Is the outbreak of Ebola in West Africa really “the most severe, acute health emergency seen in modern times,” as Margaret Chan, director-general of the World Health Organization, said on Monday?
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It is not, at least not yet, despite the dramatic visions inspired by graphic descriptions of this truly nasty hemorrhagic disease. In reality the fear of an apocalyptic pandemic spreads much faster than the virus itself.
Infection with Ebola is unarguably terrible. Symptoms start with fever and quickly progress to nausea, diarrhea and finally the tell-tale hemorrhaging from mucous membranes, from all orifices. But arguably other diseases are more contagious and more lethal and have a greater propensity to spread.
Acute the crisis may be; the most severe it isn’t. Chan’s statement is hype at best and panic-mongering at worst.
She could be trying to stimulate general awareness, but she did it in a manner “that could possibly be interpreted as misleading,” says Prof. Jonathan Gershoni, an expert on virology and immunology Tel Aviv University and an Israeli member of the Global Virus Network.
Start with the fact that unlike some other viral conditions such as influenza, Ebola is relatively hard to catch. It isn’t airborne. It requires direct contact.
“The disease causes hemorrhaging, and so, unfortunately, victims obviously are covered in bodily secretions, infectious fluids such as mucus, saliva, blood, urine, semen and so forth,” says Gershoni. “Anybody who has dealt with infected people, alive or dead, and has not taken precautions can contract the disease.”
Use the proper gear and one won’t catch it.
Containment has worked
Secondly, look at a map, Gershoni advises. The more than 4,000 infections reported so far have been almost entirely confined to three countries: Liberia, Guinea and Sierra Leone.
“The disease’s spread is rather restricted,” he points out. “It’s not spreading out of control throughout all of Africa or even all of West Africa.” Nigeria and Senegal have had a handful of cases, no more. “They contained the epidemic,” Gershoni says.
In other words, the sense is that even this biggest known outbreak of Ebola is hardly an uncontrollable rampant spread of a viral infection. Meanwhile, the disease’s propagation seems to be slowing in West Africa as practices for handling the sick and rituals in tending the dead are becoming more careful.
“There’s no real reason for panic, but rather caution and focused investment in the countries hardest hit to care for the victims so to effectively break the chain of infection,” Gershoni says.
Thirdly, the disease is horrific but there is also a 50 percent probability of spontaneous recovery, illustrating that the body’s defenses are able to combat this disease.
There is no cure for Ebola. For the moment, the most doctors can do is treat symptoms and boost the immune system, and in Ebola’s case that works half the time. But new antibody treatments are just around the corner and progress in producing a vaccine is being made, says Gershoni.
Not a biological crisis
The current crisis is humanitarian, a reflection of poverty, poor health systems and, arguably, western indifference toward underdeveloped countries. Ebola is not a biological crisis, and scary as it is, people can overcome the infection, Gershoni says.
By contrast, HIV is a death sentence.
“People do not get well from AIDS,” Gershoni says. “Look at Liberia and Sierra Leone and Guinea: The number of people dying from AIDS is about 10,000 in the same period of time that 4,000 died from Ebola. People need to put things into perspective,” says Gershoni.
Today Ebola is believed to have infected some 8,000 people. The figure for HIV is 35 million. For hepatitis C that’s about 130 million and another 300 million have hepatitis B.
Last year about 1.5 million died of AIDS and more than a million associated with viral hepatitis, says Gershoni, adding that a half a million people die from flu every year.
And those are just the viral conditions. Malaria, which is caused by a parasite, has about 200 million sufferers worldwide and kills more than half a million people a year.
Ebola may appear more dramatic but its impact is for the moment puny compared with those horrifying statistics. “People have horror-show-type fantasies,” Gershoni says. No, Ebola isn’t the next AIDS: It’s a totally different beast, he says.
A stable virus
Feeling more hopeful? Read on.
A moment on Ebola genetics: Its genome is relatively stable, unlike that of influenza, for instance. That is why influenza mutates constantly, suddenly moving from one species (like pigs or birds) to others (humans). There are five known variants of Ebola, but if its genome is relatively stable, then it’s easier to make vaccines for it that will have efficacy over time.
There’s another item of epidemiological optimism. The course of Ebola is fast. That means it can peter out a lot more easily than a disease that lingers on for years. And not only is it a question of time. “Ebola sufferers get so sick they have very little inclination to interact with others,” observes Gershoni.
“The message has to be that whereas Ebola is a very acute disease, causing enormous suffering in its victims, if the medical staff and countries implement appropriate steps towards prevention and care of the sick, there’s no reason for alarm. Awareness, and immediate action, care and financial aid to Africa would do better than scare tactics to curb the epidemic.”
That’s for now. For the future, the next generation of virologists and immunologists needs to be prepared because in this age of jet travel, a contagious disease could devastate the human species. The flu pandemic of 1918 killed 20 million to 40 million people and that’s before people and their germs were casually climbing onto planes.
But maybe the world will be readier. A scientific collaboration organization called the Global Virus Network came to its feet five years ago, to be a neutral place where virologists from around the world can work with business elements to meet the challenge of the next emerging viral diseases.