Fear’s not a bug; it a feature of our modern system

So I see by this morning’s news that the doc in New York who had contracted Ebola while treating patients in West Africa has fully recovered.

So far, we’ve had an Ebola epidemic consisting of one aid worker, a missionary, three doctors, and an NBC cameraman who brought the disease home with them from West Africa, all of whom fully recovered. In addition, one visitor brought the disease with him from Liberia and subsequently died. Two nurses were infected while caring for him and also fully recovered. Thus ends the great Ebola epidemic of 2014.

While the country was never in danger from Ebola, it certainly was from the panic, ignorance, and cowardice displayed by a huge chunk of the U.S. population and their political leaders.

Ebola is one of the viral hemorrhagic fevers that afflict mankind by interfering interfere with the blood’s ability to clot. The viruses can also damage the walls of the body’s tiny blood vessels, causing them to leak. That can result in death, often made all the more frightening because of the mystery of what’s happing.

This, of course, was not our first go-round with viral hemorrhagic fever in this country, only the most recent. Given the scientific illiteracy of the modern United States, however, no one—least of all the politicians and media blowhards trying to make political hay out of the unreasoning fear they were busily propagating—remembered what had gone before.

There aren’t a lot of viral hemorrhagic fevers (VHF), but the list includes some of the most frightening names in modern medicine: Dengue, Ebola, Lassa, Marburg, and Yellow Fever.

Here in the U.S., our VHF experience was mostly with Yellow Fever, a disease that could honestly be nicknamed The Slaves’ Revenge.

There was no Yellow Fever in North or South America until the virus was brought here from Africa in the bodies of slaves, starting in the 16th Century. The Yellow Fever virus is transmitted only by the bite of an infected mosquito, although it would take hundreds of years for medical researchers to figure it out.

The disease was as horrifying as it was mysterious. Those stricken suffered high fevers, chills, nausea, muscle pain (particularly in the back), and severe headaches. After that first phase, most victims then suffered through a second, more toxic stage that causes severe liver damage resulting in the jaundice that gives the disease its name, and a painful death.

Yellow Fever was apparently brought to the Caribbean islands and South America by African slaves imported by the Spanish. It didn’t take it long to spread north. The first outbreaks in what would eventually become the United States took place in New York City in 1668 and Philadelphia in 1669. At least 25 major outbreaks followed, including a major one in Philadelphia in 1798—then the nation’s capital. The city was evacuated by the national government as nearly 10 percent of its population perished.

Periodic Yellow Fever outbreaks continued throughout the balance of the 18th and into the 19th centuries, with Louisiana and Florida suffering periodic flare-ups, some of which had effects and caused fear right here in Kendall County. For instance, on Sept. 19, 1878, the Kendall County Record’s Oswego correspondent, Lorenzo Rank, noted: “George W. Avery Jr. is selling out his house and furniture on the 28th inst.; he is bound for the yellow fever lands.”

In the Nov. 21 edition of the Record, Rank noted “L.N. Stoutemyer, an Oswego boy, now one of the editors and proprietors of the New Orleans Times, apparently has been the one that stood the hardest siege with the yellow fever without surrendering. About a week ago his friends here received word that for the first time in 43 days he sat up a little while.”

And what about George and Ed Avery and their families, who had headed to the “yellow fever lands” in 1878 and 1879? In the Oct. 19, 1882 Record, Rank reported of George’s brother, Ed: “The sad intelligence was received last week that Ed Avery had died at Pensacola, Florida from yellow fever.”

One of the worst of these periodic Yellow Fever outbreaks occurred in 1879 in Memphis, Tenn. It began with just one patient in August of that year, a steamboat crewman named William Warren who brought the disease with him from New Orleans, where a periodic outbreak was then on-going. Although officials had attempted a quarantine of steamboats coming north from New Orleans, Warren managed to evade it, before landing in a Memphis hospital, where he died, but not before Tennessee mosquitoes picked up the virus from him and spread it, first to a Memphis food stand operator on the waterfront, and then to dozens and then hundreds of others.

That’s when the panic hit, and residents began fleeing for their lives. Well over half the city’s 47,000 residents headed to rural areas outside of town, only to be met with “shotgun barricades” manned by small townsmen terrified they’d spread the disease to their families. Even so, the exodus led to the spread of the disease to Kentucky, Indiana, Illinois, and Ohio, although in none of those areas did Yellow Fever boil up with the ferocity it did in Memphis.

As if the disease wasn’t horrible enough, if it didn’t kill those it struck, the medical care of the day often did, with the normal treatment being bleeding and dosing with purgatives that often led to death through dehydration.

The black residents of Memphis, most too poor to flee what homes they’d made there, became the backbone of those who kept the city from disintegrating. That was because while blacks were no more or less susceptible to contracting the disease, their death rate was only about 7 percent of those who came down with Yellow Fever. Medical historians suspect that was because the African-American population had built up some immunities to the disease over the centuries. As a result, according to “Yellow Fever in Memphis 1878 by Robert A. Dunn, “The African-American survivors in Memphis became the glue that held the city together, caring for the sick and dying, burying the dead, and taking over may positions in the Memphis police, fire, and other city services.”

After the epidemic was stopped by the first frost in the autumn of 1878, Memphis found itself bankrupt, with the State of Tennessee taking control of the city’s finances. Not only were the city’s debts paid off, but low-lying, swampy areas in the city were drained, trash and debris cleaned up, and an innovative sewer system was installed that, for the first time separated sanitary sewer lines from storm sewers. Those initiatives combined—despite another Yellow Fever outbreak in 1879 that caused 600 deaths—to stop further major outbreaks, although no one really knew why.

It wasn’t until Dr. Carols Findlay suggested that Yellow Fever was actually spread by mosquito bites that the medical profession began taking a serious look at the idea. Then Walter Reed, a U.S. Army doctor working to defeat Yellow Fever during the construction of the Panama Canal, proved conclusively mosquitoes were the culprits.

Under the direction of Army doctors, mosquitoes were eradicated in Cuba and Panama, and with them went Yellow Fever. Similar efforts in the United States eliminated the disease from New Orleans and other low-lying cities that had been periodically afflicted with Yellow Fever.

Ebola is particularly dangerous because it’s spread by its animal hosts, not easily controlled insects, which means it can not only spread from animals to humans but from humans to other humans. Fortunately, as the recent nine-person epidemic in the U.S. showed, it’s not really easy to get Ebola. Someone has to be in close contact with a patient in the final phases of the disease when the victim’s body is producing astonishingly huge numbers of the Ebola virus and then be directly exposed to the victim’s bodily fluids.

Given the problems exposed in the Texas healthcare system with the outbreak in Dallas, it’s fair to wonder whether any further exposures would have occurred in the case of the Liberian patient had he been seen at a modern hospital in, say, New York or Chicago. And as for the New York doctor infected, but now recovered, the healthcare system in that state did what they were supposed to do, and they, like all the other hospitals treating cases, not only prevented any further transmissions but also cured the guy.

The problem, it seems to me, is not that Ebola got to the U.S., or that it was so easily contained. It’s that there’s a horrible, on-going Ebola epidemic in West Africa, and there’s a chance it could spread to, say, the crowded megalopolises of India or Bangladesh or Brazil. That could be a catastrophe of literally unimaginable proportions, something that should be encouraging us to move with all possible dispatch to stop the epidemic at its source as quickly as possible.

 

 

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Filed under Frustration, Local History, People in History, Science stuff, Semi-Current Events, Technology

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