One of the most controversial questions during the current Ebola outbreak has been whether restricting air travel to West Africa is more of a help or a hindrance. There have been passionate arguments on both sides, and the question has become politicized. For a balanced look at the question, see this recent National Geographic article. I found some of the better comments on this piece to be nearly as enlightening as the article itself. The bottom line is that there are pros and cons to both policies, which need to be acknowledged by each side in the debate. …
This morning we learned that sad news that Thomas Eric Duncan has died in Ebola in Texas. While much of the recent coverage of Ebola has focused on the United States, an outstanding piece in the Washington Post (Out of Control: How the World’s Health Organizations failed to stop the Ebola disaster) provides an excellent history of the Ebola outbreak. Through interviews with medical personnel in West Africa, it describes how it was that the international community failed to intervene until too late.
Prof. Smallman, International Studies, Portland State University.
WHO: Map of Ebola Cases in Guinea, Liberia and Sierra Leone as of 6 September 2014
The Ebola outbreak in West Africa has not received the resources it merits, in part because other Ebola outbreaks proved relatively easy to contain. Those epidemics, however, tended to take place in a rural context, and Africa has changed profoundly since the 1970s. The urbanization and transportation networks that are remaking the region have also meant that it is far easier for diseases to spread. The current outbreak is expanding exponentially. The latest map on the Ebola outbreak by the World Health Organization makes clear the scale of the challenge that the global community now faces. When you look at this map, keep in mind that these are confirmed cases. So this map is an underestimate. According to some calculations, there may be 100,000 cases in Africa by December. Without rapid and massive international aid, this outbreak will not be controlled. On Twitter? I recommend following Laurie Garrett (Pulitzer prize winner for her writing on public health), who has a great commentary on the outbreak, which includes key documents such as this map. If you are interested in global health, you might also be interested in my book on the AIDS Pandemic in Latin America.
There is a great deal of news today about Ebola, which has now spread to Senegal, the fifth country in West Africa to be affected by the outbreak. The nation has tried to protect itself by banning flights from affected countries, but this is unlikely to be effective given that most people cross the border by ground transport. In Liberia the government has lifted the quarantine on the slum community of West Point, after widespread media reports that the quarantine was being flouted by people who bribed police to leave. At this time, quarantines do not seem to be effective in dense urban environments in developing countries; they are difficult to enforce, and the social costs are high. …
“Wallpaper World” by Salvatore Vuono at freedigitalphotos.net
A crowd of men recently overran an Ebola clinic in Liberia, after which 17 patients disappeared. One of the factors driving this event may have been a sense of denial that Ebola exists. Such concerns led to an improbable new pop culture hit in West Africa: a song titled “Ebola in Town.” In recent article on NPR (titled “`Shadow and `D-12′ Sing an infectious song about Ebola”) John Poole describes the emergence of this unlikely piece. At first, there would seem to be few things more inappropriate than a pop song about a fatal disease. But the song emerged from local concerns that people did not believe in Ebola, or understand how to fight the spread of the disease. For this reason, the song informs people about the appearance of Ebola, its spread through physical contact, the importance of social distancing and the dangers of bush meat. All with a catchy beat. Click here to read Poole’s article and hear the song. And bravo to NPR in general for their great coverage of the outbreak. Want to read more about the epidemic? One great source is Ian Mackay’s blog, Virology Down Under.
Today a clinic in Liberia that cares for Ebola patients was overrun. The looters even stole a bloodied mattress, while patients left the facility. Everyone receiving care at the center had tested positive for Ebola, and seventeen of them had disappeared after this tumult. According to Elise Zoker and Caroline Chen’s piece in the Sydney Morning Herald, one of the attackers said that they did not believe in “this Ebola outbreak.” To many readers, it may seem inconceivable that people would choose to take people infected with a deadly and communicable disease back to their families or neighborhoods. It’s perhaps equally unthinkable that people would walk unprotected through a facility drenched in a virus so deadly that it should be contained in a biohazard level four facility, and then take an item soaked in the blood of an Ebola patient. But such strange behavior is not new; denial has always been a part of major disease outbreaks. When I read this news, it reminded me of the early history of HIV. …
The Spanish Influenza. Chart showing mortality from the 1918 influenza pandemic in the US and Europe. Wikipedia commons.
In 2009 people globally learned of the appearance of a new strain of influenza named H1N1A or “swine flu” in Mexico. By June the World Health Organization had declared the outbreak to be a pandemic, the U.S. and European governments were spending billions of dollars on vaccines and medications, and the tourism industry in Mexico was devastated. For most Americans, vaccine became available only after influenza had already peaked in their communities. Predictably there was an outburst of anger when the mortality rate proved to be low, as people felt that they had been misled by authorities, and frightened unnecessarily. Conspiracy theories regarding the WHO, pharmaceutical companies, and national governments abounded on Youtube and Twitter. While the mechanisms for communication were new, the problem faced by governments was not. Indeed, the U.S. had faced a similar situation in the 1970s. A historical perspective on influenza can provide some much needed context for policymakers and health authorities. George Dehner’s recent book, Global Flu and You: A History of Influenza, is a concise, well written organized overview of influenza’s history, which can help us to better understand contemporary health issues. …
“Camel Caravan In A Desert” by m_bartosch at freedigitalphotos.net
MERS COV (Middle East Respiratory Syndrome Coronavirus) first appeared in Saudi Arabia in 2012. This disease is caused by a corona-virus, much like the SARS epidemic in 2003. A great deal of work was done early in the epidemic to identify the original host for this virus. Although there is a great deal of evidence associating the virus with camels, which are also infected, it now seems that the original host may be the Egyptian tomb bat, an appropriately scary name for a disease vector. Given that many other viruses seem to have bats as their original hosts, this would be unsurprising if true. The disease is a respiratory virus, which causes difficulty breathing, coughing, and fatigue. Roughly 40% of patients die. …
“Burning Sugar Cane” by think4photop at freedigitalphotos.net
I’ve written twice before on this blog about an emerging disease in Central America called Chronic Kidney Disease. In my original post I described how in some communities in the region between a quarter and seventy percent of men may suffer from the disorder, which is a truly staggering number. In a subsequent post, I argued that something mysterious was happening in Central America, because the disease appears to be something new. While some people argue that the illness takes place because of pesticide exposure or dehydration, this argument seems problematic to me. If this is true, why do we not see a similar illness in the Caribbean or the Atlantic coast of Brazil? That is why in this post I suggested changing the name of the disorder to EKD, so as to reflect the disease’s novelty. The fact that the illness focuses on the Pacific Coast of Central America, mainly affects men, but also seems to impact workers outside the sugar cane industry, all seems significant to me. …
“Chest X-rays, 3D Image of lungs, Sagital Plane Image” by Praisaeng at freedigitalphotos.net
Valley fever (cocci dioides), a fungal disease in the Arizona, New Mexico and California, has received a great deal of media attention lately, with good reason. There have been over 20,000 cases documented, which likely is only a fraction of the total number of people infected. Tom Geoghagen of the BBC has a good piece on the disease, and the video interviews of the affected families are heartbreaking. In late June 2013 a judge in California ordered California to move inmates held in two prisons in San Joaquin in order to reduce their risk of contracting the disease, which made people living in local communities wonder if they should also move. …
One of the most controversial questions during the current Ebola outbreak has been whether restricting air travel to West Africa is more of a help or a hindrance. There have been passionate arguments on both sides, and the question has become politicized. For a balanced look at the question, see this recent National Geographic article. I found some of the better comments on this piece to be nearly as enlightening as the article itself. The bottom line is that there are pros and cons to both policies, which need to be acknowledged by each side in the debate. …
