Factual · Powerful · Original · Iconoclastic
It was, we were told, a horrible case of life imitating art. First there was the hit movie Outbreak, with an Ebola-like virus threatening to wipe out the United States. Closely following was the TV movie, Virus, starring Ebola itself. And then there was the media’s Ebola onslaught, with such offerings as CNN’s The Apocalypse Bug and Newsweek’s cover: "Killer Virus." And this time it was for real. Not. As it happens, Zaire’s virus is one of the poorest excuses for an apocalyptic anything. Not only does it pose no threat to America, it doesn’t even pose much of a threat to Africa. But there is a cautionary lesson here, and it’s not what so many would have us believe. Make no mistake, Ebola is a terrible disease to get. It’s also extremely deadly. Apparently as many as 90 percent of its victims die, although to a great extent that number reflects the poor medical care available in the afflicted areas. But the good news is that Ebola is extremely hard to catch. You don’t get it from doorknobs, toilet seats, or being coughed upon. As the World Health Organization notes, "transmission occurs by direct contact with infected blood, secretions, organs, or semen." That’s why almost all the victims have been hospital patients, care givers, or persons who handled the dead bodies. Standard precautions would prevent such spread in American hospitals, but in dirt-poor Zaire, even masks and gowns can be hard to come by. The other factor that works to contain Ebola is that the victims don’t carry it long before becoming symptomatic themselves. According to Dr. Carl Johnson, retired head of the Centers for Disease Control and Prevention (CDC) Special Pathogens branch, "Incubation is on average seven to 10 days." Further, he told me, "Probably during most of that incubation period there’s not enough virus in that person to" allow transmission to someone else. Still, what’s the worst case scenario for the U.S.? What if a Zairian teeming with Ebola stepped off a jet tomorrow at JFK? Sorry thrill-seekers, it’s not complete envelopment of the U.S. in 48 hours, as was the case in Outbreak. Dr. C.J. Peters, current director of the Special Pathogens branch, told me, "It’s possible that someone with Ebola might leave a remote area where the disease is occurring and might even get sick here." But, he added, "Because our socioeconomic level allows high standards in hospitals . . . there would be a few cases but they would be controllable under our circumstances." The fallacy that because a disease is a major problem in Africa it may become one in the U.S. got its start with AIDS. To this day we hear that AIDS is poised to sweep through America’s heterosexual population because, after all, it’s primarily a disease of heterosexuals in Africa. That different populations spread disease with varying degrees of efficacy is conveniently ignored. Ebola: Deadly, but Hard to Catch
But what is most remarkable about this latest hype is that by Africa’s sad standards, Ebola is a pipsqueak. The current Ebola epidemic will probably fall short of the previous one in 1976, which killed several hundred people. Yet each year malaria kills an estimated one million Africans, tuberculosis kills three million, and other tropical diseases besides malaria kill as many as two million. There is probably no deadly disease in Africa that will kill fewer Africans this year than Ebola. When I pointed this out to CNN’s reporter, Andrew Holtz, during a question and answer computer forum after The Apocalypse Bug aired, he replied that all this was true but that after all "AIDS started with just a few cases." Yes, and World War I began with the murder of a single couple, so anytime a couple is murdered we must brace for world war. But that’s the ratings game for you. Still, much of the media coverage of Ebola has been responsible in tone, if irresponsible perhaps in the sheer amount. The worst problem is that everybody is trying to get us to draw the wrong conclusions. First, they are using Ebola as evidence of old pathogens developing resistance to antibiotics and perhaps thereby reemerging as a major threat. This is a problem, but concerns bacterial infections, not Ebola nor any other virus. Second, we are told this is the folly of continuing to encroach upon the environment, that so doing exposes us to more deadly pathogens. Actually, throughout history populations have exposed themselves to new diseases. But now, as always, they usually arise through interactivity between different groups of people, not with creatures of the rainforest. The real lesson is that we must be prepared to quickly identify those pathogens which do emerge. "We can’t think from crisis to crisis," Rockefeller University virologist Stephen Morse told me. "This will pass. The next one may not be so easily averted." True enough. Yet the CDC annual budget for New and Reemerging Infections is a paltry $5.3 million. This while the CDC spends over $385 million a year on AIDS education which emphasizes a politically correct but medically wrong "everybody’s at risk" message. This while the CDC’s Agency for Toxic Substances and Disease Registry, which chases medical phantoms allegedly emanating from hazardous waste sites, saw its budget balloon from $45 million in 1989 to over $60 million in 1993. What has happened with the CDC is illustrative of what so often happens to when an agency loses sight of its original purpose in pursuit of flashier causes. Ebola should be a kick in the pants to Congress to put the Centers for Disease Control and Prevention back on the course of controlling and preventing disease.