' knowledge of natural infectious disease through virtual symptoms." But she also noted that the children likely saw the spread of the disease as little more than something to watch rather than as an actual biological process to learn from.

In the case of WoW, while many players were instantly affected by the plague, others found they could avoid it by maintaining a distance from victims. At the same time, many players used healing spells to help the afflicted recover.

One WoW player, known as Valewalker, told CNET News.com that the effects of the plague looked like a scene from a Steven Spielberg movie.

"Someone teleports into town with the effect of the disease on them," Valewalker said. "It was like dominos watching the plague itself hop from person to person within personal space of each other. And next thing I saw was many players dead left and right in seconds."

WoW plague

Patrick Bowman, a production coordinator at Activision (not the maker of WoW) and an avid WoW player who fell victim to the plague, saw similar scenes, and like many others, decided it would be amusing to see if he could intentionally spread the disease.

"I...saw hundreds of dead bodies and bones around the area," Bowman said. "I realized that now it was actually spreading from person to person so I ran over to the Fly Point and affected everyone around it."

WoW is the most successful massively multiplayer online game in U.S. history, partly due to remarkable player loyalty, as well as what many say is the best implementation of game play, graphics, user interface and story line of any online game.

Jacobson explained that the disease was not originally supposed to spread, but was intended as a way to inflict temporary damage on high-level players attacking a "boss" in one area of the game.

"It (was) meant to spread within the raid group attacking him with the plague as it does...damage to anyone who gets it," Jacobson said.

Pets infect players
What was unexpected, he said, was the way the plague infected players' pets and then later transferred from those pets to others in populated areas of the WoW world.

"People would infect nonplayer characters standing next to each other and continue spreading to any players who wandered nearby," Jacobson said. "Pretty much anyone under level 20 would die from it after getting it."

Blizzard would say only that the plague had been the result of a bug and had been quickly fixed.

But according to Bowman, at least half of the players on his WoW server--the game is broken into numerous servers in order to adequately handle the game's more than 4 million players--were afflicted at any given time in the days immediately after the outbreak. Further, he said, as many as 10 percent of those players' characters died.

To be sure, many epidemiologists may never have heard of WoW. But at least one, Nina Fefferman, a Tufts University assistant research professor of public health and family medicine, took notice of the scourge. She recently told National Public Radio that players' reactions to the WoW plague were realistic. Fefferman--who did not return phone calls or an e-mail asking for comment--also said she would like to partner with a game company in a formal study of an outbreak of an infectious disease in a virtual world.

Getting the right information out
"I think that's a great idea," said Alan Tice, an infectious disease specialist and a professor at the University of Hawaii's John A. Burns School of Medicine. "It would be a valuable thing and an important thing, particularly when it comes to infectious disease. How do we get information out to people? It's a big problem, getting things out to people in a timely manner and with appropriate information."

While Tice was not directly familiar with the WoW plague, he instantly saw the potential of such an online virtual world to be a test bed where scientists could watch the way dangerous diseases spread and how people react as they try to get out of its path.

"How many people are there? How many people open it? This is important from a public-health standpoint," Tice said.

Tice said the most important element of keeping a quickly spreading disease under control is managing the attendant spread of information about it. Because environments like WoW and "Whyville" give players easy access to communication tools, researchers can track how such tools are used and how effective they are at giving players the data they need to stay out of harm's way.

Players like Jacobson and Bowman agree that a game like WoW could be a fascinating infectious disease test bed, but caution that there are limits to how effective such an experiment could be.

"I think on a very basic level, it may be an indication of how something can spread in a synthetic environment," said Bowman. But "it would be hard to mimic real-life scenarios since the means of delivery are limited in some way, shape or form. In the end it is all code and there are only so many ways that you can affect someone."

Jacobson acknowledged that during the WoW plague, players were attempting to inform each other about how to steer clear of the disease and were also working hard to heal victims as they were hit--both likely scenarios of a real-life outbreak.

But he said that that without the consequences of a true plague, many players wouldn't take it seriously.

To Tice, however, that's exactly why such virtual worlds are a terrific place to study how people react to a fast-spreading disease.

With modern communications tools, "you can't do blood testing, but you can (discuss) clinical descriptions," Tice said. You can have "people providing information to others about recognition, about diagnoses, 'Do you have the disease,' etc. It's also critical in getting the right information out there."