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Topic overview

New and dangerous infectious diseases are surfacing around the planet at an accelerating rate.

From the spread of Zika virus into the southern U.S. to an Ebola epidemic in West Africa, to a swine flu pandemic that began in Mexico, each of these recent health threats seems have taken the public by surprise.

But they shouldn’t have. We have been in a continuous battle for survival with bacteria, viruses and fungi that live in the environment and inside our bodies. History has been filled and shaped by infectious disease outbreaks that killed millions – from the plague in the Middle Ages to cholera deaths throughout Europe in the 19th century.

In the 20th century, humanity learned to tame many of these dangerous microbes with improvements in sanitation, hygiene, animal and pest control. The discovery of antibiotics and the implementation of childhood vaccine programs all have led to a steep decline in infectious disease deaths. While pneumonia, tuberculosis, and diphtheria were among the top causes of death in 1900, non-infectious diseases like heart disease, cancer, and strokes replaced them by 2014.

Humanity’s success in controlling infectious disease outbreaks, however, is under pressure. The combination of the world’s exploding population and human behavior are giving dangerous microbes potential advantages again.

Globalization, in the form of international trade and airline travel, mean diseases can’t be contained by borders. The rise of industrialized farming, the destruction of wildlife habitats and climate change means there are more ways for the planet to incubate disease than ever before.

The majority of disease-causing microbes – about 60 percent to 75 percent – originate in the bodies of furred or winged animals and then jump to humans. From cows came tuberculosis, from pigs and birds, influenza; from primates and mosquitos, malaria and from bats, Ebola. Scientists estimate there may be more than 500,000 unknown viruses that could jump from animals to humans and cause disease.

Meanwhile, some parents are refusing to vaccinate their children for known viruses, causing pockets of outbreaks of childhood diseases that had once been eliminated, such as measles and whooping cough, thus risking everyone’s health. Overuse of antibiotics in medicine and agriculture have led to the rise of an increasing number of “superbugs” – bacteria that are resistant to antibiotics – threatening all the gains of modern medicine.

Reporters are certain to be covering these complex and multidimensional threats to public health. It is crucial the stories be informative, sensitive to people’s concerns and evidence-based – all without inflaming fears.

Doing so is especially challenging today. There is inherent uncertainty involving the spread of a disease outbreak, particularly if it isn’t well-understood, as was the case with Zika virus when it began to spread from Brazil in 2015. That uncertainty is difficult for media to convey without raising fears.

Social media enables apprehension and skepticism to spread, unchecked by scientific evidence, as was the case during the 2014 Ebola outbreak. Though reporters published interviews with public health officials stating that no one could get Ebola without direct contact with the infected person’s bodily fluids, many people panicked about an Ebola outbreak in the U.S.

So how should reporters be thinking about covering the infectious disease beat?

Before there is another outbreak, begin thinking about infectious diseases as an ongoing security threat.

Because of better surveillance, the number of total reported infectious disease outbreaks worldwide has tripled since 1980 to more than 3,000 annually, according to the World Health Organization. Effective infection control has meant that the number of infectious disease cases, per person, has declined, but the current factors of globalization, population explosion, and antibiotic resistance is challenging public health resources and could reverse that progress.

Ask questions of local, state and federal leaders, advocates, officials and researchers about the risk assessments that have been made about a health security threats in your communities, whether it be a local transmission of a new virus from an animal or an unvaccinated child. Explain that risks to communities differ based on diseases and how they spread among people in a particular region.

Become familiar with the public health terms that are used by public health officials to control infectious disease, such as epidemic, pandemic, endemic, infectious, vaccine, virulence, and pathogen — and be able to explain what they mean. Understand and distinguish the roles of epidemiologists, virologists, and ecologists to explain the many different science angles related to a disease outbreak.

Understand the difference between incidence versus prevalence – meaning, how many cases of a disease have been reported versus the percentage of the population that has been infected.

Ask questions about the level of preparedness, among first responders, at hospitals, doctors offices, and schools for a potential outbreak, whether it be from a flu, or disease that might be more prevalent in a particular region. How much money and time has been invested in health disaster preparedness? What lessons have been learned from past outbreaks and what gaps need to be filled?

Seek out reliable and relevant experts as sources and make sure their assertions about diseases are corroborated by peer-reviewed medical evidence. Giving voice to opinions of scientists or individuals that aren’t based on medical evidence can raise inaccurate and harmful doubts about established public health tools, such as vaccines.

Other questions to ask during an outbreak include what are the causes of the particular disease? What harm specifically can it do to people? What level of risk is there, based on evidence, that someone will get the disease, versus the perception people may have of the risk of the disease? How can people protect themselves and are some people more at risk than others? How can the spread of the disease be stopped and can the harm be treated?

After initial reports on the news of an outbreak, journalists can focus on reporting why the outbreak happened at this particular time and place, whether it happened before, and what can be done to prevent it happening again? What were the lessons learned?

When there is an outbreak, reporters play a pivotal role in communicating essential information from government officials to the public. Reporters should be skeptical of the sources of information and also mindful of avoiding sensationalist and emotional language that could over-hype the risks of the outbreak. The Association of Health Care Journalist has created an ethical guide for reporters covering infectious disease outbreaks to help them ask these questions.

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