Ebola, continued

That's odd. Aren't there any Ebola denyers?

As I recall, this Ebola virus was discovered sometime around 1976.

Despite the occasional sky-is-falling scare tales from the CDC, the cumulative total number of deaths from Ebola worldwide (population 6 billion) over the past 30 years is 1,250.

Last year in the United States alone, 1,344 people choked to death on food.

In order to provide the public with sensible, sober and accurate risk assessments, most epidemiologists are in dire need of some basic statistics classes from actuaries.

Right Charles. Perhaps epidemiologists should even state those very numbers about Ebola.

You're a historian, correct? Can you provide some evidence to support that CDC ever claimed "the sky is falling" in regard to Ebola?

I concur and think those Ebola numbers should be stated prominently every single time that topic is discussed or whenever anyone raises some new microbe-of-the-moment alarmism. Agreed?

As for the CDC's sky-is-falling scare tactics, remind yourself about a situation that developed in a squalid, teeming city called Kikwit in western Zaire (now Congo) back in 1995.

Then go read the press releases from the CDC's Special Pathogens Branch, or look up Pierre Rollin or Tom Ksiazek and read their comments, or check the quotations in a May 1995 issue of *Newsweek* with its cover story, "Killer Virus" and let me know what you think of all that.

I carefully ignore the absurdities and calumny of the 1995 movie *Outbreak* or the apocalyptic warnings from Laurie Garrett's *The Coming Plague" or Richard Preston's *The Hot Zone* all of which sober and prudent epidemiologists, of course, recognize as pot-boiling tales.

Perhaps you can enlighten me, since I don't see the Newsweek article online and the outbreak postings only go back to 2000. What I did find was a few writings by Michael Fumento (such as this one) quoting CJ Peters, Karl Johnson (former head of the CDC's special pathogens branch) and Stephen Morse being quite sensible. And Johnson criticizes the same things you do. As with the current situation with avian flu, much of the so-called "hype" and "sky is falling" mentality comes from the journalists, not from the scientists.

Let me just respond to your final sentence here.

It serves no purpose to shift the blame to the journalists who only write what the scientists tell them or allege or predict.

A case in point is Robert Webster, a world renown virologist, whose claims and suppositions about H5N1 avian flu formed the basis for many journalistic scare-tales.

Exhibit #1 - an article about Webster in the January 2006 issue of *The Smithsonian," written by Michael Rosenwald.

Read that article with your careful, skeptical eyes wide open and see whether it's Webster or Rosenwald who gives the distinct impression of some looming, impending, possible "pandemic that might kill as many as 20 million people." (p. 39)

Rosenwald reports that "Webster says the world is teetering on the edge of a knife blade. He thinks that H5N1 poses the most serious health threat since the Spanish flu pandemic of 1918, which killed an estimated 40 million to 100 million people worldwide." (p.43)

World is teetering? Poses the most serious health threat? What kind of talk is this if not scare-mongering and fear arousal? Actuaries would laugh in the laugh of someone who makes such outlandish and groundless about risk assessment.

One last little statistic - over an 8 year period, from 1997 through November 2005, out of 6 billion people worldwide, a grand total of 126 individuals (all of them in Asia and likely living in crowded, unhealthy conditions) contracted H5N1 avian flu and 64 died.

I rest my case.

A final point - a fine book by physician Marc Siegel, *False Alarm: The Truth About the Epidemic of Fear* (Wiley and Sons, 2005) goes into much more detail about several more concocted fears.

Siegel stresses repeatedly how academics, researchers, government officials and the pharmaceutical industry exploit and spread fear for profit, prestige, and power.

The CDC's role in the anthrax scare, bird flu scare, West Nile virus scare and others is amply documented throughout Siegel's book.

Read that article with your careful, skeptical eyes wide open and see whether it's Webster or Rosenwald who gives the distinct impression of some looming, impending, possible "pandemic that might kill as many as 20 million people." (p. 39)

Rosenwald reports that "Webster says the world is teetering on the edge of a knife blade. He thinks that H5N1 poses the most serious health threat since the Spanish flu pandemic of 1918, which killed an estimated 40 million to 100 million people worldwide." (p.43)

World is teetering? Poses the most serious health threat? What kind of talk is this if not scare-mongering and fear arousal? Actuaries would laugh in the laugh of someone who makes such outlandish and groundless about risk assessment.

But it's based on the evidence. Millions *did* die from influenza in 1918. We currently have an avian virus that is highly lethal in humans, and 20 million deaths certainly wouldn't be unheard-of in the event of an influenza pandemic, be it due to H5N1 or another strain. It's not "fear-mongering," it's the simple black-n-white numbers and no one in the world is prepared, as even the government is realizing.

As far as Siegel's book, I disagree with many parts of it, but I agree with the basic premise: that reason should trump fear when it comes to all sorts of "scares." I deal with all kinds of nasty pathogens every day, but I certainly don't let fear rule my life, and neither should anyone else. But part of reason is being educated on the issues, which means that scientists need to be able to state the facts without accusations of "fear-mongering." As even you note, the word "possible" is in there. No one knows whether H5N1 will mutate into a H2H transmissible form, but it pays to be ready.

I know you're new here and probably don't realize I'm repeating myself, so rather than belabor this point I'll suggest you read posts in my pandemic flu series (dated, I'll note; it's from last October) and another post I wrote on the difficulty of writing about emerging infectious diseases. This post on public health funding and homeland security also elaborates on why I think an "all hazards" approach, rather than a flu-specific or bioterrorism-specific (etc.) approach is the most efficient way to go in order to prepare us for a variety of potential threats.

I totally agree with you about not letting fears rule our lives.

I wish that you would state more emphatically what the actual risk factor is for avian flu or for Ebola based on the past incidence, not alarmist projections or predictions.

I am not disputing the historical facts of past epidemics but I am urging caution, care, skepticism, and attentiveness to the actual risk levels in your "all hazards" approach in which you ought to clearly rank such threats or hazards in importance or likelihood.

There is a possibility that an airplane will crash into your study while you are typing a reply to me. There is the risk of grave bodily harm while riding a road bike. We all take prudent and sensible precautions without allowing our lives to be governed by untenable "what if" scenarios. But the key question is simply stating then positing a plausible answer to the question - how much am I at risk and for what?

You never indicated which parts of Siegel's book you most strongly disagaree with so I would be eager to know that.

Each year, approximately 2.4 million Americans die of all causes, but infectious diseases account for less than 1 per cent of that number. That inescapable fact is what we should be talking about in terms of hazards as well as the actual, documented leading causes of death - coronaries, various cancers, strokes, accidents, suicides and homicides and what can be done to prevent or reduce their numbers.

I think that journalists, physicians, CDC officials, and epidemiologists should be free to make all the predictions and guesses about future public health hazards that they want.

But I think that we historians ought to hold them to account whenever those predictions fail to pan out and that we should widely publicize (even excoriate) such errors and failures in the hope that such folks are careful and prudent in the future. Agreed?