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EBOLA: What to really be concerned about:

EBOLA, what to really be concerned about:

Many of you may know that I have worked in the infectious disease arena for many years and while I wouldn't suggest that the Ebola threat isn't serious, especially with a reported 70% death rate, I thought I would just offer the following perspectives so that readers of my blog don't get caught up in the media frenzy of looking for the next patient and "disappointed" that it's not an epidemic in the U.S.. Ebola has without doubt created a significant health crisis in West Africa. At this writing, nearly 1500 people have died in the coastal countries of Sierra Leone, Guinea, and Liberia. This region is generally without modern hospitals, clean water, medical education and access to care, and most live in close quarters and in densely populated communities. Those are ingredients for an infectious epidemic. That is not the case in the U.S. and while sadly some will be horribly affected here, this will be controlled.

MORE CONCERNING is that people in the U.S. don't have the same fear and preparation for "the flu"...yes plain old influenza. Some facts to consider:

Around 3-5 million people around the world become severely ill due to the flu virus every year, resulting in 250,000-300,000 deaths! That's a frightening number of people, even though the actual mortality rate is fairly low. In contrast, the 1918-19 influenza pandemic took an estimated 31 million lives worldwide. In the last ten years, the flu has claimed an average of 32,000 lives/year in the U.S. according to the CDC.

However, this is just "plain old seasonal flu". There are novel strains, such as those typically found in animals. "Bird flu" or influenza virus subtypes H5N1 and H7N9 contain strains that are found in birds that have the potential to cause disease in humans. Some strains of H5N1 are highly virulent, and have wiped out tens of millions of birds and has had a 60% mortality rate in humans. The virus can pass from infected bird to human, but does not readily spread from person to person. H5N1 can mutate so fears about "bird flu" are justified.

It's also worth noting that the H1N1 pandemic of 2009 was caused by a strain that was quite similar to one found in pigs, leading to the nickname "swine flu." During that year's flu season, the majority of cases were due to H1N1. From April 2009 through May 2010, there were over 18,000 laboratory-confirmed deaths due to H1N1. However, some estimates have put the actual number of deaths at nearly 15 times higher, citing a lack of laboratory testing in the hardest-hit areas as a reason for the underreporting.


Flu vaccines need to be administered each year because of the incredibly high mutation rate. Each passing year brings the possibility of another strain that could have devastating consequences especially for those who are more frail, have concomitant disease, or are immune-compromised (cancer patients, HIV patients, etc.). Please get vaccinated before Thanksgiving this year not just to protect yourself, but because if you come down with the flu, who else will you put at risk?

SO, help this humble author put an Ebola viral epidemic in perspective and if you're going to get riled-up about anything, let's get some pressure on the current federal administration to 1) provide more transparency about what's actually happening and to whom, 2) put the necessary resources in motion to deal with Ebola, and 3) close the inbound borders to known areas of transmission. This is not a time for political campaigning by any party.

Photo credit: dgpaulart

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