 The great newsman and commentator Eric Sevareid once said, "The biggest big business in America is not steel, automobiles, or television. It is the manufacture, refinement, and distribution of anxiety."
 We certainly have fear covered in this country. Visit the news on any network channel or big-media website, and you'll catch the same worrisome stories, with minor variations, covering the same catalog of familiar frets -- the environment, the economy, the threat of conflict, the failings of education, and a fair-sized host of others.
Some of the spookier, and more prominent, stories are about emerging diseases and threatening epidemics.
But all these stories tend to ebb and flow, don't they? One week, for example, we're barraged with avian flu stories, the next week the stories dwindle. Pretty soon we haven't heard anything about avian flu for months. What's going on here? Are these fits and starts merely the product of a fickle media? And assuming that each of us has only a certain number of worry beads to work with over a lifetime, which of the public health issues should we take most seriously?
Alan Taege, MD, a specialist in infectious disease at the Cleveland Clinic, is philosophical about the ebb and flow of these kinds of reports. "The media sensationalizes these things, therefore the public may get a distorted view," he says. "Unfortunately, if it isn't sensational, it doesn't sell. It’s one thing to say, ‘Bacteria may pose a threat to public health,’ and another to say, ‘Flesh-eating bacteria are coming!’ It’s a tough balance for reporters and editors, but I wish they could tone it down a little."
We’re trying our best here at Synergy to be level-headed as we rank, from least to most urgent, some of the more prominent health scares in recent years.
6. Mad cow diseaseBovine spongiform encephalopathy, or BSE, is more familiarly known as Mad Cow Disease. That moniker, though easier to remember, is a bit alarming when you wonder if this brain-destroying disease is something that you could catch by eating a bad hamburger.
Actually, people don’t contract BSE -- that’s for cows only. Instead, eating BSE-contaminated meat can sometimes (but rarely) lead (according to strong evidence) to a human version called new variant Creutzfeldt-Jakob Disease (nvCJD). The diseases are believed to be related, and certainly similar in their dismal outcomes -- always fatal.
Mad Cow Disease has been a serious health concern in the United Kingdom, where tens of thousands of cases occurred in numerous herds of cattle in the early- to mid-1990s. Careful watch was kept around the world for signs of the disease spreading. Luckily (for us state-side), the problem was kept largely isolated in the British Isles, and the case numbers have dwindled, thanks to constant vigilance and careful practices. In 2007, only 37 cases were reported.
Meanwhile, the human version has always been rare. According to the Centers for Disease Control and Prevention (CDC), 195 cases were reported from 1995 to 2006. Most were in Europe (162 in the United Kingdom and 20 in France), with only 2 occurring in the United States. According to the CDC, "the risk to human health from BSE in the United States is extremely low." Moreover, "the current risk for infection with the BSE agent among travelers to Europe is extremely small, if it exists at all."
 5. Severe acute respiratory syndrome (SARS)SARS is a viral respiratory disease, characterized by high fever, coughing, and, in most cases, pneumonia. It was identified in China about 5 years ago, and traveled quickly around much of the world in 2003, infecting over 8,000 people, killing 774. Only eight cases occurred in the United States. Each of those patients had traveled in countries where SARS had established itself.
SARS is spread in the same way as the common cold virus, by exposure to people coughing and sneezing, especially in close quarters (don’t you love them?), or by touching contaminated surfaces and then your eyes, nose, or mouth. People in constant contact with the public -- healthcare workers, airline personnel, and teachers, for example -- are at increased risk, just as they are for any airborne illness.
There are no current reported cases of SARS in the U.S. In fact, the World Health Organization issued its last update on SARS in the fall of 2004, when there was a minor outbreak in China, caused by infections acquired in a laboratory.
Risk: Very small.
4. West Nile virusWest Nile Virus is a virulent mosquito-borne disease that causes meningitis and encephalitis (inflammation of the spinal cord and brain) in both animals and humans, and is sometimes fatal. In the past 70 years or so it has spread north gradually from Africa to Europe, then to points east and west. It landed with a bang in North America in 1999.
In 2007, the U.S. had more than 3,300 cases of West Nile virus, with almost 100 deaths. Geography offers very little protection -- only a handful of states have reported no human cases this year. Moreover, no vaccine can protect against the disease, although one is being developed.
The good news about West Nile virus -- if you can call it that -- is you can tell where it comes from -- your local mosquito. (Dead birds in your area may be a sign that West Nile virus season has arrived.) You can avoid the virus with a little conscientious use of insect repellent by wearing protective clothing, avoiding the mosquito "wilding" hours of dawn and dusk, and denying mosquitoes their breeding places -- puddles of water. (Beware of the Asian Tiger mosquito, however, which is quite busy during the day.) Be sure to empty those rain-filled buckets and planters, stagnant birdbaths, and unused kiddie pools.
Risk: Minimal, but it’s worth avoiding mosquitoes.
3. Bird fluAll influenza viruses are not created equal. In recent years, the media has focused on the potential threat from avian flu, also called bird flu, which occurs naturally in wild birds. The avian flu strain called H5N1 has made its way into the domestic bird population in some areas of the world.
In some cases, the virus has been transmitted from birds to humans, with mortal results in over half because people have no immunity to H5N1. Although these deaths have resulted from direct contact between humans and infected birds, or from very close contact between family members, public health officials fear that H5N1 will eventually change so that human can transmit the disease to each through the air, as easily as they can seasonal flu or a cold.
Without a buildup of immunity or a widely available vaccine, the results could lead to a pandemic -- an outbreak that crosses borders, multiplies exponentially, and causes widespread sickness and death, and quickly. In an age that combines the close confines of air travel with nasty respiratory diseases, the potential for a few infected travelers to bring about a global health catastrophe is, to say the least, a concern.
This is one to monitor closely. Let’s hope world governments are taking steps to prepare for it.
2. Seasonal fluNo great surprise here. Seasonal flu, for which many of us get vaccinated every year, can be widespread and quite dangerous for the elderly, the young, and those with weakened immune systems. The vaccine is a best-guess preventative that may or may not actually counteract the strain that crops up (not all vaccines treat all strains).
Most people have some immunity that helps protect them, but the symptoms of a serious case -- high fever, dry cough, sore throat, muscle aches, and extreme fatigue -- are nothing to trifle with. The statistics speak for themselves: In a typical year in the U.S., 5 - 20% of the population will get the flu, over 200,000 will be hospitalized, and 36,000 people die from it. In the 1960s, the last worldwide flu pandemic, meanwhile, left about 1 million people dead.
Consequently, the flu should always been on your radar each fall and winter.
 1. MRSA, the staph superbugOne of the more recent news-booms has centered around the "superbug" bacterial disease that can attack the skin, soft tissues, and even the bloodstream: methicillin-resistant Staphylococcus aureus (MRSA). Hospital patients and healthcare workers are particularly at risk. Increasingly, these resistant staph infections are being found in the community at large (witness numerous school closings in the fall of 2007).
First reported in Great Britain in 1961, MRSA has spread throughout the world. These bacteria are able to stare down strong antibiotic treatments, although some antibiotics can still fight these infections, especially if they’re identified early. A recent report on incidence in 2005 estimated 94,360 serious cases of MRSA that required hospitalization. Among those cases there were 18,650 deaths -- a sobering ratio of about 20%. Even more alarming is the fact that, while staph infections in hospital settings have been fairly common, there’s been a steady increase in the antibiotic-resistant variety.
Some of the rise in MRSA infections, according to the Cleveland Clinic’s Alan Taege, can be attributed to the overuse of antibiotics in unnecessary cases, which encourages the eventual increased resistance in bacteria. "Patients should not demand antibiotics to treat common colds, and doctors need to be smart about how we prescribe antibiotics, and for how long."
The bottom lineMad Cow Disease, SARS, and West Nile virus are part of our health universe. They can’t be ignored, but they’re not worth losing sleep over, either. "We need to be aware of these things," Taege says, "but they’re not in our face."
More worthy of constant vigilance are the seasonal flu virus, already among us this winter, the potential for a pandemic caused by a change in the H5N1 strain of the avian flu, and the growing menace of antibiotic-resistant staph infections like MRSA. The seasonal flu vaccine can be very helpful, and is well worth taking.
Otherwise, for all of these threats, the most important preventative measure is the same: "Hygiene for everybody," says Dr. Taege. "If you wash your hands, you’re less likely to have trouble. If you put on clean clothes, you’re less likely to have trouble. You can extend this kind of thinking into multiple areas. The messages about these measures almost get boring, unfortunately, but they’re effective, and they need to be repeated over and over. Take care of yourself."
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