Pandemic!

– Steve. Green Beetle, LLC

There’s a renewed focus on emergency preparedness in the media and being 2012 it seems appropriate to share more thoughts about the end of the world.

A pandemic is defined as a disease or condition that is prevalent throughout an entire country, continent, or the whole world; an epidemic over a large area.

There are many movies based on the pandemic premise.  We generally see the military attempt to quarantine a town then deviously plot to eradicate the infectious threat by destroying the whole town and everyone in it.  People are herded up and probed to determine which side of the fence they go on while the camera ominously pans through a tent full of the ghastly dead and dying – who, depending on the movie, may be about to spring back to life and ramble about seeking brains!

Pandemics are terrific fodder for dramatic fiction and horror movies and they’re also a disaster many people see as inevitable.  Including the CDC and top infectious disease scientists.

Swine Flu is a great example.  The statistics on yearly flu deaths are hotly contested so it’s difficult to say how much more or less deadly the Swine Flu outbreak in 2009 was to previous flu seasons.  Of concern is that it was an antigenically new virus, something scientists refer to as antigenic shift.  When this occurs a virus either mutates or hangs out with non-human viruses and acquires new genes for new surface proteins that our immune systems have never seen before and for which there is no active vaccine.  Years in which antigenic shift occurs in the flu virus tend to be especially deadly.  If and when the H5N1 Avian Flu gains the appropriate genome to increase its transmission rate among humans, for example, scientists fear the worst.  The mortality rate for Avian Flu may be as high as 60%.

Viruses aren’t the only bugs mutating to elude our defenses.  The emergence of antibiotic resistant bacteria is real problem, one for which the CDC and Infectious Disease Society of America have been ringing the alarm bell for years.  There aren’t very many new antibiotic drugs in the current development pipeline to take on these resistant bacteria:   MRSA, VRSA, ESBL organisms, drug resistant acinetobacter, and many others.

Consider drug resistant tuberculosis called XDR-TB (extensively drug resistant tuberculosis) which infects 40,00 new people per year.  Regular tuberculosis is curable with modern medicine and enough doses of antibiotics over time, but XDR-TB is extremely difficult and costly to treat.  We generally don’t concern ourselves with TB in the United States but the truth is that 1/3 of the earth’s population outside of North America carries the bacteria and infrequent cases of XDR-TB have already been in appearing in the US for more than a decade.

Here is some history of disease outbreaks in the western world for more perspective.  It is a limited list:

  • Ebola virus found in imported Philippine monkeys in USA, 1989, 1990, 1996.  Zero dead.  But several individuals test positive for antibodies.
  • Dengue Fever 2010, Puerto Rico. 20 dead.
  • SARS virus 2003, worldwide.  900 dead.
  • Yellow Fever 1793, Phillidelphia.  5,000 dead.
  • Polio outbreak 1917, United States.  7,000 dead.
  • Swine Flu 2009, United States. 10,000 dead. Figure debated.
  • Cholera 1994, Peru. 10,000 dead.
  • London 1952 Great Smog Event.  12,000 dead.
  • Yellow Fever 1978, USA. 13,000 dead.
  • Yellow Fever 1878, United States. 13,000 dead.
  • Malaria 1865, Civil War.  30,000 dead? 1 million infected.
  • Typhus 1847, Canada.  40,000 dead.
  • Asian Flu 1956. 69,800 dead in USA.
  • Cholera 1855, Spain.  250,000 dead.
  • 1918 Flu Pandemic.  650,000 dead in the US alone!
  • Typhus 1918-1922.  3,000,000 dead.
  • Smallpox in the Americas. 40-90% of the Native American population dies.
  • HIV 1981-present.  21,000,000 dead worldwide.
  • European plague.  350,000,000 dead.  40-50% of the population.

In the 19th century disease outbreaks typically claimed more lives than bullets.  In the 20th century 1/3 of WWI military casualties may have been from typhus alone.  When hygiene and sanitation break down things get ugly.

I take away several points from the information above.

First. Pandemics are real and can be deadly.  A potentially devastating viral pandemic is regarded as likely by really smart, level-headed people.  And further, such disasters have been frequently recorded in history.  We are currently in the midst of a slow-motion global pandemic called HIV which kills 10,000 Americans every year.  The flu regularly kills thousands of people in the US each year and when the right (wrong) antigenic shift occurs…  Wash your hands frequently, don’t touch your face, don’t take your kids to visit people in the hospital, cover your mouth when you cough or sneeze, stay fully immunized, keep mosquitoes/ticks/louses/dead or dirty animals away, keep pests off your pets and keep your living environment vermin free.

Second.  History has proven that hygiene is paramount.  The rapid spread of typhus, cholera, other waterborne illnesses, hepatitis, plague and many pandemic diseases that we consider rare today in the western world are all possible again with the breakdown of hygiene and sanitation.  In fact, in developing nations the leading cause of death is still infectious diseases, especially waterborne ones.  Antiseptics, staying clean and managing waste (food, feces, urine, vomit, menstruation, water, dirty apparel, animal carcasses, etc) are important when planning for any disaster.

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