Lions, tigers and ebola–oh my!

ebolavirusUnless you’ve been living under a rock (which is admittedly difficult), you might be aware of the Ebola virus. And that it has entered the USA–one patient, not exactly an epidemic. And, according to public health officials, about 10 people are at risk from the disease from contact with this “patient zero” in the USA. Despite these minuscule, small, tiny numbers, you’d think America is facing a disaster of epic proportions.

Not so fast. I’m not saying we should ignore this disease, or minimize it’s danger, but seriously, in the grand scheme of the world, is this something to actually worry about? I have completely ignored the disease, other than mocking homeopaths for attempting to cure the disease, because there are so many infectious diseases that are actually more scary than Ebola.

Let’s get some facts then.

What is Ebola?

Ebola, which is sometimes called Ebola hemorrhagic fever, is a fairly rare, but deadly, disease caused by the Ebolavirus, a genus within the family Filoviridae. Ebolavirus can infect both human and nonhuman primates (monkeys, gorillas, and chimpanzees). There are five Ebolavirus species, four of which can infect humans. All have the same signs and symptoms in humans, and must be treated in the same way.

Ebola is not easily transmitted, and it cannot be spread through air, water, and food (with the except of contaminated meat). Insects do not transmit the virus, only mammals can be infected and spread the Ebolavirus.

The only way that the Ebolavirus is transmitted from human to human is:

  1. blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola.
  2. objects (like needles and syringes) that have been contaminated with the virus

Though this may sound like a clear and present danger. But in the world of reality, it generally means that unless you’re in close contact with a victim of Ebola, it’s not going to be easily transmitted from person to person. This isn’t like the flu or other vaccine prevented diseases, which can be spread by casual contact, or by someone sneezing in an enclosed space. I’d be much more concerned that the person coughing on the bus is going to transmit the flu or whooping cough to me than Ebola.

In an area with modern medicine, which includes much of the developed world, treatment of the disease is surprisingly simple. Early intervention with oxygen and fluid replacement, along with treatment of secondary infections, is extremely effective. As infectious diseases go, Ebola may actually be one of the least dangerous if it is treated quickly. What is scary, however, is that if left untreated the prognosis is poor.

How dangerous is Ebola compared to other diseases?

Fox-ebola-fear

There have been around 14,000 case of Ebola this year in West Africa, which seems to be ground zero for the disease. The death rate for the disease, in West Africa, is around 40-60%, but the rate is lower as more medical resources have been sent to Africa. Let’s put this into further context–the total population of West Africa is around 245 million, which means the absolute risk right now would be estimated to be 6 out of 100,000. That number simply does not scare me.

Why? Because there are many more frightening diseases (both infectious and non-infectious) in the USA. Today. Right now.

I could go on and on and on. Yet, politicians and the popular press is screaming and yelling about Ebola. They want to ban travelers coming to the USA from West Africa. Some want to expel people from these countries (but with Congress’ xenophobia, that’s to be expected). However, we actually ignore the things that actually can kill us. We can prevent flu epidemics that are seriously more scary. We could do much better with heart disease with better screening and management. We can control guns. We can force drunk drivers off the road.

But none of those make the headlines like Ebola. Because many people can only focus on 140 characters on their Twitter feed, and EBOLA COMES TO THE USA makes people read than FLU HAS 6X MORE HOSPITALIZATIONS THAN EBOLA. Partially, it’s because if you asked the average person across the world, they think that flu is nothing more than an inconvenience. But, Ebola kills. Millions of people.

I find the Ebola outbreak to be somewhat scientifically interesting, but personally, not that important. I’m more worried about the type 2 diabetes epidemic across the world. Or vaccine deniers who put innocent people at risk. Or irresponsible gun owners (and I do realize that most gun owners are responsible) who allow children to access guns. Or the high rate of smoking in some countries that contributes to higher rates of heart disease. Or anything else. Ebola probably ranks #47 on my list of 100 things to worry about. Slightly above being hit by a random meteor. And far below heart disease.

 

Key citations:

The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!

10 Replies to “Lions, tigers and ebola–oh my!”

  1. Actually I would not want to be the same room with an Ebola victim if they were coughing or sneezing. Droplet transmission, or droplet to hand transmission would be quite possible. Small fluid droplets could easily transmit the disease from coughing or sneezing, probably up to 6 feet directly. No, I think I’d much rather not be near a victim in a bus, train or plane. It’s transmission characteristics seem closer to TB than flu, but that does not mean it’s hard to transmit. It’s just that flu is remarkably easy to transmit. And remember, flu isn’t 50% (or more) fatal! No, if Ebola gets here and begins to be transmitted in an uncontrolled fashion then a rather nasty, if little, outbreak is quite possible. Panic and hysteria would almost certainly result in the hygienic precautions required to quickly end it. Until the fear of disease had overcome our Polly-annyish reluctance to take stern measures to reduce the low, but real risks, we would remain vulnerable to an outbreak. If one were to happen that hysteria and panic would probably be worse than the disease even. So perhaps it might be better to implement risk reduction strategies (like for example restrictions on travel from affected West Africa) now, when they can be carefully controlled and reasonably handled, rather than with harsh overkill in reaction to an actual outbreak.

    1. Couple of points.

      Ebola does not have a risk of 50% mortality. In fact, in a modern healthcare environment, it might be close to zero, which is far below the flu. If you look at the Ebola outbreak, the mortality rate is dropping quickly as more medical resources are employed.

      In addition, there are lots of reasons why aerosol transmission of the Ebolavirus has a low risk. Everyone assumes that viruses are somehow perfectly adapted to everything, but they are not. Moreover, the viral load in saliva is small versus blood and feces. I probably would rather avoid an Ebola victim on a crowded bus, but since that’s outside of my control, I know that the risk of contracting the disease is vanishingly small.

      It’s all about risk, not putting together a large set of assumptions that tries to increase the risk is not logical from my standpoint.

    2. In addition to the fact that Ebola is not though to be spread by aerosol transmission and that you are very unlikely to be in the same room with someone with Ebola (or on bus, plane, or train), coughing and sneezing are not typical Ebola symptoms. And the best risk reduction strategy is going to be working to help control the Ebola epidemic in West Africa.

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