The Year of the Outbreak: Swine Flu Might Not Be as Deadly as Some Feared, but There Are Many Other, Less Publicized Outbreaks Killing Millions across the World Each Year That Health Officials and Risk Professionals Must Confront

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Following a sharp rise of H1N1 "swine flu" cases in Australia in June, the World Health Organization (WHO) officially declared that the ongoing epidemic had reached pandemic status. This marked the first officially declared pandemic by the WHO in 41 years, though experts were quick to point out that pandemic status denotes how widespread a disease is, not its severity. Still, the fact that as of July 6 only 429 (or 0.45%) of the 94,512 cases of H1N1 identified worldwide have proven fatal has led many to feel that the media coverage of the outbreak has been sensationalist reporting at best or, at worst, fear mongering.

Even though Mexico City shut down for several days in May to contain the disease, and Egypt conducted a nationwide swine cull in a misguided effort to prevent the disease from entering the country, the global effect of HIN1 has fallen far short of the worst-case scenarios noted by pandemic experts in recent years. In terms of public impact, HIN1 is on its way to join SARS and the H5N1 "avian flu" as diseases whose barks were worse than their bite.


What throws the risk posed by the current pandemic in stark relief is the ongoing toll taken by any number of diseases currently infecting people across the planet. At the moment, outbreaks of malaria, dengue fever and cholera underscore just how persistent and severe disease risk continues to be, not just in the developing world, but any place where conditions for the rise and spread of infection exist. But in every case, there lies the opportunity to curtail the impact of the disease.

Case in point: the bubonic plague. The dreaded "Black Death" that killed a third of medieval Europe's total population is still fairly common in subSaharan Africa. Recently, Libya reported a plague outbreak near the Egyptian border town of Tubruq that infected up to 18 people and killed at least one. The cause of the outbreak was traced back to old water pipes that were contaminated with the plague bacterium Tersinia pestis, which is typically carried by rodents and insects.

Reports of the outbreak caused alarm in Egypt, but Libyan health officials, who have experience dealing with the disease, moved swiftly to identify those infected and treat them with antibiotics. Within days, the local Tripoli Post reported that the outbreak had been contained and the infected had been cured. Despite this success story, bubonic plague remains a health concern in Asia and even in the United States, where cases are periodically reported.

A more acute epidemic recently struck the people of Zimbabwe when a nation wide outbreak of cholera sickened nearly 100,000 people and killed more than 4,200 between February and June of this year. By the beginning of the summer, the epidemic seemed to be tailing off, but further casualties appear likely. The cause of the outbreak was a regrettably prevent able one: a lack of access to clean water.

In February, the Zimbabwean government had all but ceased to function over disputed election results, following years of endemic incompetence and mismanagement. The result was a hyperinflation of the national currency that crippled the Zimbabwean economy and left officials incapable of preventing even basic utilities from breaking down. Clean water supplies ceased to exist throughout much of the country, providing the perfect conditions for cholera. Nongovernmental organizations such as Doctors Without Borders and the Red Cross proved instrumental in treating known cases but, ultimately, the incident serves as a grim example of the consequences of the failure to provide basic disease risk management. …


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