Understanding orangutan respiratory disease syndrome (ORDS) could help conservation efforts to preserve this critically endangered species, according to speakers at Tuesday’s Plenary Session at the ATS 2024 International Conference.

Nancy Lung, VMD, MS, editor in chief of the Journal of Zoo and Wildlife Medicine, and Jennifer Taylor-Cousar, MD, MSCS, ATSF, pediatric and adult pulmonologist at National Jewish Health, discussed their collaboration to improve the management of ORDS.

Debra Boyer, MD, ATSF, and Immediate Past ATS President M. Patricia Rivera, MD, ATSF, moderated the session.

Orangutans are critically endangered due to deforestation and habitat loss in their native lands of Indonesia and Malaysia, caused primarily by the demand for palm oil. Reversing this trajectory will require international and corporate action, but the orangutans don’t have the time to wait. This is why a network of rescue centers is taking in starving and orphaned orangutans with plans to release them back into native forests, if possible.

“These animals exist as a protection against extinction of the entire species,” said Dr. Lung. “Our goal is to ensure these captive populations are sustainable until we have healthy, natural rain forests.”

Approximately 2,000 orangutans currently live in captivity in zoos and rescue centers. One of the biggest challenges to preserving this captive population is ORDS, a chronic condition characterized by recurrent infections in the sinuses, air sac, and airways that results in progressive airway destruction and early death.

Until recently, not much was known about the etiology of ORDS. Work by Dr. Taylor-Cousar and colleagues has shown that computed tomography scans and bronchoscopies of orangutans with ORDS closely resemble those of humans with cystic fibrosis (CF). Subsequent genetic analyses have identified a mutation in the CFTR gene, suggesting it may be hereditary. This finding has changed the way ORDS is managed.

“Until we started pursuing ORDS as a CF-like condition, it was managed as individual events. Animals presenting with respiratory disease received antibiotics and were managed surgically if needed. We didn’t realize the lungs and sinuses were so damaged” said Dr. Taylor-Cousar. “Now, we treat it similarly to CF, with nebulized hypertonic saline and albuterol, administering antibiotics when needed.”

Dr. Lung provided several examples of how people can support efforts to preserve orangutans. The Cheyenne Mountain Zoo has developed an app and other resources to help consumers choose products made with sustainable palm oil. She also recommended supporting organizations like The Borneo Orangutan Survival Foundation and the Sumatran Orangutan Conservation Programme.

“These are critically endangered animals. We aren’t doing this for the sake of human research,” said Dr. Taylor-Cousar. “But if we’re able to identify some non-CF bronchiectasis genetic variants, that could be very relevant to what we see in people.”

The Plenary Session also included the passing of the gavel from Dr. Rivera to current President Irina Petrache, MD, ATSF, the ratification of the bylaws, the 2024-2025 slate of officers, and the presentation of several respiratory health awards and presidential commendations. 

Dr. Rivera reflected on her tenure as president.

“The honor to serve as a leader in the ATS has given me the capacity to dare to be more, build more, and learn more,” she said. “But importantly, I’ve made a lot of new friends along the way.”

Dr. Petrache accepted the gavel and remarked on her new role. “I’m grateful to be taking over the leadership of an organization that has made so many strides in promoting women in leadership,” she said. “I want our organization to continue to fight for health equity around the world, for clean air, and a tobacco- and vaping-free environment.”