Ebola in Africa, chikungunya in the Caribbean and bubonic plague in China have made the rounds in the media this summer. They're scary to hear about and admittedly, they make for interesting stories. But it's important to step back and take stock of the actual dangers and risks. How worried should we be about them here in New York? We spoke with a professor of epidemiology at Columbia University's Mailman School of Public Health, Dr. Abdulrahman El-Sayed, about what New Yorkers should or shouldn't worry about. As it turns out, Ebola is low on the list. Here are a few other diseases that outrank it, in rough order.
If you're going to catch a virus in New York, this could be it. The flu is endemic, painful, and for some people, deadly. According to the World Health Organization, about 3-5 million people catch severe cases of the flu annually around the globe. The WHO estimates that 250,000-500,000 people die from the flu each year, especially the very young, the very old and those with weak immune systems.
"We normally don't pay much attention to it because it's something that you think of as pretty common," El-Sayed said. "But it kills a number of people each year, especially at the extremes of age."
During the last flu season, from October to the end of May, New York State alone reported 37,065 cases of the flu, with 1,447 deaths from the flu and pneumonia combined in New York City.
El-Sayed said that on a scale of 1-10, where 1 means "No Worries" and 10 means "Panic," HIV/AIDS still lands a 4 or 5 for him - even if you practice safe sex and don't share needles. While being diagnosed with HIV/AIDS is no longer a death sentence in the U.S., he said it's still an epidemic. The CDC estimates that there are 50,000 new infections every year and New York and New Jersey are two of the top ten states for prevalence of HIV/AIDS. If you are a drug user or have unprotected sex with multiple partners, that score shoots up to a 9 or a 10 for El-Sayed. He said drugs like Truvada, which may prevent HIV transmission, are promising, but education and outreach about this virus are still crucial.
Like HIV/AIDS, hepatitis is a major concern in New York and is transmitted in the same ways. Most cases are chronic and it can be deadly if left untreated, possibly leading to liver damage and cancer. According to the New York City Department of Health and Mental Hygiene, more than 240,000 New Yorkers may be living with hepatitis B or C, many of them undiagnosed. There is a vaccine for hepatitis B, and a new drug called Sovaldi can treat hepatitis C, but at $1000 per pill, it may be out of reach for many who have the virus.
Thanks to 2012's dry winter, a large portion of the tick population in New York and New Jersey was killed off, which could mean fewer lyme cases this year. At the same time, overall warmer climates may be allowing ticks to spread to new areas. Lyme disease is prevalent in New York and New Jersey and any ticks can potentially carry the disease. Last year, New York State reported 3,873 confirmed cases of lyme disease. New Jersey reported 3,766.
Unless you've been to the Caribbean since December, there's no need to lose sleep over chikungunya. While some travel-related cases were reported in New York and New Jersey via an outbreak in the Caribbean, many of the methods health officials use to fight West Nile virus, like spraying insecticides,can also slow the spread of chikungunya. The mosquito-borne disease can cause extreme and chronic joint pain, fever and fatigue, but chikungunya isn't fatal. As of August 5th, the CDC reports Florida has the most cases of chikungunya in the U.S., 127. New York reported 72 cases and there are 25 in New Jersey.
WEST NILE VIRUS:
No human cases have been reported in New York City or New Jersey so far this year, although several mosquitos in New York City tested positive for the virus in July. 99 percent of people who catch West Nile virus will be fine, experiencing cold-like symptoms. But that one percent of cases is why health officials spray for infected mosquitos every summer. For people who are most vulnerable (the very young, the elderly, the sick), West Nile can lead to encephalitis, which can be very deadly.
If you're worried about an Ebola outbreak in New York, you can rest easy. Mt. Sinai Hospital reported Thursday that a man who developed a high fever and stomach problems after a recent trip to West Africa tested negative for Ebola. Even though City Health Commissioner Dr. Mary Bassett said it's likely a few travel-related Ebola cases could appear in New York, she and El-Sayed believe local officials are well-prepared.
"Because we're on such high alert and it's well known that this virus has been common in West Africa, I think most travelers coming from West Africa who might come down with these symptoms are very likely going to check themselves in and come to medical attention very quickly," El-Sayed said.
Ebola can only be spread through direct contact with bodily fluids - it's not airborne. Even then, people with Ebola aren't usually contagious unless they're showing symptoms, which include fever, diarrhea and in some cases, bleeding from orifices. As of Thursday, more than 900 people have died during the outbreak in West Africa.
SMALLPOX, ANTHRAX AND AVIAN FLU:
The CDC reported lapses in handling protocols for samples of anthrax, avian flu and smallpox, but according to El-Sayed, there's nothing that suggests these diseases got loose. The CDC has shut down the offending labs until these lapses can be addressed and is reviewing its handling protocols.
While Chinese officials quarantined parts of the northern city of Yumen after a man died from the bubonic plague, El-Sayed said there's no need to worry about a return of the Black Death. Bubonic plague is easily treatable with antibiotics once it is identified. Which is a good thing, he said, since it's still endemic in many parts of the world - including the western United States, where it is transmitted by ground squirrels.