There’s This Nasty Little Disease

Let me start by saying that I am not a doctor or any other kind of medical professional. I’m just a voracious reader with a lot of general scientific and technical interests and background. I’m the perfect demographic to be a Scientific American reader. The point being that what I pass on to you here is what I understand, but I could well be wrong on some points, minor or major. Check your sources.

Twenty years ago I saw a review of a new non-fiction book by Richard Preston, “The Hot Zone.” The book is beautifully written and stunningly terrifying. It is a wonderful introduction to a class of diseases which are emerging from West Africa. Outbreaks of these diseases have been seen in Uganda, Angola, Zimbabwe, Kenya, and the Democratic Republic of the Congo.

These viral hemorrhagic diseases, such as Marburg and Ebola, are rare, which is good for the human race. It is somewhat difficult for the virus to spread. “Somewhat” is the key word. They’re not spread as easily as the common cold virus, or measles, or the flu. For the most part, you need to have direct contact with blood, bodily fluids, or tissues that are infected. You can also get infected by handling or eating infected animals (monkeys are suspected to be a key vector) or being exposed to infected guano in caves (bats are another).

They are also incredibly deadly with no known cures, which has the potential to be very bad for the human race. Ebola kills nine out of ten people it infects, and it’s not a pretty death. “Hemorrhagic” diseases are so named because they cause you to hemorrhage from just about every orifice in the body. The specifics and explicit details I’ll leave to those who want to read the book. (Highly recommended, by the way! But most definitely not for the faint of heart.)

So far, the outbreaks have been largely contained in Africa, with only a few cases of travelers coming home from Africa (for example, to Germany, the US, Netherlands) while infected. The number of deaths per outbreak has been relatively small, averaging a couple dozen each, with worst cases (so far) being about 225 deaths in one outbreak for Marburg (Angola, 2004-2005), 280 for Ebola (Zaire, 1976).

For comparison, the common flu is estimated by the CDC to kill on average about 36,000 people every year just in the United States. (What, Jenny McCarthy told you not to get a flu shot? And you’re freakin’ stupid enough to listen? You – out of the gene pool!) But looked at another way, about 15% or so of the population gets the flu in the average year, which makes roughly 50,000,000 Americans sick with the flu at some point or another during the year. 36,000 deaths out of 50,000,000 infections with 200,000+ hospital visits means that out of every 100,000 people who get the flu, about 725 (ballpark figures) die from it.

For Ebola, out of that hypothetical 100,000 people, more than 90,000 would die, not 725.

If that doesn’t get your attention, I don’t know what will.

This is the stuff that horror movies and books are made of, and Ebola has been a key player in several. Tom Clancy used it as a major plot point in “Executive Orders.” There have been several movies using plots involving Ebola, including 1995’s “Outbreak”, which unfortunately tried to turn Dustin Hoffman into an action/adventure movie hero. (That is an evil that does not sleep!) And I can guarantee that Seanan McGuire mixed some ebola facts and figures into her hypothetical zombie apocalypse “Newsflesh” trilogy (which you should also read because it’s excellent and some of the scariest shit I’ve ever read).

Except that Ebola and Marburg are not only the stuff of “apocalypse entertainment.” Take a look at that Ebola table I referenced about six paragraphs up. See where one of the Ebola strains is called “Reston?” Would that have anything to do with Reston, Virginia, which lies just between Dulles International Airport (ten miles to the west) and downtown Washington, DC (thirty miles to the east)? You bet it does, which is one of the stories of “The Hot Zone.” We were this close…

For now, I don’t sweat it much on a daily basis because these diseases are primarily on the far side of the world where I am highly unlikely to be, and they are hard to transmit between infected victims. I don’t know if someone could really weaponize the virus and make it highly contagious as Clancy and others have wondered. It makes for pretty good reading, but I don’t know that the CDC believes that it’s likely or even possible.

But once you’ve read the books mentioned above, I guarantee that when you are flipping through the online news, something like this headline from today’s New York Times will catch your eye every freakin’ time: “Ebola, Killing Scores In Guinea, Threatens Nearby Nations”

Don’t worry. It’s probably not that big of a deal. It never has been before. What’s the worst that could happen?

Sleep tight!