In modern times, we have become highly dependent on the high technology that has, in many cases, eliminated the scourge of infectious disease. Antibiotic and antiviral medications are now available in their 3rd or 4th generation versions, and physicians aren’t reluctant to use them when necessary.
Few, however, consider the possibility that a major disaster may wipe out the ability to manufacture these drugs in mass quantities. Severe restrictions exist which put these drugs out of the reach of the common man. What, then, will happen if we are struck by, say, an electromagnetic pulse event and the grid goes down? We will be left with only the most basic options to deal with many medical issues. In this circumstance, we will feel the full brunt of an infectious disease that might affect entire communities.
You’ve seen epidemics in the news and concern about their potential for the next great pandemic. but what are they? Let’s start with some definitions so that you’ll know what we’re talking about:
An Epidemic is a rapid widespread occurrence of an infectious disease in a community that is not always present in an area. Influenza, EnterovirusD68, and Ebola are examples.
An Endemic disease is a disease regularly found among particular people or in a certain area. Obesity, for example, is endemic in the United States; Malaria is endemic in many tropical countries.
A Pandemic occurs when an infectious disease runs rampant throughout a large region or, in the case of the Great Spanish Epidemic of 1918, the whole world.
METHODS OF TRANSMISSION
A pandemic isn’t a pandemic, by definition, unless it spreads. The speed at which an infectious disease spreads can topple entire economies, even governments. So how do pandemics spread? There are a variety of ways that infectious disease can run rampant through a region:
Ingestion – Eating infected animals is a common cause for the viruses to spread in humans. Bats and monkeys are part of the diet of many people in Africa, and are known carriers of the Ebola virus. Poultry is thought to be the reason that humans get the bird flu.
Inhalation – Spread through air or by breathing in droplets from the infected, such as blood splatter, phlegm, or saliva. Bodily fluids usually have a great deal of bacteria or viruses and some of them can be aerosolized into the air. Influenza is a typical example. Blood and phlegm will, if they enter your mouth, nose, eyes, or an open cut or sore, easily pass their germs to a new host.
Injection – From needle sticks or other medical items. Hepatitis is a disease commonly passed this way, but almost any disease is a candidate for spread in this manner.
Absorption – Touching secretions from the infections and then touching mouth, eyes, or open sores. You won’t believe how often this happens. Just look at the average person for a while and count the number of times they touch their face. The West African cultural practice of family members personally washing the body of deceased ebola victims is probably responsible for entire families wiped out by the disease.
Sexual– From the semen and bodily secretions of infected persons during sexual contact. Syphilis is a disease commonly sexually transmitted and, from the 1400s to the early 1900s, was a scourge of almost every civilized country. Al Capone, the famous gangster, is just one of the victims of this disease. Ebola can be transmitted sexually for weeks after a patient has recovered from the disease.
Pregnancy – Passed from mother to fetus – HIV, Syphilis, and Ebola are just some of the diseases that can be passed this way.
Complacency – Lack of attention to infection control is probably the biggest reason for the spread of pandemic diseases. Many simply ignore a disease in their area or adopt a fatalistic attitude towards it which could be, well, fatal.
We only have to look to the past to see what a pandemic could do in the uncertain future. In our next article, we’ll explore pandemics throughout human history.
Joe Alton, M.D., aka Dr. Bones the Disaster Doctor
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