May 21, 2024

Aedes triseriatus mosquito eggs. CDC public domain image

Multiple outbreaks and unusual cases of infectious disease are in the news right now. That means it’s more crucial than ever that journalists include context in their stories to help readers make sense of their personal risk for various types of infections and what actions they do — or don’t — need to take to protect themselves. 

Recent headlines include a surge of dengue cases in Puerto Rico, a single case of H5N1 avian influenza in a person in Texas, a national increase in meningococcal disease, and a substantial uptick in measles cases and outbreaks across the U.S. The actual risk each of these diseases poses to any particular individual doesn’t just vary based on geography, and it may not match up with people’s perceived risk to themselves. That’s why reporters’ job in reporting on these topics becomes so important. 

Paradoxically, the cognitive bias known as affect heuristic can cause people to fear rare events that are less likely to occur to them than more familiar and common ones. For example, many people who are terrified of flying — despite the extreme rarity of plane crashes — don’t think twice before driving in a car, even though more than 40,000 people die in car crashes each year. 

Similarly, many Americans may worry more about a rare disease — like the human avian flu case in Texas — than a disease like measles which is far more common and contagious. 

Broadly speaking, here are the questions to answer in any infectious disease outbreak story:

  • How many cases are there now, and where are they?
  • What is the risk to your audience right now? 
  • What is the risk to your audience in the future? 
  • Which members of your audience are at highest and lowest risk?
  • If at risk, how can people protect themselves?  
  • If at risk, what symptoms should people look for and what should they do if they experience them? 
  • How does this disease, including its risk and method of transmission, relate to our broader work, including human behaviors, climate change and other relevant factors that can help people understand their relationship to the world a bit better? 

Meningococcal disease cases 

On March 28, the CDC issued an alert about an increase in invasive serogroup Y meningococcal disease in the U.S. The total case count is low compared to many other diseases — 143 cases in 2024 as of April 9, with expectations of surpassing last year’s numbers — but mortality has been higher than in past years. So far, 18% of people have died this year compared to 11% who died in cases from 2017-2021.

Here are some important points to consider in your reporting:

  • This is a generally rare disease, with most cases reported in Texas and Virginia. Virginia has been managing an outbreak since June 2022. 
  • Those at highest risk include people who are Black, who have HIV, and who are between the ages of 30-60. 
  • In sharing the symptoms of meningococcal disease, highlight those that differ most from other illnesses and suggest the need for urgent medical care, such as a stiff neck and sudden confusion.
  • Note that this disease is preventable with a vaccine and share details regarding who is recommended to get vaccinated.

Dengue in Puerto Rico

Puerto Rico declared a state of emergency on March 25 related to dengue cases, with 549 cases reported as of March 27. Here’s what to emphasize in reporting:

  • The outbreak is currently limited to Puerto Rico, so it currently poses a risk only to those living or visiting there. 
  • Dengue is a mosquito-borne illness, so people can reduce their risk by taking precautions to prevent mosquito bites and mosquito breeding. 
  • A vaccine now exists for dengue and is available in the U.S. for children in areas with endemic dengue, including Puerto Rico.
  • Covering this story is an opportunity to discuss the impact of climate change on vector-borne diseases like dengue and malaria.

Human case of avian influenza 

In several outlets and platforms, I’ve seen more stories or discussion about this single case than about the other three outbreaks combined — a good example of the mismatch between actual risk posed to people and perceived risk or fear. 

Driving that fear is the collective trauma we’ve all experienced from the pandemic and concerns that avian influenza could cause a new one. Here’s what to emphasize:

  • Although it’s being called “highly pathogenic avian influenza,” that terminology refers to its impact on chickens, not people.  
  • This is one case resulting from an occupational exposure in someone working with cattle known to be infected, and the case has been extremely mild. It’s only the second case ever in the U.S., and the only symptom has been eye irritation (conjunctivitis). It was identified because of routine testing in people working with the infected cattle. 
  • The risk to humans is low and primarily only in people directly working with potentially infected animals, such as dairy farm workers. 
  • This avian influenza type, H5N1, and several others are among those the CDC is regularly tracking and assessing for pandemic potential, but that risk remains remote for now, and the CDC already has candidate vaccines for such a possibility.

Measles cases rising

Though perhaps the least “sexy” of all these stories, the one that should inspire the most concern is the collection of measles outbreaks across the U.S. That’s because measles is highly contagious but also extremely preventable. 

We noted two months ago that the global rise in measles cases poses a threat to the U.S., especially given the lapses in measles vaccination that accompanied the pandemic. Last week, the CDC published a report about the increase in measles cases and the broader threat from pockets of low vaccination coverage. Here are the major points to cover: 

  • Measles is possibly the most contagious disease to humans, but the vaccine is 99% effective and recommended for everyone born after 1957. 
  • As of the first week in April, the CDC was reporting seven measles outbreaks (three or more cases) across the U.S. in 2024. Most of the 113 measles cases reported in 2024 are linked to these outbreaks, which literally stretch from coast (California and Washington) to coast (New York and New Jersey). 
  • The number of outbreaks is nearly double that of 2023, when only 28 of 2023’s total 58 cases were linked to outbreaks. Further, more than half of the current cases are hospitalized either to isolate the patient from the population or to manage disease complications. 
  • The biggest of these outbreaks is in Chicago, also home to the fourth busiest airport in the country. With more than 33 million people traveling through Chicago O’Hare each year, a major measles outbreak nearby is concerning. 
  • If you’re an older adult, are immune-compromised, or have other chronic conditions, and you’re living in an area where an outbreak is occurring, you may want to consider testing your immunity (titers). But frankly, it’s easier and cheaper just to get a booster.  
  • Parents should make sure they’re following the CDC’s recommended vaccination schedule for their children. 

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