INTERNATIONAL AFFAIRS by Patrick J. ByrneNews Weekly
Africa's Ebola tragedy: the straight facts
, November 8, 2014
West Africa’s Ebola outbreak has up to a 70 per cent of mortality rate, and 1.4 million people may be infected by January, according to the U.S. Centers for Disease Control and Prevention (CDC).
Since 1976 there have been over 20 Ebola outbreaks. The current is the most extensive, affecting 50 countries.
Ebola is spread by bats infecting other primates. Humans become infected through the handling or eating of infected animals. Roasted “bush meat” is a delicacy in many African countries.
Ebola is spread from human to human primarily through contact with blood, vomit and diarrhoea. At a later stage of infection, when virus concentrations increase, it can be spread through sweat and saliva.
While it can survive outside the body from a few hours to a several days, the virus deteriorates as fluids dry or when it is exposed to sunlight (The Conversation, October 28, 2014).
People with the disease are not contagious until symptoms appear, when levels of the virus increase rapidly in the blood.
These symptoms are also found in other fevers that cause haemorrhaging, such as malaria, cholera, typhoid fever, meningitis and others.
The rapid spread of the disease is related to the high levels of poverty in African countries, resulting in poor sanitation, inadequate health systems and lack of trained medical personnel. Ignorance, low levels of education and the high cost of health services mean that many don’t trust or can’t afford health services.
Many contract the disease while treating their own infected family members or when preparing the deceased for burial.
The World Health Organisation (WHO)’s response has been slow and limited. Budget cuts have reduced it to a technical advisory bureau rather than the primary response agency to a disease outbreak.
The outbreak has had knock-on effects. Mortality from other diseases, such as HIV, malaria and tuberculosis, is now rising as limited health resources are being diverted to fight Ebola.
Also, in some regions like Lofa County, the bread basked of Liberia, many farmers have died from the disease, so now the population is threatened with starvation (News.com.au, October 9, 2014).
While the disease is spreading rapidly in several countries, Nigeria and Senegal have been declared clear of Ebola, for the moment.
Typically, death from the virus occurs six to 16 days after symptoms appear, and is often due to low blood pressure and severe dehydration.
To combat these symptoms, Nigerian health workers pumped infected patients with an old and simple concoction — large doses of water laced with salt and sugar.
Survivor Dr Adaora Igonoh drank at least five litres (1.3 gallons) of this disagreeable-tasting solution every day for five to six days, even though her mouth sores, sore throat and severe depression made this difficult. Yet this simple treatment has radically cut the death rate in Nigeria.
Nigerian health workers tracked down nearly 100 per cent of those who had contact with the infected, paying 18,500 visits to 894 people.Officials are crediting their success to strong tracking and isolation of people exposed to the virus, and aggressive rehydration of infected patients to counter the effects of vomiting, diarrhoea and other symptoms (News.com.au, October 21, 2014).
This process is not easily achieved in many other African countries.
However, in developed nations, this level of vigilance means that it is unlikely that Ebola could spread widely among the population, at least in its current form.
Then there is the inevitable question: could a terrorist group like Islamic State use Ebola as a terrorist weapon?
Writing in web-based security journal, Stratfor (October 23, 2014), Scott Stewart dismisses the idea. He describes the failure of the notorious Japanese cult Aum Shinrikyo when it tried to use chemical weapons.
Aum Shinrikyo did attempt to obtain the Ebola virus as part of its biological warfare program, and failed.
Stewart says that the virus is fragile, is difficult to transport and can only be sustained in ideal laboratory conditions. He adds: “Reproducing the Ebola virus would present additional challenges because it is an extremely dangerous virus to work with. It has infected researchers, even when they were working in laboratories with advanced biosafety measures in place.”
On average, an Ebola carrier infects only one or two other people. Smallpox can infect 12 to 18 people, while HIV, which is only passed only via sexual contact or intravenous blood transmission, has a basic reproductive rate of two to five people.
To date there is no proven cure for Ebola, although a limited issue of an experimental drug appears to have cured two Western health-workers.
Governments are now making public commitments to find a cure, but it will take time to develop.
The Ebola outbreak, terrible though it is, needs to be put in perspective.
As of October 25, over 10,000 people have been recorded as being infected, with 4,900 deaths recorded in Liberia, Guinea and Sierra-Leone, with a small number of deaths in Nigeria, Senegal, Mali, Spain and the U.S.
In fact, in many African countries far more people die of other diseases. In Sierra-Leone, in four months, 650 people died from meningitis, 670 from tuberculosis, 790 from HIV/AIDS, 845 from diarrhoea disease and more than 3,000 from malaria.
The health systems in these countries are ill-equipped and poorly managed — a fact acknowledged at the recent Nossal Institute for Global Health’s recent annual forum in Melbourne.
Of the 193 members of the World Health Organisation’s legally binding international health regulations, which include procedures for identifying and managing disease outbreaks, only 80 countries were meeting the core capacities required by the regulations.
The Ebola outbreak is now bringing these failings into focus, with demands for greater international support for the health systems in these countries.
Patrick J. Byrne is national vice-president of the National Civic Council.