It’s one of the deadliest diseases on Earth, with a fatality rate as high as 90 percent. It’s also grotesque, sometimes causing bleeding from the eyes, ears, mouth and rectum and a bloody full-body rash leading to a quick demise. Ebola virus disease fascinates worldwide though its spread has been limited to sporadic epidemics in Africa. It’s one of a handful of illnesses that are so deadly that governments consider it a threat to national security. Each wave of new cases raises questions about what can be done for its victims, how to prevent public panic and the best way to protect against the virus.

The Situation

 

Source: World Health Organization 

The current Ebola outbreak is the worst on record and is centered in the area where Liberia, Sierra Leone and Guinea meet. Reports began in March and the death toll began to accelerate in July, topping 1,000 by early August. Nigeria had its first deaths after an infected man flew to Lagos, a city of 20 million people. Aid workers have been taken to the U.S. for treatment and given experimental drugs, raising questions about who should have access to them. This wave of Ebola is the first in West Africa, an area with an acute shortage of doctors. It could take several months to stem the tide. The disease is being transmitted by victims who are avoiding hospitals because of stigma and fear, as well as unsafe burial practices. Efforts to contain the outbreak have been hampered by a lack of supplies, along with hostility to medical workers and populations that questioned whether the disease really exists. International aid groups including Doctors Without Borders have set up isolation units using biohazard suits and more than $200 million has been pledged to help stop the illness. Ebola jumps to humans from infected animals that live in the rainforest through contact with blood and other secretions from animals like chimpanzees, gorillas and bats. It spreads among humans the same way, with medical workers and family members the most at risk. With the current strain of Ebola, sick people begin to erupt with symptoms four to six days after exposure. Liberia and Sierra Leone began to quarantine villages, shutting schools and markets. Guinea and Cameroon have banned the sale and eating of bats. Governments around the world are on high alert and travelers were checked at borders and airports for signs of the disease. The World Health Organization declared the outbreak an international public health emergency, but stopped short of recommending a general travel and trade ban.

The Background

Researchers think fruit bats are the most likely host of Ebola, which was first identified in 1976 near the Ebola River in what is now the Democratic Republic of Congo. Outbreaks have also been reported in Congo Republic, Uganda and Sudan and are typically contained within a few months. Prior to the current wave, a total of 2,387 cases had led to 1,590 deaths, according to the World Health Organization. There are no drugs or vaccines approved to treat or prevent Ebola. The rarity of the disease and its prevalence in rural areas of poor African nations doesn’t provide enough incentive for big drugmakers to tackle the virus. Instead, smaller biotechnology firms and government-funded labs have taken up the challenge. The quick and horrible death of Ebola victims and the potential threat of an epidemic was captured in the 1994 best-selling non-fiction thriller “The Hot Zone.” It’s also considered a possible vehicle for terrorism. The U.S. Centers for Disease Control and Prevention lists the virus as a Category A bioterrorism agent, alongside anthrax and smallpox, compelling an expensive search for remedies.

The Argument

Ebola doesn’t travel through the air, making it harder to transmit than other pathogens, such as influenza, as long as adequate health-care practices are followed. Other diseases kill many more people. Influenza kills up to half a million people a year around the globe, and resurgent diseases such as tuberculosis and the growth of antibiotic resistance are a bigger focus for global public health organizations. While Ebola is unlikely to spread outside Africa, the fear associated with it can prompt people to flee to hospitals outside the affected area, spreading the disease across borders and around the continent. That panic leads governments to impose travel and trade restrictions on the affected countries each time Ebola emerges from the forest.

References

Read fact sheets on Ebola at the Centers for Disease Control and Infection (CDC), World Health Organization (WHO), and the National Institutes of Health (NIH).

A Bloomberg News article on treatments in development for Ebola, including antibody cocktails being developed at Mapp Biopharmaceutical in San Diego, which is working with the U.S. Defense Advanced Research Projects Agency, the National Institutes of Health and the Defense Threat Reduction Agency.

Richard Preston’s 1994 best-selling book about Ebola, “The Hot Zone” and Laurie Garrett’s 1995 book “The Coming Plague: Newly Emerging Diseases in a World Out of Balance.”