As Ebola spreads, Australia faces rise in 'biblical' disease risks

Link copiedShareShare articleThe bugs that cause Ebola, hantavirus and diphtheria are microscopic, but many of the barriers to controlling them are human-sized. In the video game Plague Inc, the goal is to create a pandemic and infect the world. And for Doherty Institute director of epidemiology Jodie McVernon, it's more than a game. "I make my students play it," she explains, to help them understand how pathogens evolve and thrive in certain environments. With Ebola, hantavirus, diphtheria, measles and syphilis all in the headlines, reality has started to resemble the simulation a little too closely, both in Australia and abroad. To understand how rapidly an infectious disease is spread, scientists use the basic reproduction number, known as R-nought or R0. This calculates the number of people a single infected person is likely to spread the disease to. It's not an exact number, but a complex mathematical estimation that takes into account the infectious period, the transmission mode and the contact rate of an infected person. It's based on a population where everyone is hypothetically susceptible to the disease. But the R0 number is only one part of the story. In the Democratic Republic of Congo (DRC) in central Africa this year, one of the world's deadliest viruses has resurfaced: Ebola. It's the first major outbreak in more than a decade, and the World Health Organisation has declared the situation a "public health emergency of international concern". The Bundibugyo strain of the virus is spreading in both the DRC and Uganda, with a total of at least 1,000 cases and more than 260 deaths. The Ebola virus has an R0 of 1.8. The case fatality rate (CFR) for the Bundibugyo strain is between 30 per cent and 50 per cent, which means up to one in two people infected with the disease die. Health workers on the ground in Africa are dealing with a complicated set of barriers to containing the disease, including ongoing violence and instability in the DRC after decades of conflict. Thousands of people have been displaced, and health workers are also facing attacks on Ebola treatment centres. Another huge challenge is community denialism. A tour operator living in the DRC told the ABC's Radio National that large parts of the population don't even believe the disease exists. UNICEF deputy representative for the DRC, Mariame Sylla, says tackling denialism is a top priority and the UN has set up an online chatbot to help counter misinformation. "The key to controlling and getting this epidemic under control is community engagement," she said. After visiting the hardest-hit region in the DRC earlier this month, WHO director-general Tedros Adhanom Ghebreyesus says although the disease has had "a big head start", he believes the agency is "catching up". Professor McVernon says the fact Ebola can only be passed on once an infected person has symptoms means control is possible with the right support on the ground. "With effective identification and case isolation, it's a controllable disease from a public health perspective," she says. "The control of Ebola is about engineering and safe isolation and management of infected waste in health treatment centres where people can be isolated. "So, we know how to address the risks in-country, but that's obviously made much more complicated by conflict and the kinds of mistrust of authorities and unrest that are occurring. That's really where the danger is." The Australian government says the Ebola outbreak in Africa is "deeply concerning", but it has no plans to impose border restrictions at this stage. University of Queensland infectious diseases expert Paul Griffin says the risk of Ebola reaching Australia is low, "but we do need to make sure, given the significance of the situation in that region, that everything that needs to be done is done to contain it as quickly as possible". In Australia, the largest diphtheria outbreak on record has prompted the federal government to spend $7.2 million on a vaccine blitz. Professor McVernon says structural disadvantage, racism and poor living conditions are playing a part in the emergence of diphtheria. "I've seen the term 'biblical disease' up on a whiteboard… really old diseases, you know, we don't even think about them most of the time. "But this is a re-emerging infectious disease." A recent report by the Global Preparedness Monitoring Board (GPMB) warns the world is more vulnerable to pandemics and deadly disease outbreaks than it was before COVID. When we look at the data, Australia has not met its 95 per cent immunisation target for five-year-olds since 2020 — the year COVID-19 began. Professor McVernon says a creeping complacency about vaccines is a big issue. "We've been very successful at immunising in Australia, and we've maintained very high levels of vaccine coverage. "But as those levels start to fall, this is what we start to see is you might have little outbreaks, they might be reasonably

As Ebola spreads, Australia faces rise in 'biblical' disease risks

Key takeaways

More in international