Top 5 Factors that Fuel Disease Outbreaks & How to Protect Yourself

Zika was a foreign word in the United States a couple of years ago, but in 2016, the virus made it to the mainstream. First discovered in the 1950s, Zika was originally found only in Africa and parts of Asia until 2007, when 49 confirmed cases were reported on the island of Yap in Micronesia.

In 2014, the disease made its way to South America, with infections confirmed in Brazil in May 2015, then spreading to other countries in South America, Central America, the Caribbean and Mexico. In early 2016, the World Health Organization (WHO) announced that Zika was expected to spread through most of the Americas by the end of the year. It now estimates that 1.5 million people in Brazil have been infected by the virus.

Zika has made its way to the United States, with nearly 700 travel-related cases being reported as of mid-year 2016. In June 2016, a lab employee in Pittsburgh contracted Zika after accidentally sticking herself with a needle, marking the first lab-related case of the disease in the U.S. Also that month, a baby was born with Zika-related microcephaly (a condition where babies are born with small heads, and brains that haven’t fully developed) in a New Jersey hospital. The mother came to the U.S. from Honduras during her pregnancy.

How Diseases Trigger and Spread

Zika is known to spread in three ways: mosquito bites, sexual contact, and during pregnancy, from the mother to the baby. It was once believed to be virtually harmless with no symptoms, but now it's known that it can lead to birth defects, including microcephaly. It is the second virus in the past two years that has led to the World Health Organization declaring a global health emergency, following the Ebola outbreak of 2014 and 2015. In recent years, outbreaks of such conditions such as MERS, H1N1, swine flu and chikungunya have also made news.

What has led to the spread of these diseases? Here are top 5 causes of epidemics: 

1. Greater Travel & Trade

First, there’s the increased travel in today’s world, something that affects expats. This is an old concept, dating to the 1300s when ships brought rats infested with the plague to Europe. Air travel has been around a while, but in the modern world, you can fly to virtually any place in the world on any given day.

Globalization has led to more work-related travel, and websites offering discounted available tickets make world travel more affordable. Unlike the plague lurching across Europe in the 1300s, a traveler can now bring a deadly strain of bird flu from China to Europe within 24 hours. People, animals, and goods are moving faster than ever, and with that comes the risk of pathogens spreading quickly.

The fact that travel can bring a disease to a country within just days can result in several complications. First, people in that area are likely to be more susceptible to the disease because neither they, nor their parents or grandparents, were previously exposed to it, which means an immunity for it hasn’t been built.

It also means doctors and medical staff are dealing with something they’ve never encountered before. When Ebola began to spread in West Africa, in 2013, many countries there had never dealt with the virus before. That’s one factor that led to Ebola spreading to epidemic proportions for two years. Today, the spread is considered under control, but cases are expected to develop for years.

Nations in East Africa, however, already had dealt with Ebola outbreaks over decades. When a case was reported in Uganda, health officials and media sent information to people as to how to stay safe, and people who even suspected they might have symptoms went to doctors, helping to control the situation.

2. The Growth of Cities – Emerging Humanitarian Disaster

Cities can be the perfect hotbed and breeding grounds for disease to spread as more people move to crowded areas. The world is becoming more urbanized, and as cities grow, they may not be kept cleaned and maintained especially in impoverished cities. Although big cities have public health services - hospitals, street cleaners, sanitization departments - when cities grow too fast, the population can outgrow the effectiveness of those services.

The spread of Zika came from the Aedes aegypti mosquito, which carries the disease and lives alongside people. The disease spread through Latin America, affecting 113 million people living in favelas or slums that lack clean water and store water in open containers with no air conditioning. Zika spread quicker and infected more people in heavily populated cities, Rio de Janeiro and Sao Paula. Poor sanitation coupled with health officials’ lack of experience with Zika led to the epidemic.

3. Agriculture - Transfer of Diseases from Animals to Humans

Population growth also has led to an increase in agriculture, which presents several opportunities for disease growth. Any time humans come in contact with animals, there’s a risk of disease spread. Diseases such as small pox, measles and tuberculosis started with farm animals transmitting the diseases to humans.

An increase in factory farming, in which cattle, poultry and pigs are confined indoors, has only intensified this. According to the CDC, factory farming weakens animal immune systems, and overcrowding helps disease spread quickly. This has been a factor in outbreaks of e. coli and salmonella.

4. Warm Climate Triggers Outbreaks

Climate change isn’t only making the world hotter, it’s helping to spread diseases. According to Centers for Disease Control and Prevention (CDC), climate change is impacting the health of human beings in several ways, including the spread of disease. Changes to the “vector ecology,” meaning areas where disease-carrying animals and insects live, can help promote the spread of diseases such as malaria, Lyme disease, bird flu, West Nile virus and others. The effects on water quality can help spread cholera and other diseases, and increased air pollution contributes to asthma.

5. How Poverty Factors In

Viruses spread faster and cause more death in poor areas. For example, in 2014, Ebola killed more than 11,000 people in West Africa. The disease also made its way to the Western World, but just 11 cases were reported in the United States. Two of those cases were fatal. In Spain Germany, France, the U.K., Switzerland, Netherlands, and Italy, there were 15 cases total, most of which weren’t deadly.

There is better health care in developed countries like the U.S. and in Europe. Ebola can be treated with kidney dialysis, IV, antibiotics and hospital care. That isn’t as available in developing countries like Guinea and Sierra Leone.

Other Diseases on the Rise

Another disease that has been detected recently is tuberculosis, which is the leading cause of death associated with infections disease globally. According to WHO, more than 9.6 million new cases of the disease occurred last year.

Yellow Fever - Southern Africa is now seeing the spread of yellow fever, with the outbreak beginning in the city of Luanda in Angola. The outbreak began in December 2015, with the first cases being confirmed by the National Institute for Communicable Diseases in January. In May 2016, the WHO determined that outbreak in Angola and the Democratic Republic of Congo (DRC) were “serious public health events.” By late May, Angola had reported more than 2,500 suspected cases, 301 of which were fatal. The DRC reported 48 confirmed cases, 41 of which were imported from Angola. In late June WHO announced it would provide vaccinations along the border of the two countries, beginning in July.

Malaria - The latest CDC data shows that in 2015, an estimated 214 million cases of malaria occurred worldwide and 438,000 people died—a large percentage of cases occurred in Africa. With no vaccination, travelers should be careful of mosquitos and look into preventive medication.

African trypanosomiasis Known as the “African sleeping sickness,” a neglected parasitic infectious disease spread by the tsetse fly that has re-emerged in the last two decades as a new epidemic in the region. Currently, WHO reports 36 sub-Saharan Africa countries are home to the disease, although the amount of cases dropped below 10,000 for the first time in 50 years in 2009.

Leishmaniasis - Although not commonly known, Leishmaniasis is a group of diseases caused by parasite of the genus Leishmania, which is endemic in 88 countries and leads to significant morbidity and mortality. This infectious disease occurs from a bite of Phlebotominae sand flies, and can cause problems to both internal organs and the skin. Although primarily affecting those in the tropics, it is becoming more prevalent in Southern Europe. The WHO reveals that more than 1.3 million new cases are reported each year.

Protect Yourself

As you travel the world, you can protect yourself from viruses and diseases by following travel warnings, getting vaccinations, and having health insurance coverage. 

Be aware of any virus or pandemic before traveling abroad. Find out health risks through travel advisory resources:

1. U.S. State Department has travel notices for Zika and other viruses along with safety and security. It recommends that pregnant women not travel to disease with ongoing Zika virus transmissions, including Argentina, Barbados, Brazil, Colombia, Jamaica, Mexico, Panama, and Venezuela.

2. The CDC has a list for travelers about specific diseases and a page where travelers can search for information about diseases by region.

3. Clements’ country risk guides contain travel warnings and unprecedented outbreaks along with recommendations from the CDC. The guides also contain information on safety, security, and terrorism.

Have you been vaccinated for measles or Tetanus-diptheria-pertussis (Td/Tdap)? Before going abroad, learn more about recommended vaccinations for the 10 most common expat destinations.

As infectious diseases spread throughout the world, get protected with international health insurance coverage for tropical diseases.  

Clements Worldwide offers 24/7 tropical disease specialists on call, including more than 200 recognized global experts in rabies, diarrhea, and vaccinations, plus specialists in more than 575 travel clinics. This is all part of Clements Worldwide’s portable international health insurance with flexible medical benefits in more than 170 countries. 

Call us today at +1.202.872.0060 or 800.872.0067 or e-mail request@clements.com to discuss how Clements can mitigate risk against Zika and other tropical diseases to protect your organization. 

Recommended Vaccinations for Travelers