Think this way about infectious diseases


By dr. Wilhelm von Ludwig

Princess Diana caused a stir in 1993 when she touched lepers with her bare hands. The photos of the royal contact with the dreaded disease spread faster than fake news around the world. And although a messianic theme was on everyone’s mind, the aunties in front of the TVs still wondered: Is she not going to catch fire?

In the vernacular, contagiousness is synonymous with danger. The white coveralls reminiscent of aliens are frequently seen during Ebola epidemics and more recently during the Covid pandemic. And although a cold is just as contagious as Ebola, the former is not handled with coveralls or by sanitariums.

The most contagious disease we know is measles. This virus breaks all infection records with an infection count of 18. This means that in a population that has not been vaccinated at all, each person with the disease will infect 18 others on average. However, as diseases adapt and change, they must sacrifice lethality to promote infectiousness. After all, dead people don’t spread disease easily. So we see that each new variant of a virus is usually more contagious and at the same time less deadly. Covid is a good example so far, with every variant changing in line with this.

Princess Diana caused further controversy when she sent her two sons to a normal school. The royal physician must have been fed up with the kaleidoscope of childhood illnesses that little William and Harry brought home.

Blame is often laid at the door of parents who send their children to school sick. After all, they are going to set the whole playgroup on fire! And yet it is often the children who do not yet show any symptoms who are most contagious. Colds and flu are the most contagious during the first few days of the illness. And even though we know by now that viruses and bacteria can occur anywhere, we like to blame a variety of other factors: the weather, the foreigners, the anti-vaxxers, big pharma, the government, China, Zimbabwe, and of course the New World Order.

But the contagiousness of these infections is what makes them so troublesome. Germs do not hesitate to turn your closest family members into biological weapons. Or to turn last week’s braai into a distribution event. Viruses don’t just shop at the cheaper supermarkets either, and of course enjoy going to the movies now and then.

And if by this time you feel like you’d rather go wash your hands, you’re welcome. I am waiting for you.

Things get even more complex when you start distinguishing between the germ and the disease it causes. Tuberculosis of the lungs is very contagious, but tuberculosis of the knee (yes, believe it or not, it is also a disease) is not contagious, although it is caused by the same bug. The same bug can often cause throat infection, ear infection and pneumonia. As a result, Charles’ infection is contagious, but he is not necessarily going to saddle the other uncles of the British House of Lords with the same disease.

If we want to stick to our theme, antibiotics are the Dodi Al-Fayed of the discussion. It just makes things more complicated and awkward. Because you see, up to 50% of all antibiotics prescribed (especially in the winter months) are unnecessary because they are prescribed for viral diseases. Flu is a viral disease. Cold is a viral disease. All your so-called childhood diseases are viral in nature. So are most middle ear infections and cases of bronchitis. In each of these diseases, antibiotics have no impact on infectivity or course of the disease. If antibiotics are indicated, the turnaround is often dramatic. For example, leprosy is no longer contagious after 48 hours. Which brings us back to the nagging question of the princess’ contact with the disease. The patients at Ananbadan were already on medication and therefore no longer contagious. However, Diana brought it home crystal clear with the fact that she was not only there, but sat on the patients’ beds and held their hands as she talked to them.

There are several other aspects of contagiousness that I haven’t even touched on. Like carrier status, viral load and vaccinations, but I’m afraid it might be the Camilla, Fergie and Megan of the conversation…

  • Wilhelm von Ludwig is a general practitioner who practices in Polokwane. Follow him up TikTok or Facebook.