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Ebola is not the only, or most dangerous, challenge we face

By Peter Curson - posted Tuesday, 28 October 2014


Each day we are confronted by disturbing stories of how Ebola continues to wreck havoc in West Africa and by the threat that it offers to the rest of the world.

In Australia considerable concern has been expressed about the possibility of a returning healthcare worker or tourist transporting the infection to our shores.

But what about the major epidemic of mosquito-borne infectious disease that has been raging through the Pacific Islands over the last two years.

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So far 120,000 people have reported being infected but the real figure is probably closer to 200,000. Since 2012 most of the Pacific as experienced huge outbreaks of Dengue, Chikungunya and Zika all mosquito-borne viral infections and while not very many people have died it remains the worst outbreak of viral infection to hit the Pacific for many decades.

In New Caledonia there were 11,000 cases of dengue during 2012-13 and at least 400 so far this year. French Polynesia has experienced a huge outbreak of Zika with more than 20,000 cases, Fiji has had more than 25,000 cases of Dengue while Papua-New Guinea experience a major epidemic of Chikungunya in 2013 producing tens of thousands of cases.

But unlike the Ebola epidemic this ‘Pacific epidemic’ has attracted absolutely no media or official attention in Australia. Why is this so, given the fact that a mosquito vector (Aedes aegypti) closely linked to Dengue epidemics is widespread throughout Northern Australia?

To be sure there is little doubt that the Ebola epidemic currently surging through West Africa is unprecedented in scale and the largest the world has ever seen. It is also much more deadly with a mortality rate of between 70 and 80%. Is this one of the reasons why it has dominated the news reporting and official reaction in Australia?

Are we more moved by the threat of death rather than the effects of incapacitating and debilitating disease? One is tempted to argue that our Public Health is mortality driven. If something threatens to kill us we do something about it. If, like Dengue, it simply incapacitates and lays us low for a few weeks after which we eventually recover, we are forced to live with it.

If Dengue and Ross River Virus were deadly and killed more Australians we would most probably have had a cure or vaccine decades ago. As it is we still have no specific treatment. But there is another side to all of this as well and that concerns the role of the media. So far the public reaction, fear and hysteria generated by Ebola has in many ways been totally out of all proportion to the realities of the disease.

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There is no doubt that it is a real tragedy and disaster for West Africa but for Australia? There is also little doubt that the public reaction to the Ebola epidemic in the developed world has been to a large extent orchestrated by the mass media. Talk of “the plague to end all plagues”, the need “to protect Australia”, “the disaster of a generation”, “Fear Killer Has Arrived” and “the war on Ebola” have all been headlines in Australia’s daily press as well as elsewhere in the Western world.

Our newspapers are full of stories about the possibility of an infected traveler reaching our shores and the need to screen travelers, isolate potential contacts and establish special hospital wards with trained staff. Yet to be frank the chances of Ebola reaching Australia pale by comparison to what has been taking place in the Pacific. Where is the talk of screening arrivals from Fiji, New Caledonia or Papua-New Guinea for fear of Dengue, Chikungunya or Zika being introduced? Do we simply shrug our shoulders and say – ‘well parts of Northern Queensland experience Dengue every now and again, so let’s live with it?

There is no doubt that our reaction to major epidemics of infectious disease evolves through a complex chain of social interactions involving a variety of players including the government, public health officials, healthcare workers and the media. It is through the media that most people have learnt about Ebola and we are much influenced by the way the media presents the current outbreak in terms of language, image and placement. Ebola is without doubt the very essence of hard news and is in media eyes exceedingly “newsworthy’ and “great copy”.

The media knows that we are all more moved by the tempest than the gentle rain and react accordingly. In doing this they play a defining role in helping shape the public’s view of risk, creating fear and hysteria, attributing blame, constructing heroes and scapegoats and posing solutions. While it is true the media creates awareness in times of crisis placing health security at the top of the agenda, it is also true that the temptation to sensationalise stories through arresting and emotive headlines allied to dramatic images is often overwhelming.

So as far as the media is concerned it is SARS all over again when we were endlessly regaled by stories of a “new killer virus” as well as frightening images of people in masks, blocks of houses being quarantined and cleansed and fumigated as well as stories of human reaction, fear and panic.

Given the number of Australians and others who visit the Pacific Islands and return to Australia there is little doubt that the current Dengue, Chikungunya and Zika epidemics represent a much greater threat to Australia’s health security that does the Ebola outbreak in Africa. Perhaps if such infections threatened to kill Australians we might recognize this and do something about it. In many ways we need to rethink our reaction to epidemic crises and restructure our health security accordingly.

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About the Author

Peter Curson is Emeritus Professor of Population and Health in the Faculty of Medicine and Health Sciences at Macquarie University.

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