Fever

24 10 2014

As is not-unexpected, New York has its first case of Ebola.

Am I worried? Nope, not even a little—at least, not for myself. For the doc who got it, on the other hand. . . .

My students have asked me, a not-MD, about Ebola, and I have been vigilant in cutting down any fears about the disease. I even went after a colleague who said she was hesitant to fly due to Ebola.

It’s not airborne! I barked at her. You’re not going to get it.

And that is the crucial piece for those of us who a) do not live in Guinea, Liberia, or Sierra Leone, and b) are neither health care nor mortuary workers—i.e., those of us who are unlikely to come into contact with the bodily fluids of infected persons.

Those who are likely to so come into contact are at great risk: the virus is highly infectious, so tremendous caution must be taken to avoid contact with any fluid. But, again, for the rest of us—something else will get us before Ebola does.

Laurie Garrett introduced me (personally!) to Ebola in her terrific book, The Coming Plague. The cases she discussed had a very high kill rate—over 90 percent—which was both terrifying and, oddly, a kind of insurance against its spread: it killed people so quickly it could sweep through an isolated population before anyone had a chance to travel and transmit it elsewhere.

That kind of virulence-insurance would crumble once it reached more densely populated areas, which of course, it has. The death rate in some cases has fallen to “only” 50-60 percent, which is still appallingly high, and this microbe will kill thousands more people before health officials get ahead of it. That these outbreaks have occurred, and that the world health community (WHO, CDC, pharma, health ministries & depts, etc.)—with the exception of MSF—have, shall we say, underperformed in response to initial reports of its spread, is appalling in its own way, but there does seem to be a fair amount of confidence that the spread can be halted.

Or, to put it another way, Ebola may terrify us for its fast-moving virulence, but those old standbys HIV and malariaand flu—will likely kill far more people this year and next than Ebola.

This could change, of course: as Ebola spreads, it’s changing (as infectious microbes are wont to do), and epidemiologist Michael Osterholm has written of his fears that, via combination with other microbes, it could—could—become airborne.

Now, it’s possible that any mutations which lead to Ebola becoming a respiratory illness might also mean it becomes less virulent, but it’s also possible that it could join its mighty virulence to easy transmissibility to become a super-bug, much like the (misnamed) Spanish Flu pandemic of 1918.

If that happens, then, yep, I’ll be afraid.

But until then, I’ll be more worried that the kid sitting next to me or the guy standing in front of me on train will give me the regular old flu (due to my egg allergy, my doc advises against a flu shot) than a deadly hemorrhagic fever.

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One response

24 10 2014
dmf

we’ll see if the feds put money back in the WHO and the center for disease control or just keep cutting…
http://backdoorbroadcasting.net/2014/09/sally-davies-the-drugs-dont-work-a-global-threat/

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