[August 18, 2014]

Global Ebola Pandemic Unlikely, Say Catastrophe Risk Management Experts

According to RMS, the world's leading catastrophe risk management firm, the current Ebola outbreak is the largest in history and a serious concern for the West African region due to a confluence of circumstances, including the pathogen's virulence and transmissibility as well as societal and environmental factors, but it is unlikely to spread beyond the region and become a global pandemic.

"Any emerging disease, especially one that is highly transmissible, poses a great risk and has the most potential to become a global pandemic because there are no vaccines or treatments available," said Mary Chang, medical research analyst and pandemic expert at RMS. "The current strain of Ebola is quite deadly but not particularly transmissible in comparison to other infectious diseases. Societal and environmental factors in West Africa have created unique circumstances for the disease to spread quickly, but infection-control measures and medical practices outside of the region make it unlikely to pose a global pandemic threat."

RMS experts have identified contributing factors to the spread of Ebola in West Africa, as well as reasons a global pandemic is unlikely:

• Virulence: The current Ebola outbreak causes death in 55 percent of those infected. Some Ebola outbreaks have had a mortality rate up to 90 percent. For comparison, the mortality rate for bubonic plague typically ranges from 25 to 60 percent, while flu is fatal in less than 0.1 percent of cases.
• Transmissibility: It is unusual for a disease to be both highly virulent and highly transmissible, as typically such diseases kil those infected before there is time to transmit the infection to someone else. Ebola has a relatively low transmissibility rate than other infectious diseases as it is only transmitted via direct contact with bodily fluids. However, transmissibility can be increased in some regions due to cultural customs. For example, traditional burial practices in which families wash the deceased can expose additional people to the virus.
• Medical access: Lack of access to medical treatment and infection-control measures in areas currently affected has contributed to the disease's spread. However, the risk of a global pandemic is low due to standard public health and infection control practices in place in many countries globally.
• Infection-control measures: Ebola can only be transmitted via direct contact with bodily fluids, especially blood, which means that caregivers are the primary people who might be exposed to the virus. In many countries including the U.S., the general practice is to treat all blood as potential sources of infection, due to HIV and other blood-borne diseases. In quarantine situations, such as those being used with the American Ebola cases in Atlanta, the likelihood of transmission from a single person is miniscule.
• Availability of medical treatments: There is no specific therapy or drug available for Ebola, which is often the case for new or emerging diseases. Ebola outbreaks occur sporadically and are caused by different virus strains, making vaccine development more difficult. Treatment usually consists of supportive care, such as management of blood pressure, oxygen and fluid levels. With the exception of experimental treatments, there are no pharmaceutical interventions available for Ebola, and access to healthcare varies substantially by region or population. Experimental Ebola drugs are not applicable to large populations at this time.
• Non-medical intervention methods: Various countries in Africa have begun to implement non-medical intervention methods, including quarantines, school closures and travel restrictions, in hopes of stopping the spread of Ebola. These types of countermeasures can limit disease transmission but are often difficult to time or enforce properly. Ebola can have an incubation period of anywhere from two to 21 days.

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RMS models and software help financial institutions and public agencies evaluate and manage catastrophe risks throughout the world, promoting resilient societies and a sustainable global economy.

Learn more at www.rms.com and follow us @RMS.

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