Tara Ornstein, Contributing Blogger
The leaders of the global health community have sought to quell the hysteria surrounding the outbreak of Ebola in West Africa. On 14 August 2014, the World Health Organization (WHO) released a statement confirming that the risk of transmission of Ebola during air travel is low. “Unlike infections such as influenza or tuberculosis, Ebola is not airborne,” the Director of the WHO’s Global Capacity Alert and Response Unit, Dr. Isabelle Nuttall explained in the statement.
The Director of the U.S. Centers for Disease Control and Prevention (CDC), Dr Thomas Frieden, issued a similar statement while testifying about Ebola before Congress on 7 August 2014. He commented that “we [the CDC] do not view Ebola as a significant danger to the United States because it is not transmitted easily, does not spread from people who are not ill, and because cultural norms that contribute to the spread of the disease in Africa – such as burial customs – are not a factor in the United States.”
In an op-ed published in the New York Times last April, David Quammen, author of Spillover: Animal Infections and the Next Human Pandemic, asserted that “Ebola in Guinea is not the Next Big One, an incipient pandemic destined to circle the world, as some anxious observers imagine.” Rather than feeding our fears, he wrote, we should sympathize with those affected by the outbreak and send help.
Ebola: An Overview of the Virus
The Ebola virus disease, officially known as Ebola Hemorrhagic Fever, causes severe illness in humans and other primates. Ebola virus was first documented during two simultaneous outbreaks in Nzara, Sudan and Yambuku, Democratic Republic of the Congo in 1976. According to the WHO, outbreaks primarily occur in remote villages in Central and West Africa near tropical rainforests. A strain of the Ebola virus has been observed in the Philippines and the People’s Republic of China, but there have been no reports of illnesses or deaths related to this strain so far.
The Ebola virus is a zoonotic disease that is transmitted to human populations though close contact with the blood, secretions, and other bodily fluids of infected animals. Evidence collected by different researchers working in Gabon and Guinea suggests that fruit bats may the reservoir of the virus.
Once infected, the average person begins to experience symptoms within a week but the incubation period can range from 2 to 21 days. According to the CDC, Ebola symptoms include fever, vomiting, severe headache, weakness, abdominal pain, and muscle pain. As Dr. Frieden explained, people are only infectious while they are experiencing symptoms or after they have died of the disease. Ebola can be diagnosed in laboratory but testing must be conducted in strict bio-safety level 4 labs (BSL-4).
There is no cure for Ebola, but as The Economist recently explained, “there are ways to treat victims that will maximise their chance of survival and help prevent transmission.” These methods include isolating infected patients, keeping them hydrated, monitoring their blood pressure, and treating any secondary infections.
2014 Outbreak in West Africa
Unfortunately, none of these methods were employed effectively during the 2014 outbreak. As of 13 August 2014, the WHO says that there have been a total of 2127 cases in Guinea, Liberia, Nigeria and Sierra Leone. Of these, 1145 people have died resulting in a case fatality rate of 53%. On 16 August 2014, the Wall Street Journal reported that scores of health workers were infected with the virus, with many later succumbing to the disease, because they did not have basic supplies such as rubber gloves which are vitally needed for infection control.
Global Health expert Laurie Garret wrote that the affected countries are among the most impoverished in the world and spent less than US$100 per capita on health annually. Writing in Foreign Policy Magazine, Garrett cited an article published by the Christian missionary organization SIM, which helps to provide health services in West Africa. According to the article, there were less than 200 physicians working in Liberia before the epidemic. Now the number is down to 50. The WHO estimates that there were 0.2 physicians for every 10,000 people in Sierra Leone and 1 physician for every 10,000 people in Guinea.
Challenges of Quarantine
Understandably, the lack of supplies and trained personnel has led patients to avoid hospitals and clinics at all costs. There have been cases of frightened relatives removing Ebola patients from hospitals in Sierra Leone, health workers fleeing quarantine in Nigeria, and attacks on health clinics in Liberia and Guinea.
There is also a huge economic cost to quarantine. Although it is too early to forecast, the World Bank has already revised down its economic-growth estimate for Guinea this year by one percentage point and the Liberian Finance Minister, Amara Konneh, believes that the International Monetary Fund’s projection of 5.9% growth in his country is now unrealistic. According to Konneh, most West Africans will not contract the virus or know anyone who does, but millions will be affected by Ebola’s economic impact.
Ebola may not post a threat to the health or finances of those living outside the region, but this outbreak has provided a clear example that maintaining and protecting global health requires commitment and support from the international community.