Chikungunya is coming

Chikungunya is coming

Ebola is the current infection in the news and it has been a devastating disease in Africa, with 730 deaths as of today.

Ebola is spread by direct contact with blood or secretions from the infected person and as such should, in areas with resources, be controlled with aggressive infection control procedures. Based on what is known to date, I do not worry overmuch about the spread of Ebola in the US. Direct contact is not a very efficient way to transmit infections, especially infections that are rapidly fatal. Most infections routinely spread by direct contact are relatively indolent.

Although homeopaths have weighed in on the appropriate magic water to be used to treat Ebola, evidently they are not heading for Africa to prove the efficacy of their therapy and there will be scant opportunity for them to use their magic in the US or Europe to treat Ebola.

Homeopaths credit their superior therapeutics to the cholera outbreaks in London in the 19th Century. Given the purging and bleeding that were the standard medical therapy at the time, the nothing of homeopathy was likely better than the dangerous medical interventions of the time.  Bleeding someone who is losing their intravascular volume at a prodigous rate from cholera is, by modern understanding, as counter to reality as homeopathy.

There have not been many epidemics this century by which homeopathy could test their mettle. H1N1 hit hard and fast and to judge from the few papers on homeopathic treatment, it can be judged as hit or miss. Or perhaps miss and miss, since no quality pseudo-medical research resulted from the H1N1 epidemic.

We may be primed for a new epidemic in the US: chikungunya. It is in the Caribbean where it is going gangbusters: in 8 months over 500,000 cases.

Six out of 10 cases have been reported from the Dominican Republic, which tallied 307,933 cases in Epidemiological Week 31, up 26,000 cases from last week. In addition to the DR, Guadaloupe reported 71,000 cases, Haiti reported nearly 65,000 and Martinique recorded 54,000. The French side of St. Martin, where the epidemic began has reported 4,500 cases.

Spread by mosquitos, almost every one who gets the virus has symptoms: fevers, muscle and joint pain, rash and headache, often quite severe.

There are now a few cases transmitted in the US, and once it gains a toe hold it should spread fast. It took West Nile less than a decade to cross the US, although it had help from birds. Perhaps it will hit the poor disproportionately since they do not have air conditioning to keep them cool and away from mosquitos.  But I will be surprised, given the distribution of the mosquito vector, if this virus does not go through the US South like grass through a goose.

Homeopaths have treatments for chikungunya, although they lack their usual inability to understand the difficulties in assigning causality to events when treating a process that by its nature is self-limited.

We are probably on the cusp of millions of cases of chikungunya in the US. Given that there is no specific treatment or prevention (besides avoiding mosquito bites) for chikungunya and 70-90% of those infected will become ill, it is perfect opportunity for homeopathy, and the other pseudo-medicines, to put up or shut up. An epidemic is coming for which medicine only has supportive care, the perfect opportunity for pseudo-medicines to demonstrate their effectiveness with modern methods.

Somehow I suspect it will not happen.

Points of Interest 8/6/2014
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