Environmental-Related Infectious Diseases

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

World Population is 7 billion people.

Worldwide Annual Mortality Rates:

Approximately 56,000,000 people die per year (a little less than 1%)

Communicable Infectious Disease – deaths per year:

Infectious Disease – 13.1 million deaths per year out of the 56 million

Malaria – 219 million new cases per year, with 1.2 million deaths

Tuberculosis – 9 million new cases per year, with 1.1 million deaths

HIV/AIDS – 35 million people living with AIDS, with 1.5 million deaths

Respiratory Tract Infections, viral influenza – 3.1 million deaths per year

Diarrheal Disease – 1.7 billion cases per year, with 1.5 million deaths in children

less than 5 years of age, #2 cause of death in children. #1 is pneumonia

Non-communicable, Non-infectious Disease – deaths per year:

            (Infectious disease                         13.1 million deaths per year)

Ischemic Heart Disease                      7 million

Stroke                                                     6.7 million

COPD                                                     3 million

Lungs Cancers                                     1.6 million

Diabetes mellitus                                1.5 million

Road Injury/Trauma – MVA            1.3 million

Hypertensive Heart Disease            1.1 million


It is estimated that communicable or infectious disease accounts for 48% of deaths worldwide each year. For travelers and the adventurous, who dare to leave the familiarity and safety of their own homes, part of being safe and staying healthy is understanding how large the world of infectious disease is and how it can and will impact your health and happiness.

Over the years we authored a lot of articles on various types of infectious diseases. In this article we are going to focus on and review the various infectious diseases that one can acquire from rodent, bat, and bird droppings, i.e., urine, guano, poop.

You have to wonder: who cares about the risk of infectious diseases that can be spread by the droppings of rodents, bats, or birds? Although these various illnesses are not all that common, they are common enough to be concerned about, easy to prevent, and can be hard if not impossible to treat, which can lead to long-term illness or even death.

Poop: droppings, excrement, feces, guano, stool, and of course everyone’s favorite sh*t.

Various animals can act as reservoirs in nature and harbor infectious diseases that may be harmless to them, but can cause illness in humans. Some of these diseases can be spread from the animal to humans by insect vectors such as mosquitoes, ticks, black flies, or fleas, to name a few. However, some of these diseases can also be transmitted in an animal’s saliva, urine, and/or feces. It is these animal secretions and excretions that are the vector for spreading disease. If the poop, urine, or saliva harbors the disease, and these excrements manage to become airborne or aerosolized and inhaled by a human, that unfortunate person can become infected with that illness.

This aerosolized contact is a common risk for cave explorers who may find themselves walking in or crawling in dried bird, bat, and or rodent droppings. An example is the hantavirus outbreak in the US Southwest, that was caused primarily from people cleaning and sweeping out cabins that had been left uninhabited for several months. As a result, rodents moved in and pooped and peed on the floor. As the humans swept, dusted, and cleaned the little stinkers fecal matter, they inadvertently aerosolized the droppings that contained the hantavirus and inhaled the virus into the lungs. As a result they developed a viral pneumonia that was very hard to treat and in some cases it was lethal.


Little Brown Bat (Myotis lucifugus)

Cavers, in particular, should pay attention to this article.

Bat-borne Diseases:

All of the bat-borne illnesses are viral diseases.

For these viruses the primary reservoir is a species of bat.

These viruses are transmitted by the bat bites, bat saliva, aerosolized bat saliva, aerosolized bat urine, and bat guano found on the ground that becomes aerosolized and inhaled.

These viral illnesses include:

Coronaviruses – SARS, Middle East Respiratory Syndrome (viral respiratory fever)

Hantaviruses (viral respiratory fever)

Hantavirus Pulmonary Syndrome (viral respiratory fever)

Hemorrhagic Fever with Renal Syndrome (viral hemorrhagic fever)

Lyssaviruses – Rhabdoviridae (rabies virus, 100% lethal CNS illness)

Lassa virus (viral hemorrhagic fever)

Ebola virus (viral hemorrhagic fever)

Marburg virus (viral hemorrhagic fever)

Nipah virus (viral respiratory and neurological fever)

Hendra virus (viral respiratory and neurological fever)

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Volume 27 Number 4

What is a Virus?

What is a pandemic?

Why do we care?

By Frank Hubbell, DO

Illustrations by T.B.R. Walsh

There are currently a lot of concerns about infectious disease and the risk of another worldwide pandemic. This is being driven by the current Ebola scare. Over the course of human history, there have been many pandemics that did have a major impact on human populations and history itself.

In our most recent history, there was and still is, the Human Immunodeficiency Virus (HIV) pandemic. When HIV was first described in the mid 1980’s, there was a great outcry that it was the next great pandemic. Experts at the time estimated that it would kill upwards to 20% of the world population in 10 years and a much higher percentage in developing nations. HIV never became as serious as estimated because of dedication to good research, medical science, and excellent education. Today HIV remains a very serious illness, but it is very well understood, and excellent antiviral medications have been developed. As a result, it is under good control, at least in developed nations.

The last major, true worldwide pandemic was the Spanish Flu Pandemic in 1918.

From 1918-1919 the Spanish Flu raced around the globe, the worst influenza pandemic to date. Caused by an H1N1 flu virus, it was responsible for more than 500,000 U.S. deaths, as compared to 50,000 US servicemen who died in WWWI the previous two years. The worldwide death estimates range from 20 million to 100 million.

This Spanish Flu pandemic occurred before the invention of antibiotics. Antibiotics are essential in treating the secondary bacterial infections that often kill flu-weakened patients. So, that number would most likely be much lower today with the use of antibiotics to treat the potentially life-threatening secondary respiratory infections and pneumonias.


Major Worldwide Pandemics: (only the largest pandemics are noted.)

Date                        Number of Deaths and Location                                    Cause

165-180                  30% of Europe, Asia, and North Africa                               Smallpox

541-542                  40% of the European population                                          Bubonic plague

1346-1350              30%-70% of the European population                                Plague

1629-1631              280,000 deaths worldwide                                                    Plague

1665-1666              100,000 deaths in England,(Great Plague of London)    Plague

1816-1826              >100,000 deaths in Europe and Asia                                   Cholera #1 epidemic

1829-1851              >100,000 – Asia, Europe, and North America                   Cholera #2 epidemic

1852-1860              1,000,000 deaths in Russia                                                   Cholera #3 epidemic

1875                         40,000 deaths in Fiji                                                               measles

1889-1890             1,000,000 deaths world from influenza                              influenza

1899-1923              >800,000 Europe, Asia, Africa                                             Cholera #6 epidemic

1918-1920              75,000,000 deaths worldwide – the Spanish flu               influenza

1957-1958              2,000,000 deaths worldwide – the Asian flu                      influenza

1968-1969              1,000,000 deaths worldwide – the Hong Kong flu           influenza

1960 – now            >30,000,000 deaths from HIV/AIDS pandemic             HIV/AIDS

2009-2010             14,286 deaths from viral influenza                                      influenza

2013-2014            6,000+ deaths from Ebola virus                                    Ebola virus


In regard to pandemics, smallpox is no longer a threat, declared eliminated as of 1974 through the efforts of worldwide vaccination programs. A similar program is currently being undertaken by Rotary International in an attempt to eliminate the poliovirus as well.

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ISSN-1059-6518 Volume 27 Number 3

By Frank Hubbell, DO

What is Ebola Virus Disease?

Ebola virus disease (EVD), also known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans caused by the Ebola Virus.

The mortality rate is about 90%.

The virus is transmitted to people from wild animals by the body fluids and organs of infected animals. This occurs from hunting the animals, butchering them, and consuming them.

In Africa, EVD has been spread by infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines that were either hunted or found dead in the rainforest. It is probable that if the meat had been cooked thoroughly, the virus would have been killed.

Once in the human population, the virus is contagious and can spread via human-to-human transmission through contact with body fluids.

It is stated by the researchers that the Ebola virus cannot be spread airborne, but I humbly disagree. If the virus is in body fluids, when the patient coughs, the virus is going to be expelled and potentially spread by the airborne droplets. The point being, you have to protect your airway as well as using all BSI when working with any patients with a potentially contagious disease.

Currently the EVD outbreaks have occurred in remote villages in Central and West Africa: Sierra Leone, Nigeria, Guinea, and Liberia.

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