Behold the pale rider. Only one death and three US cases treated and we already have an Ebola Czar. Why? Because the grisly hemorrhagic deaths are more newsworthy than morbidity from other infectious diseases, say like flu and pneumonia. And, there is no vaccine....and, ebola carries a high death rate....and, no one is certain what the best treatment is....and, Flu and Pneumonia are more boring, and, Ebola makes good press. Thus is the political reality of what gets people frightened and why we fund certain diseases.
I find the Ebola hysteria ironic working in Public Health. Slowly but surely, the personal belief exemption rate is climbing for children whose deluded parents see vaccines as not green, containing deleterious preservatives, causing autism, etc. However, these potentially deadly and disabling diseases are preventable. But throw in a lurid, exotic disease in a continent an ocean away and the panic builds. We are not vaccinating against disease what we can prevent; we are more concerned about being infected with a remote disease because of frenzy. Great, now everyone who did not get a flu shot who gets flu-like symptoms will think they have been exposed to Ebola.
Should we be concerned about Ebola? Yes, we should be concerned with the management of the disease, loss of life in West Africa, and what Ebola is doing to bankrupt those nations trying to manage the outbreak. But we should also be concerned the global community did not act swiftly enough to recognize how deadly this outbreak was and mobilize a contagion strategy. This is the sad reality in public health: finding funding to combat diseases before they become epidemic.
While the world is looking at West Africa, unfortunately no one is looking at Asia. For decades now, there have been numerous avian flu viruses wrecking havoc all over the world but primarily in Asia. The perfect storm of incubating a pandemic is people, poultry, and pork. Avian flu viruses assimilate easily in pigs, making these pandemic viruses a convenient route for humans. Though H5N1 did not become the global human pandemic that was feared, hundreds of people died and millions of birds were culled or succumbed to the disease.
But the untold story which continues out of Asia is the emergence of multiple strains of avian flu viruses. H5N1 continues to circulate in Asia (Russia, China, and SE Asia), however, there is also H5N2, H7N7, H5N6, H3N2, and H7N9. Of course, not all of these avian flu viruses are alike-some are more deadly than others. When H5N1 began circulating, telltale signs of the disease were the droopy beaks, fragile egg shells, pin point hemorrhages in the feet, and the cyanosis of the chicken's wattle and combs. The avian viruses looming on the horizon are becoming more lethal and show less symptoms in their hosts before they die. Added problems include third world farmer's hiding sick chickens from inspectors and a fairly high level of secrecy in identifying and managing the disease from countries like China. Here's a quote from Food and Agriculture Organization from the UN:
"Influenza viruses are constantly mixing and recombining to form new
threats," said FAO's Chief Veterinary Officer, Juan Lubroth. "However, H5N6 is
particularly worrisome, since it has been detected in several places so far from
one another, and because it is so highly pathogenic, meaning infected poultry
quickly become sick and, within 72 hours, death rates are very high."
The CDC made this same mistake with H1N1. In an attempt to get the public to take H1N1 as a serious threat and get the vaccine, they launched an ambitious public health campaign outlining the risks of getting this disease. Grandiose promises were made that vaccine would be available to stem the tide of the epidemic. It worked, but there was a big problem: by the time the vaccine was available, it had to be given to first responders and the most vulnerable population first. People who did not fit into those categories became angry and frightened about not being able to get the vaccine. When vaccine finally became widely available, people lost interest, got the disease (I did), or gave up trying. It was an eye opening year and an intense time to be working in immunization. In spite of mobilizing a huge vaccination campaign, that year saw millions of dollars wasted in H1N1 vaccine.
But let's get back to Ebola because it's scarier. We now see how a regional problem with infectious disease becomes a global threat. But this time there is no vaccine. The media is fueling anxiety because it's such a good horror story. And we all know some of the best horror stories are based on anxiety and not reality. The reality is one person died, three are currently infected from Ebola, and we now have an Ebola Czar.
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