With Ebola continuing its rampage throughout large swathes of West Africa, the world has been put on high alert. The death toll now stands at over 3,000 , while reports of infections continue. But amidst the chaos of Ebola, the key to understanding its destructive capacity may lie in uncovering the deeper patterns of risk that it adheres to, patterns that directly affect countries like India, and that public health officials have long tried to call attention to.

Disease hot-spots

In 2008, a team of scientific researchers published a study in Nature titled “Global trends in emerging infectious diseases.” The study pointed to the rise of emerging infectious diseases over time, and highlighted that the majority of these diseases were zoonotic, that is contagious diseases spread between animals and humans. What's more, the study determined that these diseases were “significantly correlated with socio-economic, environmental and ecological factors and provide a basis for identifying (...) emerging disease ‘hot-spots’.”

Given their broad similarities in population distribution vis-a-vis particular climate and environmental conditions, it should come as no surprise then that the largest “hot-spots,” of emerging infectious disease include swathes of sub-Saharan Africa, East and Southeast Asia, and the Indian subcontinent.

Historically, the majority of new infectious diseases had emerged from wealthy countries with large urban centres, Columbia University News reported when the study was first released. But now the threat of the day, it would seem, comes from areas of the world that often lack the resources to combat potential public health pandemics.

The threat to India

While India is clearly identified by public health experts as one of several such “hotspots” of emerging infectious disease, that doesn’t mean that Ebola is its biggest threat. In fact, quite to the contrary, the real issue of infectious disease that India faces comes from the potential for other diseases that thrive in conditions of poor sanitation and weak response networks. Here are some of the emerging infectious diseases that pose a risk to Indians.

Leptospirosis is transmitted through direct contact with the urine of infected animals or with a urine-contaminated environment. Symptoms range from high fever and severe headache, to haemorrhages, and vomiting. While person-to-person transmission is rare the disease thrives in conditions where sanitation is poor. Mumbai has seen periodic outbreaks of the disease, largely during times of flooding where rat urine has been known to mix with street water.

Crimean-Congo haemorrhagic fever is a fever transmitted to humans either by ticks, or through contact with contaminated animals. The disease has a 10%-40% fatality ratio, and is considered to have epidemic potential. Cases have been widely reported in Pakistan, while India has seen three confirmed cases since 2013.

Nipah Virus is capable of causing disease in domestic animals, as well as humans. Symptoms include encephalitis (inflammation of the brain), coma, seizures and an inability to maintain breathing. The natural host of the disease are fruit bats, who can spread the infection by contaminating fruit, or by passing the disease directly to other humans or animals. Several cases of the disease have emerged in West Bengal, as well as neighbouring Bangladesh, resulting in the combined deaths of over 250 people.