Rabid Opposition to Ebola: Epidemiology Meets Hyperbole | David Katz, M.D.
Keep it real
An article by an actual expert in infectious disease
And speaking of rabies, that is a virus already well established here in the U.S. with a case fatality rate of either 100 percent, or something very close to it. In other words, rabies is a more lethal virus even than Ebola. Yet we don’t live our lives in fear of rabies for an obvious reason: we are very unlikely to get it. Rabies is not the common cold; a sneeze is not going to transmit it.
The transmission of rabies almost always involves the bite of an infected animal. Most human cases involve dog bites, not because there is much rabies in dogs — but because humans are more likely to come into contact with infected dogs than the species in which rabies is more prevalent, including raccoons, skunks, bats, and foxes.
But let’s move on, because my aim here is not to wade into rabies esoterica but to make a general point. Rabies is a horrendously bad disease, but we don’t live in fear of it because we take some basic precautions, like vaccinating our pets, and know we are unlikely to get it. We do not deport those rare individuals infected with it to some foreign land in the name of homeland security; we treat them here. And, to my knowledge, even Donald Trump has not called for the deportation of our raccoons.
The Ebola virus is nearly as lethal, and thus nearly as scary, as rabies. Like rabies, it is rather hard to catch. Direct contact with infected body fluids is required. There is, to date, no known case of respiratory transmission — meaning Ebola is not spread by coughing or sneezing. Conceivably, the virus could evolve so that changes; but in theory, the same is true of rabies. Fear of an Ebola outbreak in the U.S. is only justified among those who avoid the woods for fear that a skunk might sneeze.
David L. Katz, MD, MPH, FACPM, FACP is the founding director of Yale University’s Prevention Research Center. A specialist in Internal Medicine and Preventive Medicine/Public Health, he has co-authored 4 editions of a leading epidemiology textbook.
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