Scary Disease of the Week: Rabies

#2 Rabies. 100% fatal, and it’s a terrible way to die.

Rabies patient, 1959. CDC

Is there a vaccine? Yes. (I’ve had it twice myself.) Does it work? They really don’t know. (It’s not as if they’re going to ask a bunch of people to volunteer to take the vaccine and then infect them with rabies on purpose to make sure it worked. Not with that 100% fatality rate.)

And it certainly scores a full 10 points on my “symptoms involve the brain” scale. Terror, paranoia, and hallucinations are likely to plague you on the way to your inevitable death.

The one saving grace with this disease is its R nought, about 1.2. That is, if you have it, you’ll likely only infect one person, who will perhaps weeks later only infect one, and so on. Therefore, it’s unlikely to burst into pandemic status the way measles or MERS or the flu could. On the other hand, the infection of a group of animals could spread it locally to humans more rapidly. If every squirrel in Ontario, for instance, had it, and if they could pass it to pet cats allowed to run loose, there would be many more human cases as a result.

A diabolical person could manipulate it in the lab to become more pathogenic and then capture, infect, and release those squirrels. Because of the 100% fatality rate (exactly one person has recovered with treatment--though she still has serious and apparently permanent problems with balance--so it’s shy of that by the tiniest fraction of a percent), it’s on most biodefense programs’ list of potential weaponized diseases.

Rabies. Wikimedia Commons

And so we’re down to the final disease next week, my choice of the #1 scariest infectious disease out there.

Scary Disease of the Week: Hemorrhagic Fevers

#3 Viral hemorraghic fevers. Ebola, Marburg, Machupo, RVF, lassa, and a dozen more emerging diseases. If you’re only in your 20’s, expect to see many more discovered in your lifetime. 

Ebola outbreaks. Zach Orecchio via wikimedia commons

These diseases get a lot of press, and they seem to be #1 on most people's list of scary disease, despite the infections being rare. I suspect it’s the image of bleeding profusely (which doesn’t often happen, and not exactly the way it’s often fictionally presented), particularly from the eyes, that hits our “fear button.” The horrible part of the disease to me is the pain. As the organs are attacked and become spongy, there is reportedly terrible abdominal pain associated with that. You have a fever, you’re weak and sick, the whites of your eyes may get a few red streaks, but the pain in your gut is what pins you to the bed.

The fatality rates on these diseases range from a low of less than 5% to a high of 70%--similar to the range of flu fatality rates. Zaire Ebola (EBOV) has one of the highest mortality rates. The R nought--how many people get infected by one sick person--isn’t that bad, actually, particularly not in the countries where my readers live. The infections spreading more than that in Africa is related to funeral practices there. Nearly half the people who have died of it are health care workers, and of the rest, half are the women family members who traditionally prepare bodies for burial. If scientists can convince people to forgo their typical burial practices with the dead bodies, the R nought for Ebola drops to near 1. Viral hemorrhagic fevers can also be passed sexually, after recovery, for three to five months.

To be weaponized, you’d want to increase that aspect of the disease, making is pass more easily from person to person. Currently, with Ebola, sneezing pigs can infect people easily but sneezing people cannot. It wouldn't take much time in a lab to change that fact. Everything else about any one of these diseases is bad enough, but were you a terrorist, you’d want it to move easily through the air so that one sick person infected many. If you could change the most deadly hemorrhagic fever virus so that it had measles’s skill at jumping from person to person, you’d have a terrible weapon indeed.  

Lassa virus

Stay tuned for scary diseases of the week #2 and #1. Can you guess what they are?

Scary Disease of the Week: Botulism

A series of blog posts upon the occasion of the release of my pandemic thriller Crow Vector.

#4 Botulism.

Clostridium botulinum from Wikipedia

Until I researched various weaponizable diseases for my novel 41 Days, I didn’t know how bad this was. Now I have something new to be terrified of!

It isn’t new, of course. As a child I was told about it. Home-canned foods are the most frequent source in industrialized nations, though there is wound botulism too and rare cases of inhalation botulism with lab workers. Certain sorts of health-food eating make it more likely you’ll get this disease: home fermented foods, non-pasteurized fruit juices, and the like have never been proven by science to do you any good, and if you’re dead from botulism, they definitely didn’t do you any good.

It’s not transmissible in the same sense all of the other scary diseases I chose are. It’s from a bacteria, but it’s not the bacteria itself that infects you and directly makes you ill, as with the plague. It’s a waste product of the bacteria produced in anaerobic conditions that gets you: the botulism toxin.

The disease qualifies as scary because of how sick it makes you: blurred vision is often the earliest symptom, then nausea, vomiting, increasingly painful cramps, seizures, paralysis of the face, and eventually the paralysis spreads downward to your chest so that you can’t breathe.

In the 21st century, there are treatments, and as a result not even 5% of people with it will die in places like Canada and Australia and the U.S. But where people don’t have access to those treatment or are too poor to afford them, it's 50% of people: also scary. For my prepper fans who believe that one day a SHTF scenario actually will come to pass, I’m betting you’re not going to have a lot of botulism antitoxin on hand, so you’re back up to the 50% fatality rate in those circumstances. And you'll probably be canning food at home so be at increased risk anyway.

Furthermore, it is weaponizable, which also kicked up its scariness score to put it at #4 on my list. USAMRIID and other biodefense labs around the world think this is important enough that they are working on defenses against that possibility.

Stay tuned for scary diseases of the week #3, #2, and #1

Scary disease of the week: Creutzfeldt–Jakob

#5 on my countdown of terrifying diseases.

Creutzfeldt–Jakob disease. It’s rare, but it’s here--here meaning in the US, Canada, England, and Australia, where most of my readers reside.

It’s a prion disease. Prions are not amoebas, not viruses, not fungi, not bacteria, those being the usual agents that cause diseases. They’re something else, not even a form of life, and we can’t do a blessed thing about them yet.

It’s fatal. There’s no vaccine. There’s no treatment beyond pain pills and sedatives.

Worst of all, it’s not a good way to go. Because it in effect rots the brain, you have several stages of increasing dementia, hallucinations, muscle spasms, burning nerve pain, and eventually your brain won’t be able to tell you to breathe or swallow, which is what usually kills you.

Sometimes it comes from a genetic mutation. You can get it from eating animals that have it. (Don’t eat brains of any animal. I don’t care if you love their taste. Don’t risk it.) Cannibalism can spread it, so, er, avoid that too, in case you indulge right now. And you can get it from transfusions and transplants. Blood, transplanted corneas, and human growth hormone from infected people have spread it.

(Aside: my favorite discovery from my research for these posts was this line in Wikipedia: “In the U.S., the FDA has banned import of any donor sperm, motivated by a risk of Creutzfeldt–Jakob disease, inhibiting the once popular import of Scandinavian sperm.” Apparently, there was a Scandinavian sperm fad here that I totally missed???? Anyway...)

Stay tuned for Scary Diseases of the Week #4, 3, 2, and 1.

Scary disease of the week: introduction

Wikimedia commons

In my new novel, I make fun of “scary disease of the month reporting,” and yet here I am succumbing to the urge to do the same thing in this blog. Let me get that confession out of the way, and let me also remind both you and me that what kills people most is heart disease, COPD (both made much worse by smoking), diarrhea (in developing countries), and complications of diabetes. Among infection diseases, malaria is the biggest killer, but it’s not a disease that many of my readers have to think about. (It occurred naturally in Australia, particularly in the north, but y’all have worked hard to eradicate it.)

But even though the numbers give us that list, for some reason, it’s the emerging infectious diseases that capture our attention and frighten us. The blog posts in the following week pick five diseases that scare me plenty.

What makes a disease scary to me?

• It’s kills most of those who get it. Over a 50% fatality rate gets my attention
• On the way to killing me, it hurts me a lot or gives me dementia or nerve pain or other brain damage
• It’s out there, already near me, or could easily be
• There’s no way to prevent getting it
• Or it mutates so easily that the prevention currently available quits working
• There are no or treatments that work or the ones that do are limited in supply and expensive
• Its infection rate (called R0 or R nought, in epidemiology) is high, moving easily from sick Sue over there to healthy me
• A very bad person could use it in an act of bioterrorism

So here’s a rating chart I devised for my own use. I assigned points in every category from 1-10 to be as fair as possible in choosing my top five.

Those diseases that kill 100% got a 10, 70% got a 7, and so on. I went with the fatality rates with treatment in industrialized nations rather than its true fatality rate. As measles R nought runs around 20, most are under 10 so I gave it it’s median R nought score (if, on average, one sick person infects 4 others, it got a 4). “Crazify” is my neologism indicating the sort of torturous brain damage that scares me at least as much as physical pain and far more than bleeding out the eye sockets does. You might not feel the same about this issue, but that’s nightmare fuel to me. Imagine being paranoid, hallucinating, and demented, on top of the coughing or diarrhea. "It’s here!" means it is here in North America, something we could in fact catch right now. Usually that means it’s also in Australia and England, though not always. In one case, England has it worse than North America.

Diseases that are plenty scary but didn’t make my top five:

MERS. Terrible disease, a killer, no vaccine, but it’s still rare. You pretty much have to be in Saudi Arabia to get this and hang out with camels, or be a health care worker treating such people. It may be weaponizable though. Stay tuned to see what natural mutations and a spread to additional mammals might do to this one in your lifetime.

Measles. Worldwide, it’s a terrible killer, and the #1 easiest disease to pass along (it has the highest R nought). However, this disease is easily preventable with a vaccine. If you don’t vaccinate your children, there is no simple treatment and they have a good chance of dying. If enough people refuse to vaccinate, it’ll burst into epidemic status again in the developed world. 400 children die per day of it around the world as is. Enough people stop vaccinating, and that could jump to 4,000 or 40,000.

Smallpox. A nasty disease, very contagious, about 40% fatal, but except for some samples in labs, gone from the planet. This is not a promise on my part that some idiot won’t take those lab samples and start a pandemic again.

Naegleria fowleri, or the the brain-eating amoeba. Almost always fatal, not treatable, it scores high in my scary-brain-damage scale, and it’s here in North America, but you can’t catch it from the guy next to you on the bus. Not weaponizable and easily filtered out of city water supplies. But “brain-eating amoeba” isn’t a particularly comforting name, is it? (shudder)

Q Fever (Coxiella). I addressed this one in my novel 41 Days. It doesn’t kill now but it has a super-clever cellular trick that means if it ever was turned fatal by a terrorist manipulating the virus, or by Nature mutating it, it could be a real problem. All viruses are difficult or impossible to treat, and this one is no exception.

HIV. A killer, to be sure, but preventable and increasingly treatable (not curable, and the treatments have nasty side effects, but treatable). It is not potentially a pandemic, for it is already a pandemic. Pretty awful, but not awful enough to make it into the top five for me.

Pneumonic plague. Weaponizable and particular scary because you could wander around infecting others for a week before you got sick, scoring the maximum on the R nought scale, this can’t make the grade because it’s bacterial and almost any antibiotic will cure it...so far. (insert scary music cue) Get an antibiotic-resistant form of this one going, and we will have bad trouble.

Next week: Disease #5 on my personal list of scary infectious diseases for humans.