Stemming a deadly tide

The Ebola virus disease strikes fear into people’s hearts, not only because of its high mortality rate, but also because it ravages the body of its victims in a horrible way. There have been regular outbreaks of the disease in the last four decades before now, but we still do not have a vaccine. Why has the world been doing so little to fight the spread of Ebola?

THE Ebola virus disease (EVD), also called Ebola hemorrhagic fever (EHF) or simply Ebola, was first identified in 1976. In that year, there were two simultaneous outbreaks, one in Sudan and the other in the Congo in a village near the Ebola River, which is how the disease got its name.

Since then, there have been outbreaks about once every two years, all confined to the African continent. One of the reasons the disease had not spread wider was because it kills its victims quickly, therefore limiting the chance of transmission.

2014: a different outbreak
BUT the latest outbreak is different. It has been called the worst ever, with already over 10,000 people in Africa infected with the Ebola virus, and thousands killed by the disease caused by the virus. Cases have also been reported, for the first time, in Western countries.

The outbreak started in February with the infection of a toddler with the Ebola virus, who died from EVD together with other members of his family who were also infected. Unfortunately, the family lived in an area where the borders of three countries – Guinea, Liberia and Sierra Leone – meet.

Some relatives and friends who went to the funeral were infected and took the disease back to their countries.

Are cultural factors to blame?
EBOLA is introduced to humans through contact with infected animals, andpassed on to other human beings via direct contact with bodily fluids such as blood and vomit. The virus is, so far, not airborne, meaning it cannot be transmitted just by a cough or a sneeze.

If patients had been isolated quickly, outbreaks could have been contained and should not have escalated to their present scale in just a few months. Some are blaming cultural practices as the culprit for the fast spread of the disease.

A different understanding
VOLUNTEER doctors observed that voodoo is still practised widely in Africa, and many locals thought Ebola was caused by curses instead of viruses.

People with such erroneous beliefs chose to keep their sick relatives at home instead of sending them to hospitals promptly for treatment and isolation.

The consequences were depriving patients of timely medical attention, and exposing everyone in the same household, and even neighbours, to the the disease.

Also, many local people do not trust Western medicine. In some villages in Guinea, people actually thought the doctors were the agents spreading the disease. Naturally, they refused to grant entrance to the medical personnel.

And not knowing the risk of transmission, locals hugged and kissed the bodies of the deceased at their funerals.

Western indifference
THE three countries most severely affected by the current outbreak – Guinea, Liberia and Sierra Leone – are poverty-stricken and chronically ravaged by civil war. People lack proper education and their living conditions are unhygienic.

As Ebola outbreaks had, before 2014, been happening only in Africa and the affected regions mostly consisted of poor countries, the West has had little incentive to earnestly deal with them.

The situation could be very different had Western countries been threatened, as they were by smallpox or cholera. In those cases, drug companies were much more willing to devote mammoth amounts of research and money to creating a cure or vaccine.

Even as the current outbreak brought cases to the West for the first time, the reaction of the Western world was ludicrously pathetic. Columnist Scott Gilmore used the following analogy, “Imagine you are woken by your neighbours crying for help. You open a window to see their house on fire – they have fled to the roof and are begging for a ladder. Instead of running to assist, you frantically change the batteries in your smoke detector before fainting from fright.”

Changing attitudes
IN the face of the largest Ebola epidemic in history, things are starting to change. The World Health Organization (WHO) is accelerating the process of vaccine development, and drug makers are compressing the process that usually takes years to weeks.

According to the WHO, a vaccine trial will start in West Africa in December. Millions of doses of experimental vaccines will be produced by the end of 2015.

WHO Assistant Director General Dr Marie Paule Kieny said, “Vaccines are not the magic bullet, but when ready, they may be a good part of the effort to turn the tide of the epidemic.”

International efforts needed
BUT the deadly tide is not easy to stop, and the prognosis is grim. In September, the US Centers for Disease Control and Prevention (CDC) estimated up to 1.4 million people in West Africa may have Ebola by January 2015.

On the bright side, if one can call it that, the current Ebola outbreak has clearly awakened all countries in the world to the fact that, in the era of globalisation, no one is safe from a deadly communicable disease like Ebola.

And whether and when we can curb the Ebola epidemic now hangs on the collective efforts of the international community, particularly rich and powerful countries.