THE BLOG

Ebola: When Panic Outstrips Pestilence

27/10/2014 13:24 GMT | Updated 24/12/2014 10:59 GMT

In the decades following Edgar Allan Poe's Masque of the Red Death (1842), a short story of a bloody pestilence that bears a scarlet stained symmetry with the current Ebola outbreak, we entered an age that heralded major advancements in understanding disease. Yet despite the clear strides made in the 160 years since, the coverage of the West African crisis has so little rooted in scientific fact and reason that much could easily be lifted from Poe's dusky tale.

The rise of commercial air travel and drug resistant pathogens have put us on a tightrope from which we may one day fall into the throes of a global pandemic. But this won't happen now. Despite a lack of vaccine and cure, and an alarmingly high mortality rate, the Ebola virus is not nearly as contagious as is purported in the media. Unlike influenza, which can be spread via airborne droplets, bodily fluids of a symptomatic carrier of the Ebola virus would need to enter a new host through points like the eyes or mouth, or cuts and abrasions on the skin, for the disease to be contracted. Compared with HIV or mumps, Ebola is much easier to control and contain, and is in fact nine times less contagious than measles. So where a flu can spread quickly and infect a number of people in an office or on an airplane, the chances of the same happening with Ebola in such a scenario are slim.

Viruses and hosts are locked in an eternal struggle to outdo each other and develop to stay ahead of the game. Which is why influenza has proved so difficult to eradicate. Over the last few weeks, there has been speculation that Ebola will mutate in a way that would make it airborne, allowing it to spread quicker and easier. Whilst viruses do change their genetic make up, there is no evidence to suggest that Ebola will do so in a way that would alter its mode of transmission. Though discovered in 1976, the Ebola virus has had millions of years in animal reservoirs to make such a radical mutation. In fact, despite over a 100 years of research, no human virus has changed the way it is transmitted. It's nigh on inconceivable that the virus will mutate to such a dramatic degree now.

In an interview published in The Guardian, Peter Piot (a member of the team which discovered the virus in 1976) described the catastrophe as a "perfect storm", in which a combination of events worsened an already desperate situation in the region. As with much of the continent, war and political unrest have long affected West Africa, leading to the collapse of infrastructure and a drop in the number of health workers. For example, there were only 51 doctors in Liberia in 2010, many of whom have since died of Ebola. Poorly followed medical procedure by under trained substitute staff meant that the virus was not contained properly and new cases continued to flare up. The spread of the outbreak was also sped up by the tradition of burning the dead in their place of birth, which often meant bloody, infectious corpses were shuttled across borders in the back of taxis or pick-up trucks. It'd be difficult to envisage a time when the UK has a handful of doctors dealing with a Sisyphean stream of bleeding, heaving patients. Or cabs ferrying the dead across New York, like a bleak, Poe-penned episode of Taxi.

There are many other more transmissible diseases than Ebola, and it isn't even close to being the most widespread microscopic danger in the region, yet there remains such a heavily weighted attention to it. Malaria, to pick one of many, has long been endemic in Africa, killing an estimated 627,000 across the continent in 2012. Sierra Leone is a hotspot for the mosquito borne disease, and has around a 275% greater prevalence than Ebola. The historically high mortality rate of the disease would explain some of the media maelstrom, though this does come with a caveat. At 50%, the death per case ratio is significantly lower when compared to previous outbreaks, which reached 88% in Zaire in 1976, and it is likely that this figure has been inflated by the poor health systems in place in the affected areas.

The around-the-clock coverage could be down to the grisly nature of the disease. But much of this is cloaked in misinformation, most Ebola fatalities are caused by organ failure or respiratory complications, not, as widely reported, bleeding inside out. In fact, haemorrhagic symptoms have only been seen in less than 6% of cases in the current outbreak. Click hungry news agencies understand our relentless fascination with morbidity and know there is little call for death by run-of-the-mill fever and fits, and sate our thirst by exaggerating the more macabre aspects.

This isn't to say that the West should shut itself off from the wider world like Prince Prospero in Poe's tale of crimson pestilence. Aside from the clear humanitarian responsibilities of providing aid and support, a lack of a functioning health system in impoverished regions such as West Africa, will one day allow a more transmissible pathogen to run rampant, which would eventually see us having to step over corpses on our doorsteps. But for now, rest assured, we are not all careering towards a bloody, excrement covered date with our maker.