Spreading faster than efforts to control it


The WHO says Ebola is spreading faster than efforts to control it. That’s not good. We need it to be the other way around.

But it’s difficult. Poverty makes it more difficult. Poverty means lack of infrastructure, and that makes it more difficult.

Analysis: David Shukman, BBC science editor

Friday’s summit should provide the kind of international co-operation needed to fight Ebola but the battle against the virus will be won or lost at the local level. An over-attentive family member, a careless moment while burying a victim, a slip-up by medical staff coping with stress and heat – a single small mistake in basic hygiene can allow the virus to slip from one human host to another.

The basic techniques for stopping Ebola are well known. The problem is applying them. Since the virus was first identified in 1976, there have been dozens of outbreaks and all of them have been contained. Experts point to these successes as evidence that this latest threat can be overcome too.

But working against them are suspicions among local people and the unavoidable fact that this is an extremely poor part of the world, much of it still reeling from conflict. Deploying the right equipment in properly trained hands is always going to be a struggle, one that is now extremely urgent.

On the other hand – the death rate from malaria dwarfs that of Ebola at present.

According to the latest estimates, released in December 2013, there were about 207 million cases of malaria in 2012 (with an uncertainty range of 135 million to 287 million) and an estimated 627 000 deaths (with an uncertainty range of 473 000 to 789 000). Malaria mortality rates have fallen by 42% globally since 2000, and by 49% in the WHO African Region.

Most deaths occur among children living in Africa where a child dies every minute from malaria. Malaria mortality rates among children in Africa have been reduced by an estimated 54% since 2000.

That’s an emergency too, to say the least, but it’s a familiar, as it were domesticated emergency, and we don’t worry that it’s going to come and get us, so…we don’t think of it as an emergency.

Comments

  1. Decker says

    The fact we understand so much more about malaria makes it less frightening. The death rate of those infected by E-bola is around 60%.

    Yesterday the figure given for those infected was 1,201 with more than 6 hundred deaths. Today the figure has risen to well over 1,300 infected with more than 700 dead.

  2. Decker says

    I meant to say that we have the means ( but perhaps not the will) to controle and even eliminate malaria. It’s an enemy we know.

    E-bola is much newer, it’s an enemy we know far less about, and so it’s more menacing.

    Were this contagion to spread, the death rates could potentially make those from malaria look like small potatoes.

    Then again, perhaps I’ve been watching too many of those hollywood apocalypse movies…

  3. says

    The lack of infrastructure may be giving and taking away, here. If there was good public transit, the virus could be rampant in Freetown, or even larger urban areas.

    What scares me is reports like this:
    “Ebola patients ‘refusing isolation’ ”
    ( http://www.bbc.co.uk/news/world-africa-28613885 )
    Superstition and ignorance are amplifying a humanitarian disaster; people should have basic knowledge of virology and bacterial infection – everywhere in the world – our collective consciousness should be the second most critical defense against disease (after our skin) People should understand that if you’ve got Ebola and you run home to your family, they won’t be able to help you and you certainly won’t help them. I imagine the anti-vaxxers would be out there telling these people “don’t take the vaccine!” if only one existed.

  4. says

    Were this contagion to spread, the death rates could potentially make those from malaria look like small potatoes.

    Normally, Ebola shouldn’t/won’t spread because it’s so nasty its victims are pretty quickly unable to travel, or to infect others. Malaria has a highly mobile vector that flies around and distributes it; Ebola does not. In principle, even with its insane death-rate, Ebola outbreaks can be allowed to burn out by quarantining the outbreak until everyone has either died of it or recovered. That would be a horrible worst-case scenario and would be unimaginable if the outbreak was a large urban area.

    What would be really scary would be if Ebola became airborne. A second scary scenario would be if someone infected went someplace and made a connection through Heathrow Airport, or Frankfurt, or Jeddah.

    Bringing the infected doctor back to the US strikes me as a bad idea (my microbiologist friend who used to work for CDC says: “what could possibly go wrong?!” with extreme sarcasm) and I wonder how much of it is that they want to bring it back to the US for the same reason that Carter Burke wanted to expose Ripley to a face-hugger and bring her back to earth: it’s a weapon. Indeed, Ebola’s tendency to burn out areas where it outbreaks would make it almost ideal as a bioweapon if you were the most horrible, immoral motherfucker that ever lived. Which is why I wonder if that’s what the US is up to.

  5. penn says

    Marcus, quit with the fear mongering and conspiracy theories.

    The ebola outbreak is a terrible tragedy that needs to be dealt with, but it is not a pandemic risk in the developed world because it’s not airborne and you’re not contagious until after you show symptoms. If an ebola patient, showing symptoms flew through Heathrow, odds are not a single person would become infected since that person would have to sweat, bleed, or shit on people.

    Vox did a great article on the risks of ebola in the U.S. (http://www.vox.com/2014/7/30/5948995/why-ebola-would-never-get-this-bad-in-america/in/5712456).

  6. Claire Ramsey says

    There is a pretty clear defense against malaria, bed nets: http://articles.latimes.com/2010/may/02/opinion/la-oe-shah-20100502

    But

    a bed net is a first world device not always welcomed or used on beds by Africans in malaria-ridden poor locations. (And I donate $$ for bed nets annually b/c I still believe that it’s the best defense going). But to poor Africans who have seen malaria a thousand times, its just not viewed as a big problem despite the numbers of deaths we know about b/c we have access to WHO stats, etc. Ebola, as far as we know so far, is viewed as an emergency, hence difference responses to it.

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