Bioscope ‘07

by  Dr. Barbara Price

Politics and Disease

Ebola

         Ebola is again emerging in central Africa, in Uganda, with concerns voiced by all the countries in the region. This time a new strain may be involved because the usual symptoms, dramatized in novels and movies, were not as prevalent. The new outbreak probably started in August or September but was not identified until November as Ebola.

          Political fears have been amplified by allegations that the Ugandan government tried to cover-up the outbreak so that the Commonwealth of Nations meeting (including Queen Elizabeth) in late November would not be affected. On a positive note, the number of fatalities from this "new strain" appears to be under 30%, much lower than the previous outbreak with a mortality of over 50%; if there is a new strain, the mortality may be lower. However, testing for a new strain has not been completed. While Uganda's health ministry has discouraged gatherings, many citizens are concerned about fear coloring all aspects of society, including international athletic events, holidays, neighboring country elections and normal greetings.

H5N1

          Ten years ago this month, H5N1 emerged with the first cases in Hong Kong. Even in the US, the CDC had to borrow space at the USDA laboratory to get the biosecurity needed to work with and identify the avian flu virus. H5N1 avian flu is now endemic in Asia and Africa, and, potentially in Europe. Indonesia has been hardest hit with human fatalities of 80% for the 115 victims -- 61% (206 out of 335) in the rest of the world. The importance of protecting intellectual property, but also ensuring affordable treatment and equipment in the developing world to stop the spread, has been one of the impetuses in getting a framework for cooperation between countries.

Infectivity and Preparedness

          The biggest difference between Ebola and H5N1, in terms of epidemic potential, is the infectivity of H5N1. Historically the infectivity of influenza viruses is high. Flocks of poultry have the disease; it passes between individual birds quickly. If changes allow the virus to be transmitted between humans, the potential for a quick moving pandemic increases rapidly. So far, it has only been confirmed to pass from fowl to human, but we prepare for the eventuality that human to human transmission will occur. Another difference is mortality and public perception. Is Ebola really a more frightening disease than H5N1?

          Despite the prominence of H5N1 and SARS in the news, many health departments and ministries still judge themselves ill-prepared for an influenza pandemic. We should be further ahead than we were in 1997. Certainly all countries have all spent lots of money organizing, exercising, and building labs for research and identifying emerging viruses

For the Professional in Government and Industry with an interest in Nuclear, Biological and Chemical Defense, Disarmament and Verification; Emergency and Disaster Medical Planning; Industrial Health and Safety; and Environmental Protection