Professor: Fears Over Flu Can Be Contagious

Outright panic over the swine flu has been averted so far, but that hasn't always been the case. Fifteen years ago in Surat, India, the plague killed 57 people and a third of the city's residents fled. Ron Barrett, a medical anthropologist at Emory University, speaks with host Jacki Lyden about how fear and stigma can cripple the public health system.

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JACKI LYDEN, host:

So, New Yorkers have avoided outright panic so far. It's a lesson learned from past outbreaks. Case in point: Surat, India, where 15 years ago, the plague killed 57 people. That city, in Northwestern India, saw about a third of its residents flee. Ron Barrett is a medical anthropologist at Emory University. He spent a lot of time investigating what happened in Surat.

Mr. RON BARRETT (Medical Anthropologist, Emory University): People were leaving the city in large numbers. It was estimated that half a million people left within a two-week period of the reports, and this included about 78 percent of the medical personnel, who would be needed to really help the people with the disease and to contain the epidemic in its early stages.

LYDEN: So, it must have been very disturbing that the medical professionals were fleeing the city.

Mr. BARRETT: Indeed. I think - the people I spoke with who were there at the time said that it was very disconcerting that the majority of medical professionals had fled the city, as well. I think it really led to a greater sense of distrust and further exacerbated the panic, not to mention the fact that people who were sick would not have somebody to go to for treatment.

LYDEN: I understand that some of the fears were spread by rumors that it was a terrorist attack. Would you tell me about that?

Mr. BARRETT: Yeah. In the very early stages, you know, people didn't know that it was a plague. There were some suspicious cases coming into the hospital, and a rumor had started that this was a poisoning of the city's water supply by the Muslim minority community. This was completely false, but it really did add to the sense of accusation, fear and panic at the time.

And so, initially, the population, people were not using the water supply. They weren't washing their hands, and there was a lot of tension between communities at a time in which the communities really needed to come together.

LYDEN: It sounds like at every point, things were breaking down, people not using water, lots of fear and suspicion. How did that actually spread the disease?

Mr. BARRETT: Well, what happens is the early stages of an infectious disease epidemic, you need reliable information to be more contagious than the disease itself, and you need the fear and stigma to be less contagious.

In this case, the stigma was much more infectious than the disease itself. And with that kind of breakdown, you can't easily contain a disease, and you can't get the kind of information that you need in order to be able to understand what's actually going on.

LYDEN: So, as a medical anthropologist, what lessons do you take away? What would be the bottom line?

Mr. BARRETT: The bottom line is the importance of transparency in public health agencies and governments to provide reliable information and detailed information, and it really helps to prevent the panic.

When there's a lack of information, rumors start to take over. And when you have rumors, then you have distrust. And when you have distrust, it's very difficult to get public cooperation for surveillance, for containment, and for having people come in to hospitals when they're sick.

LYDEN: Ron Barrett is an assistant professor at Emory University. His article, "Stigma in the Time of Influenza," appeared in the Journal of Infectious Diseases. Thanks very much for speaking with us.

Mr. BARRETT: Thank you, Jacki.

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