Endemic, Epidemic, Pandemic

The World is scared of the new coronavirus outbreak.
Around 80 thousand confirmed cases, more than 2.500 deaths and numbers keep growing every day.
Outbreaks of disease can spread rapidly and kill thousands.
A disease Outbreak is declared when more cases of a disease than expected are recorded in one area.
The area could be a small community or extend to several countries.
An outbreak could even be a single case of a contagious disease new to a community or not seen for a long time.
Outbreaks can last for a few days, weeks or even several years.
There are three types of outbreak: endemic, epidemic, pandemic.

Endemic: An outbreak of a disease that exists permanently, in continuity, in a particular region or population not spreading to other communities.
An endemic occurs at a predictable rate in a certain area or among a set population.
Chickenpox is classed as an endemic as it occurs at a high but predictable rate, amongst youngsters.
Endemics remain in a steady state, but do not disappear from a population.

Epidemic: An outbreak of a transmissible, infectious disease that attacks a community or and will rapidly spread amongst a large number of people in a given population, through one or several communities.
During an epidemic the disease will normally spread in two weeks or less.
There have been several epidemics since 2010, including the Ebola epidemic in West Africa, which killed 11,300 people between 2013 and 2016.
In 2003 the SARS outbreak was classed as an epidemic – it killed nearly 800 people.
In 1918 Spanish influenza killed 40-50 million people.
In 1957 Asian influenza killed 2 million people.
In 1968 Hong Kong influenza killed 1 million people.

Pandemic: A pandemic is the worldwide spread of a new infectious disease. It stretches over a larger area, infects more people and causes more deaths than an epidemic, causing severe social disturbance. A pandemic causes economic and social disruption due to high rates of illness and worker absenteeism. This is especially true if absenteeism affects key services such as transportation, communication, or power.

In history there have been a number of devastating pandemics including smallpox, tuberculosis and the Black Death, which killed more than 75million people in 1350.
In 2009 a pandemic of swine flu killed 14,286 people worldwide.

A viral pandemic occurs when:
• A new subtype of virus arises. This means humans have little or no immunity to it. Everyone is at risk.
• The virus spreads easily from person to person
• The virus begins to cause serious illness worldwide. With the speed of air travel today, public health experts believe that pandemic outbreaks could spread much more quickly. A pandemic can occur in waves. All parts of the world may not be affected at the same time.

The New Coronavirus
The new coronavirus is a new strain of the large family of viruses that has not been previously identified in humans. It is related to the common cold.
Coronaviruses are zoonotic, meaning they are transmitted between animals and people. Several known coronaviruses are circulating in animals that have not yet infected humans.
Common signs of infection include respiratory symptoms, fever, cough, shortness of breath and breathing difficulties. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death.
Standard recommendations to prevent infection spread, include regular hand washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as coughing and sneezing.
While the new coronavirus is more widespread in China than SARS, in terms of case numbers the mortality rate remains considerably lower at approximately 2 percent, according to WHO.

How do Viral Infections spread?
Viruses are very small infectious agents that can only replicate inside other living cells.
Like bacterial infections many viral infections are also contagious.
They can be spread from person to person in many of the same ways, including:
• coming into close contact with a person who has a viral infection
• contact with the body fluids of a person with a viral infection
• transmission from mother to child during pregnancy or birth
• coming into contact with contaminated surfaces
Bacteria are slightly larger than viruses and are made up of a single cell. They are very simple organisms, and most can replicate outside other cells. They are virtually everywhere.

Which infections are treated with antibiotics?
Antibiotics are medications used to treat bacterial infections. They keep bacteria from effectively growing and dividing and are not effective against viral infections.
Over-prescription of antibiotics is dangerous! It can lead to antibiotic resistance!
Antibiotic resistance occurs when bacteria adapt to resist to certain antibiotics making bacterial infections more difficult to treat.
When prescribed antibiotics for a bacterial infection, the entire course of antibiotics must be taken as not taking all the doses can prevent all of the pathogenic bacteria being killed.

How are viral infections treated?
Treatment is typically focused on relief of symptoms supporting the body to clear the infection. In some cases an antiviral medication that inhibits the viral life cycle may help to treat the condition.

The fear!
The World Health Organization characterised, globally, the coronavirus epidemic as a “very grave threat”, and the need to aggressively prevent a new pandemic is real, even if the threat to us is not immediate.
The present epidemic carries an extra charge of fear only because the virus is new, initially unknown and the danger it poses, though limited so far, cannot be precisely calculated.
People are frightened because there is a good reason for their fear, though may be not as much as they think…
The appearance of any virus that threatens our existence comes as a nasty shock as we do not normally think of ourselves as living in a great ocean of viruses and bacteria, inside and outside our bodies.
Be aware that media coverage of all disasters goes towards saying that things are bad and likely to get worse…

Best health wishes,

Maria Alice

Consultant in General and Family Medicine

General Manager/Medical Director – Luzdoc International Medical Service

Medical Director – Grupo Hospital Particular do Algarve / Hospital S. Gonçalo de Lagos

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