Getting real: Why you should fear that stray dog more than Ebola

The disease with the highest mortality rate in Africa, untreated, is African trypanosomiasis or sleeping sickness. It kills 100% of those infected.

EBOLA is grabbing all the headlines today, simply because it is the kind of disease that cannot escape attention—it has no cure, and the frightening nature of the classic symptoms, especially the bleeding from body openings, makes it the stuff of real and movie nightmares. But it isn’t Africa’s deadliest disease, not by a long shot.

The biggest killer in Africa remains HIV/Aids, which killed over one million people in 2012. Second is pneumonia, and third is neonatal complications which includes injury, trauma and infections to newborn babies, killing over 900,000 infants every year.

Diarrhea and malaria both kill more than half a million people every year—mostly children—while stroke, heart disease and diabetes, which many Africans still think are “western diseases” all are among the top 15 killers. To date Ebola, which broke out in December 2013, has killed 1,229 according to the World Health Organisation (WHO). At this rate, assuming the mortality rate of the West African Ebola doesn’t rise beyond - or drop below- the current 55%, then it could kill up to 1,845 people by December. A big number and tragedy for the families that would have lost their loves, but still small beer compared to at least 15 other disease that wreak more havoc.

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But perhaps it’s Ebola’s high case mortality rate that makes it scary—once you get it, you are very likely to die from it. In years past, outbreaks in the Democratic Republic of Congo (DRC) and Uganda have  killed more than 90% of those infected. However, one silver lining in the current outbreak is that has had more survival stories; the mortality rate is “only” 55%.

Sleeping sickness is king

Surprisingly, the disease with the  highest case fatality rate in Africa is African trypanosomiasis, also known as sleeping sickness. It kills 100% of those infected if it goes untreated. 

Death from sleeping sickness comes slowly—after being bitten by an infected tsetse fly, the symptoms start with fevers, headaches, itchiness, and joint pains. 

Several weeks or months later, a person begins to experience a disruption in their sleep-wake cycle, unable to stay awake during the day but having insomnia at night. With time, symptoms degenerate into confusion, tremors, limb paralysis, as well as psychotic symptoms such as hallucinations and aggressive behaviour; eventually, coma and death.

Sleeping sickness is one of the diseases that has affected migration and settlement in Africa. Farming communities settled in highland areas where the tsetse fly is absent, whereas in lowland areas where the tsetse is present, communities live a nomadic, less agriculturally intensive lifestyle to evade the tsetse fly.

Other diseases which have a nearly 100% death rate are prion encephalitis (“mad cow disease”) and visceral leishmaniasis, also called Kala azar, one of Africa’s neglected tropical diseases. 

Rabies is also one of the very fatal diseases—untreated, it has a death rate of nearly 100%. The World Health Organization (WHO)  estimates that there are more than 200 million stray dogs worldwide and that every year, 55,000 people die from rabies, while another 15 million receive post-exposure treatment to avert the deadly disease. 

A good 95% of these cases occur in Asia and Africa, and 99% of the fatalities are caused by dogs. In Africa, 14,000 people die every year from rabies—more than seven times the likely toll of the current Ebola wave by year’s end. 

It’s a problem African cities should be worried about—Last year, Pointe Noire city in the Republic of Congo was hit by a  rabies outbreak; by November, ten people had died and more than 190 people needed treatment after being bitten by stray dogs.

The only comforting thing is that most of these “very fatal” diseases have treatment or vaccines available, unlike Ebola—hence the super-hyper response by African governments to combat the disease, while other diseases, like malaria, look like they have become just part of everyday life.


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