[phurley]

http://www.cdc.gov/malaria/about/facts.html

You are far more likely to be infected by malaria than ebola. Ebola is scary and makes for great news that draws lots of attention -- but it is largely sensational and not truthfully something you need to rationally fear, unless you work with infected individuals.

[dllthomas]

No. Based solely on rates in the past, rather than any sort of projection into the future, I'm incredibly unlikely to be likely to be infected by either (note from your link, that of the <2k/yr of malaria in the US we see "almost all in recent travelers").

If I am infected by either, I am overwhelmingly more likely to survive a bout of malaria.

And during an unusual outbreak (which is the case for ebola at present), looking simply at past incidence will underestimate my risk.

It's still probably not a high risk, and there are higher risks (which I try to pay more attention), but I don't think it's wrong to say it poses a greater threat to me (or to the overwhelming majority on this site) than does malaria.

[danieltillett]

Actually it is very difficult to place any risk estimate on ebola (or any other new viral strain) as we don’t really know much about it.

Imagine that it is 1918 again and someone was trying to make a prediction of the likelihood of influenza becoming a deadly pandemic that would kill 100 million people over the next 18 months. They would look at the past history of influenza and say there is a negligible risk of this happening. Of course now since we know that influenza can become very serious we keep our eyes on it, but for something like ebola we really know very little.

[dllthomas]

Based on previous outbreaks of things generally I think it's most likely to be correct that this outbreak is also of low risk to the US population at large. Which is not to say that there's not a tremendously high value of information - the next thing we learn could change that (and again, probably won't, but...). I think it does make sense to be paying some attention as random individuals, and more attention as health workers or CDC employees, and I think it is probably still the case that my drive home is more likely to kill me (but I pay a lot of attention to my drive home!).

[danieltillett]

Humans tend to overestimate the danger of apparent low probability, high impact events (like pandemic ebola) and underestimate the risks involved in mundane events (like driving a car).

Given how infrequent pandemics occur, a better way to judge the risks involved would be to take a much long term view and try to measure the risk of a major pandemic occurring in your lifetime. When you look at the history of plagues over the last 2500 years they are infrequent, but common enough that we can get some handle on the risk. My very rough calculations based on past pandemic frequencies and death rates put the risk at around 1 in 1000 of being killed by a pandemic sometime during your lifetime. This is not huge, but at the same time it is not trivial.

Edit. I added the word apparent to the “…danger of…” as I realise that my wording is confusing without it.

[dllthomas]

You seem to have approximately restated what I said. That's fine, but it's best to note that that's your intent...

[danieltillett]

Not really, well not by intent :)

I might have worded it better, but pandemics are actually one of those areas that people get the risks wrong for the opposite reason than usual. While pandemics are considered low frequency, high risk events and so over-worried about, they are actually relatively frequent events on a historical time scale and are not worried about as much as they should be. They are really more in the car crash category not the stuck by lightning category, but we get complacent because a big one has not happened in living memory (unless you count HIV).

[nospecinterests]

Your chances of recovery from Malaria are far higher than recovering from Ebola. Malaria is more of a regional issue and does not necessarily have the ability to reach pandemic levels where Ebola, because of its communicability, does.

Edit: Though you are correct it is not necessarily something to be freaking-out over at the current moment. That said its a serious problem that we should not assume is benign. We should be working to contain it outside of the US.

[josephschmoe]

I've heard consistently that ebola is incapable of becoming a pandemic in first world countries. This is because it lacks the resiliency to survive outside of the human body for long periods of time.

[danieltillett]

The problem is a virus have a nasty habit of evolving - just because all the past ebola strains have had a particular property does not mean that any new strain will behave in the same way.

There does seem to be something about the strain in this latest outbreak that is different to past outbreaks.

[Crito]

Do you similarly lose sleep over the idea of AIDS becoming airborne?

Don't waste your time worrying about such hypotheticals. If you want to worry for sport, there are better things to worry about.

[dllthomas]

The odds of any particular mutation are small. The odds of any mutation are high. The odds of a meaningful mutation, somewhere between the two. The fact that we're seeing more spread than usual is already some evidence that this strain has some relevant mutation - though I don't know enough to quantify how much evidence.

[danieltillett]

No I don’t worry about AIDS becoming airbone, but when you look at the historical record of pandemics they are much more a problem than would appear of first glance. Pandemics that wipe out 1/3 to 1/2 the population and that appear out of nowhere are far too common over the last 2500 years for us to be complacent.

[ams6110]

For roughly 2300 or more of those years we didn't understand how diseases spread or how to treat/prevent them.

[nospecinterests]

That is a total overstatement/generalization.

[nospecinterests]

That would be the case if it were not for the fact that it is really good at surviving in the human body.... until the person is dead or until they have developed antibodies to fight it. Some people do survive Ebola (aka the plague or the black plague). But not many. Ebola spreads, and fast at that, in areas where there are high population densities, areas where people are in close contact (areas like NYC). Because of the symptoms, it is possible that someone may be infected, spreading the disease, but think they have the flu or some other common ailment. That is the reason why the hospital in the original article didn't take chances and put the person in involuntary quarantine (the article didn't say it but I can guarantee that is the case (and the patient may not know it because if you had Ebola you would have to be insane to decline care)). The only effective way to fight Ebola is quarantine. You section off an area, don't let anyone in or out, and wait out the sickness until it runs it course. After that you safely and securely destroy everything.

[maxerickson]

Plague refers to several types of bacterial infections. The Black Death is believed to involved bubonic plague because of the characteristic symptom described in all sorts of records:

http://en.wikipedia.org/wiki/Bubo

I guess a hemorrhagic fever can't be ruled out though.

Ebola, in the form that requires fluid transfer, won't spread all that quickly in the U.S., where people aren't all that skeptical of doctors and tend to react to disease threats by avoiding touching things (as I understand it, burial practices involving touching the bodies are a significant source of infection in the current outbreak).