Osterholm on “contagion exhaustion”

From Crof’s H5N1 Blog…

http://crofsblogs.typepad.com/h5n1/2013/05/osterholm-on-contagion-exhaustion.html/

Via The New York Times, Dr. Michael Osterholm, director of CIDRAP, writes today’s must-read: The Next Contagion – Closer Than You Think. Excerpt:

There has been a flurry of recent attention over two novel infectious agents: the first, a strain of avian influenza virus (H7N9) in China that is causing severe respiratory disease and other serious health complications in people; the second, a coronavirus, first reported last year in the Middle East, that has brought a crop of new infections. 

While the number of human cases from these two pathogens has so far been limited, the death rates for each are notably high. 

Alarmingly, we face a third, and far more widespread, ailment that has gotten little attention: call it “contagion exhaustion.” News reports on a seemingly unending string of frightening microbes — bird flu, flesh-eating strep, SARS, AIDS, Ebola, drug-resistant bugs in hospitals, the list goes on — have led some people to ho-hum the latest reports. 

Some seem to think that public health officials pull a microbe “crisis du jour” out of their proverbial test tube when financing for infectious disease research and control programs appears to be drying up. They dismiss warnings about the latest bugs as “crying wolf.” This misimpression could be deadly. 

It’s important to understand our relationship with the microbial world. Most microscopic organisms benefit humans, other organisms or the environment in some way — for example, they help us digest our food and keep bad bugs in check. 

At the same time, we are never far away from one of the 1,400 kinds of disease-causing microbes that are capable of infecting people; many infect animals, too. Of these microbes, known as pathogens, about 500 can be transmitted from humans to other humans. And around 150 of them can cause epidemics — rapidly spreading outbreaks of serious, sometimes life-threatening, disease. 

Each pathogen has its own “footprint” (or potential footprint) on our human health and social, political and economic landscapes. Far too often the public — and policy makers and journalists — confuse those infectious diseases that can be life-threatening for a limited number of individuals with those that can cause widespread damage to society as a whole. 

A disease in the former category is “flesh-eating strep” (invasive group A streptococcal disease). Approximately 9,000 to 11,500 cases are recognized each year in the United States, and about 1,000 to 1,800 of these patients die. When outbreaks of this type occur in this country, particularly if they affect schools or day-care centers, they generate front-page news and widespread concern. 

Conversely, last year worldwide 1.7 million of the 34 million people infected with H.I.V. died from AIDS. There was little front-page news coverage about these cases. Nor was there much coverage last year of the estimated 1.5 million tuberculosis-related deaths, of the 1.1 million young children who died of infectious diarrheal illness, or of the 825,000 deaths from malaria. Infectious diseases like these plague the world but, because they don’t occur in our backyard, they remain relatively invisible to Americans. 

In the case of the two latest threats — the H7N9 influenza virus and the new coronavirus — the number of infected people is small, and the infections are occurring thousands of miles away from the United States. Yet we should be seriously concerned about both.

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