Ebola Watch

Deadly virus has become a truly global threat

Thomas Duncan carried Ebola to US

No country in the world can any longer claim to be totally safe from the spread of the deadly Ebola virus. It could already have arrived unnoticed anywhere in the world, including South Africa.

The disease did not only catch international health authorities unaware, lacking in their response to early warnings, but also exposed a dangerous weakness in the timeous development of treatments. Some experts are accusing international pharmaceutical companies of failing the poor of the world.

The way in which health authorities in the United States (US) since last week have to scramble to contain the outbreak of the disease, after a man from Liberia carrying the virus fell ill in Dallas, Texas, illustrates the stealth with which it can arrive anywhere on the globe.

Because as much as 21 days can lapse from the time a person picks up the infection before the first symptoms of the disease appear, the virus can potentially go undetected and travel thousands of kilometres and cross multiple international borders before those symptoms appear. And even then, because of the way the symptoms present themselves, it might not be immediately be spotted, dramatically increasing the danger of further contaminations.

There are hundreds of possible routes for flying from Liberia, Sierra Leone, Guinea and Nigeria – the countries where an Ebola epidemic is raging at the moment and the death toll has surpassed the 3 500-mark – to just about any destination in the world. This can not only mask a traveller’s original point of departure, but also because of the potentially three week incubation period, have him a couple of counties removed from it before symptoms show up.

And, when the initial symptoms (fever, headache, weakness, cramps, sore muscles and joints, diarrhoea, vomiting, stomach pain and sore throat) do show up it can easily be interpreted as a common flu, if not malaria or cholera.

In the case of Thomas Duncan, the man who brought Ebola to Dallas, he helped a woman in labour who had the disease on 16 September in Liberia. Four days later he arrived in Dallas to visit his girlfriend, having passed fever checks at airports on his way to the US.

On September 24 he fell ill at his girlfriend’s apartment. The next morning, now 12 days after he was exposed to the disease, the girlfriend’s daughter taking tea to him in bed, found him desperately ill and an ambulance was summoned to take him to hospital. In the process he vomited at the apartment block.

At the hospital Ebola was not initially diagnosed and more people were potentially exposed to contamination, the ambulance remained in commission another 48 hours, the girlfriend’s children still went to school and where he vomited on the apartment premises was only disinfected three days later. The net result in the end was that more than 100 people had to be isolated.

World's highest priority

While the Dallas incident illustrates how the disease can develop a global footprint, the United Nations last week launched a campaign to try and prevent such an event, describing the epidemic as the world's "highest priority."

Anthony Banbury, head of the UN Mission on Ebola Emergency Response (UNMEER), said “the only way we will end this crisis is if we end every single last case of Ebola so there is no more risk of transmission to anyone ...”

But for now there is still a shortfall in the response to the disease in West Africa. The World Health Organization said in a situation update last week there was still a "significant shortfall" in capacity in West Africa, with 1,500 more beds needed in Liberia and 450 in Sierra Leone.

Doctors Without Borders, the global aid agency leading the response in West Africa, with 3,000 staff including some 250 Western volunteers and whose initial alarms as early as last year largely went unheeded, has criticised the inadequacy of international aid. It said medical teams rather than cash was desperately needed.

Britain also called for foreign help to battle Ebola in Sierra Leone, a former colony, at a London conference of ministers, diplomats and health officials from around 20 countries and world organisations.

At the London conference the charity Save the Children warned that five people are being infected every hour in Sierra Leone with the demand for treatment beds far outstripping supply. And, if the current "terrifying" rate of infection continues, 10 people will be infected every hour by the end of October.

Drug companies repeating AIDS response?

While Ebola at this stage is only transmitted by direct contact with the bodily fluid of an infected person, be it even with saliva sneezed on something like a door knob, Banbury has warned that the deadly virus could mutate to become infectious through the air.

“The longer it moves around in human hosts in the virulent melting pot that is West Africa, the more chances increase that it could mutate,” he told the Telegraph. “It is a nightmare scenario [that it could become airborne], and unlikely, but it can’t be ruled out,” he said.

In the mean time the president of the United Kingdom Faculty of Public Health, Dr. John Ashton, compared the situation to the early years of the AIDS epidemic. He also attacked the “moral bankruptcy” of a system which gives drug companies no reason to invest in treatments for “powerless minority groups”.

He wrote in a newspaper article that “we must respond to this emergency as if it was in Kensington, Chelsea, and Westminster. And we must ‘get real’ over economic development.

“We must also tackle the scandal of the unwillingness of the pharmaceutical industry to invest in research to produce treatments and vaccines, something they refuse to do because the numbers involved are, in their terms, so small and don't justify the investment.”

Also last week, Dr. Daniel Bausch, an Ebola specialist at Tulane University in New Orleans, told the US website Vox that there had been “significant developments” in fighting the disease but that “economics” stood in the way.

In the mean time the economic and social impact, not only on the, for now, directly affected countries reported before, is also spreading. The US oil giant ExxonMobil announced that it had limited employee travel to the affected West African countries and delayed the start of an exploration well in Liberia.

In Burkina Faso the cycling race Tour Du Faso, which was to be held from October 23 to November 2, was suspended due to fears of Ebola.

by Piet Coetzer

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