The writers, who are all physicians, are infectious diseases specialists for the University of Nebraska Medical Center/ Nebraska Medicine.
In recent days, two concerning stories about the ongoing Ebola epidemic in Africa grabbed our attention. On June 10, social media sites circulated posts about Congolese refugees who had crossed the border from Mexico to Texas and tested positive for Ebola. The posts circulated widely enough to be picked up by mainstream media, and Texas health officials eventually had to issue statements to refute the claims. On June 11, health authorities in Uganda confirmed the first trans-border spread of the outbreak from its source in eastern Democratic Republic of Congo; a 5-year-old child and several family members.
Both reports were alarming: the first for its falsehood and propagation of dangerous mythology surrounding emerging infectious disease threats; and the second for its confirmation that this current Ebola outbreak, now the second largest in recorded history, shows no signs of abating. As infectious disease and public health professionals, we feel there are powerful lessons to be learned from each.
Misinformation may be one of the greatest public health threats we face today. As the 21st century ages into adulthood, we run the risk of walking back the tremendous achievements of public health in the 20th century. From 1900 through 2000, American public health agencies virtually eliminated the worst childhood illnesses and diseases of poor sanitation and hygiene from the United States, increasing our life expectancy by 30 years. Yet today we face new outbreaks of vaccine-preventable disease, such as measles, fueled by baseless speculation regarding the safety of the very vaccines that we have used effectively for a generation. Public trust in established institutions of knowledge and expertise is eroding as discourse over science becomes increasingly politicized; fertile ground for ideological or political zealots to propagate their own false narratives.
The Congolese refugee story is one such example where common myths about disease are used for political purpose. Fear of disease-carrying immigrants only distorts our perception of true risk and distracts from the actions we need to take to protect ourselves. In fiscal year 2018, Customs and Border Protection apprehended 404,142 people crossing into the U.S. illegally, whereas in any average day, the agency processes over one million persons entering the U.S. through legal ports of entry. This includes over 340,000 international air travelers. In modern interdependent economies, restricting free movement of people and goods creates unacceptable economic chaos. If a disease outbreak rages somewhere in the world, eventually it is likely to end up here, and not via refugees or illegal immigrants.
It is misinformation that drives the current outbreak in eastern Congo, which has claimed over 1,400 lives. Rumors among the local population include that the outbreak is a government ruse for controlling political opposition, or that Ebola treatment units are harvesting organs. The result is families who are afraid to identify ill relatives, villages that refuse to admit public health teams, and even mobs who commit violence against health workers.
Now that the outbreak has spread across the border with Uganda, cases are only six hours by road from the urban capital of Kampala and the international airport in Entebbe. The risk of acceleration and spread increases. The events in Congo and Uganda should serve as a warning that infectious diseases are a continuing global threat, and our current public health tools are still inadequate.
This is what we can we do to help the struggle against emerging pandemic threats:
- Fight misinformation and promote credible sources.
- Adequately fund our public health infrastructure.
- Increase international collaboration for preparedness and response.
- Make new investments in innovation for pandemic defense.
At UNMC and Nebraska Medicine, we lead the world in training, research and clinical care for highly dangerous pathogens, and we will continue to work tirelessly to develop new tools in our constant struggle against pandemic threats. Let’s all pitch in and be part of the solution.