26 September 2009

Thoughts on disease outbreaks...

Here's a really interesting website - HealthMap. It led me to an entire line of thought about contagion.

If you'd like to get a chill up your spine, go to HealthMap and navigate to the east coast of Egypt, where H1N1 and H5N1 have shown up together in a couple of individuals after this year's Hajj. H1N1 is very contagious in humans but not so deadly to most. H5N1 is less contagious in humans but very deadly. Viri are notorious for picking up one another's "useful tricks". It seems clear that, at some point, matters of contagion in travel are going to go beyond wearing a mask, washing hands, and having good air filtration systems in aircraft.

I've come to understand a little of the psychology of sickness when traveling from personal experience. In late April, I took a two week trip to Morocco that I had been hoping and planning to take for a few years. Perhaps from excitement or nervousness about not speaking either French or Arabic usefully, I had a really edgy tummy through the entire trip. Although I enjoyed my Moroccan adventure thoroughly in spite of it all, by the time it was over, the one thing that I desired most desperately was to get home, crawl into my own bed, and eventually stop feeling the perpetual need to run to the bathroom every couple of hours.

I left for Morocco on the very week that the news broke about H1N1 in Mexico. In the course of the journey to Morocco, I missed my connection to Royal Air Maroc in New York and had to wait until late the next day to get a ticket for the evening flight. While I waited for the RAM counter at JFK to open, I watched the lines at the Air Mexico counter two booths down, as people rearranged their travel. I followed the whole affair in the news while I was traveling, and I was a little nervous when I got to the airport in Casablanca for the flight home whether a diligent RAM employee would notice I wasn't feeling particularly well and that I was in JFK that particular weekend and prevent me from getting on the plane. Nothing happened and I got home just fine.

My condition wasn't communicable, just a reaction of my unfortunate digestion to the stresses of travel, but if my situation were different I might have become a disease vector. I would have been strongly tempted to lie if I had to in order to get home. Whether I would actually have committed a blatantly immoral act like that if it came down to it, I don't know. I hope that I wouldn't. However, when you're feeling sick in a country where you don't speak the language and just want to get home, that isn't the best time to be thinking about these things for the first time.

Sometimes it isn't black-and-white. Arguably my actual situation was a little more iffy than I believed it to be. In the middle of the trip, I had one bad night - fever, sweats, and chills - that I put down to dehydration due to the traveler's tummy. I spent a day in bed, drinking tons of water, and then adjusted my diet. There could have been something more. How would I know? I was never in one place long enough to have anything tested and have results come back. Except for that day, I stuck to my universal remedy for life's troubles during the journey, the' marocain in a street cafe in the morning, watching the crowds go by, one touristy visit each day, an afternoon nap, and a stroll in the late afternoon or evening for a bit of window-shopping, and I enjoyed my trip. Very relaxing. Was that irresponsible? I don't know. I also don't know what my other options would have been. How many travelers do?

I can't help but think that the twin natural human compulsions to trundle on as planned as much as possible and to run home, however far away, when things are going badly are going to both be significant factors in the spread of disease.

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