Ebola: fetid transmission

Ebola could be considered a pandemic virus with the travel of cases across continents to the US; except that transmission has been limited to West Africa. The outbreak started in Guinea; reported to WHO on 23 March 2014; and  spread to four other West African countries: Liberia, Nigeria, Senegal, and Sierra Leone. Whilst Nigeria and Senegal seem to have contained the spread, the three other countries continue to show an increase of cases, as at mid September.

Ebola may be amongst the most fatal viruses for humans; but relatively easy to prevent its spread, as cases are not infectious until after they become sick; unlike measles or influenza that are usually infectious before full-symptoms. The 2003 SARS virus outbreak was controlled because most cases were not infectious before fever onset; with Ebola virus transmission looks even more restricted and requiring close contact with infected body fluids.  Of course, the virus could change at any time to become airborne! I am not sure if/how one estimates the probability of its doing so, but to me it seems more likely not to do so, but how can I say that?

Ebola virus was not ‘designed’ (or adapted) to infect humans as its primary host); bats being the prime candidates.  Fruit bats, if it matters to you.  SARS is believed to have also originated from bats (probably via the civet cat in markets that really should not exist in the 21st century).  We are at risk of more new animal virus as human activities encroach on other species, and the kinds of contacts humans have with dead animals.

It is hard to predict what will happen with the spread of this virus in these three countries in West Africa; many other countries are at risk of importing a case; or perhaps a new outbreak from ‘bush meat’.  But it seems possible that the outbreak will be contained by changes in behaviour that are currently enabling spread: at root the lack of trust in government, inadequate health resources, and ritual practices.

The world has been slow to respond, and the response could have been more strategic.  The costs to health systems yet to be measured, but if the result is improvement in health delivery, perhaps the outbreak has a silver lining.  Meanwhile, are you and your family ready for the next  emerging disease outbreak?  Remember, it will be human reactions and not the virus that causes the most damage.


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