Here’s an interesting commentary in Huffington Post that discusses the toll the Ebola outbreak has taken in West Africa, and what we can and cannot measure at this point in time. Kim Yi Dionne of Smith College and Stéphane Helleringer of Columbia University point out that along with the nearly 1,600 people and counting who have succumbed to the virus in Guinea, Liberia, Sierra Leone and Nigeria, Ebola has paralyzed already dysfunctional health care systems to the point that they can no longer adequately care for people with other deadly diseases. The extent of this collateral damage is hard to measure, however, because unlike the fairly precise death data reported on Ebola, the data on other diseases – from malaria to diarrheal disease and tuberculosis—are outdated and imprecise.

“The Ebola outbreak does not only affect health systems but can also modify the economic activity, movements, human contacts, sexual activity, and hygienic behaviors of individuals. And it does so in ways that have complicated effects on the health of populations. For example, widely reported food shortages may increase vulnerability to diseases. Violently enforced preventive measures (e.g., quarantines) may also lead to additional deaths. But, the insistence on hand washing  to prevent Ebola may also reduce the transmission of common food-borne pathogens (e.g., Typhoid fever, Hepatitis A) or of the flu. Because of quarantines and curfews imposed by governments (or because of general fear of exposure), road traffic may decline, thus leading to fewer transportation-related deaths. If individuals avoid close contacts with others to prevent Ebola, then some respiratory infections may spread less efficiently. Some of these mechanisms may counteract the extent of Ebola’s collateral damage.”

Disease surveillance is a challenge everywhere, but particularly in developing countries where historically the health of the public health infrastructure has been disproportionate to the disease burden. Here’s a link to the blog.