Sunday, April 17, 2005

Marburg virus outbreak

I'm fascinated by the epidemiology of infectious disease, so I've been reading the NYT's coverage of the current outbreak of Marburg virus in Angola. Today's article is good and long, so I ate it up. Marburg virus, of course, is a virus that causes gruesome deaths due to hemorrhage, much like Ebola. So far, the death toll is at 230, and the current outbreak is especially deadly—the first well-documented outbreak was fatal in about a quarter of those infected, but in Angola, 90% of the infected are dying. The international public-health authorities are having a tough time isolating victims and monitoring people who have been exposed because the local population doesn't trust them—it might help if the biohazard suits weren't the color (white) traditionally associated with witchcraft, eh?

Viral outbreaks like this require medical expertise, skills at tracing contacts, and logistical heroics combined with a keen understanding of local customs and human nature. It's as if the team of health experts has two equally important jobs: fighting the virus, and working within an entrenched societal structure to change the people in order to save them. For instance, recall that in prior Ebola virus outbreaks, one way the virus spread was through the tradition of careful washing and preparation of a loved one's dead body before burial. How do you convince a culture that their most strongly cherished customs must sometimes be abandoned? Hypothetically, imagine if baptism were banned here because it spread disease, or if married people were told they might die if they had sex within the first year of marriage. How many Americans would embrace the new rules?

In my next life, I'm totally going to medical school, training in infectious diseases, getting a degree in public health, and doing field work for the World Health Organization.

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