Strategies for containing Ebola in West Africa
Host genetic diversity enables Ebola hemorrhagic fever pathogenesis and resistance
What does Ebola actually do?
Is the Ebola Epidemic Ending in Africa?
A: No one knows exactly what is going on in West Africa. Several medical groups, like Doctors Without Borders, are reporting that they suddenly have far more beds than patients. In some cases, there are empty beds at centers where, just a few weeks ago, people were dying on the streets outside because there was no room.
The trend is especially noted in Liberia, the hardest-hit country. Laboratories are getting fewer samples to test. Ambulance crews are picking up fewer bodies. The World Health Organization confirmed that new cases were dropping.
But health authorities are warning that it is too early to celebrate.
It is important to remember that this happened once before, on a smaller scale. In March, after alarming reports from Guinea that a rural outbreak had reached the capital, the W.H.O. and the Centers for Disease Control and Prevention sent experts in to help. The epidemic spread to Sierra Leone, and then to Liberia. But cases grew only slowly, and by May, most of the experts were withdrawn. At the time, there was more worry about MERS in Saudi Arabia.
In early August, the chief scientist for Britain’s foreign aid agency said the “end of the epidemic was in sight.” He was wrong. About 800 people were known to be dead then. Cases had actually begun to explode in July, and now about 5,000 are dead.
There are some theories as to why the numbers seem to be going down. The leading one is that more West Africans now believe that Ebola exists, are afraid of it, and are touching each other less.
In that way, it is like lung cancer, only on a speeded-up time scale. It took 30 years for Americans to fully accept that smoking caused lung cancer. Once they believed, fewer started smoking. Deaths from lung cancer are now much lower than they used to be because many Americans in their 50’s and 60’s didn’t start as teenagers, or quit. But you wouldn’t say that the lung cancer epidemic is over.
Because poor West Africans often have many people sleeping in one room, Ebola spreads in households. Because the incubation period is up to 21 days, it often kills the family slowly, one by one. But for each other family that keeps the virus from entering its household, that can mean five or six fewer deaths.
Other theories are that tens of thousands of home-care kits have been handed out. They contain gloves, bleach, a bucket, plastic bags and a bleach sprayer. Using them around the sick, and especially during burials, may have helped.
Alternatively, hospitals may be empty because more people are dying at home. In Liberia, it has been reported that families are refusing to bring in their relatives because, if they die, they will be cremated.
Another report is that taxi and minibus drivers are refusing to take passengers who are bleeding or vomiting to hospitals. That forces them to die at home – which is cruel, but could slow the spread of disease to other passengers.
It is also important to remember that epidemics typically come in waves. The reasons for some are obvious, like the weather: flu cases rise in winter, polio cases rise in summer. Pox diseases like smallpox, measles and chickenpox used to surge every few years after a new set of young children was born. For other diseases, the reasons are not clear. Ebola may simply be having a moment between waves.
To the Editor:
Since returning from Liberia, where I treated up to 80 Ebola patients a day for six weeks, I have been incredulous, shocked and now angry at the fearful, panicked and, yes, cowardly behavior of the American politicians and public. America needs to get a grip.
I risked my life day after day treating Ebola patients, donning protective equipment with my team. Why, as Gov. Chris Christie of New Jersey implied, would I not comply with self-monitoring when it will be what saves me? Imagine the anxiety that I lived with upon my return wondering if my temperature would spike? Why does anyone think I would risk someone else’s catching Ebola? I have seen firsthand what an awful sickness it is.
A colleague of mine, Kaci Hickox, has been confined to a tent. At best she is going to be forced into a form of house arrest. Why?
There has not been one single case of Ebola infecting a member of the general public. Ebola cannot be transmitted when an individual is asymptomatic.
I feel ashamed to see how fear has a life of its own, with the result that I and my heroic colleagues are at risk of losing civil liberties for no reason other than political grandstanding and a lack of medically informed decision making.
DEBBIE WILSON
Lenox, Mass., Oct. 27, 2014
Lenox, Mass., Oct. 27, 2014
The writer is a nurse.
Tested Negative for Ebola, Nurse Criticizes Her Quarantine
A nurse who was being quarantined at a New Jersey hospital after working with Ebola patients in Sierra Leone criticized her treatment on Saturday as an overreaction after an initial test found that she did not have the virus.
“I am scared about how health care workers will be treated at airports when they declare that they have been fighting Ebola in West Africa,” the nurse, Kaci Hickox, wrote in an essay on the website of The Dallas Morning News, in collaboration with a friend who works for the paper. “I am scared that, like me, they will arrive and see a frenzy of disorganization, fear, and most frightening, quarantine.”
She described being held in isolation for about seven hours at Newark Liberty International Airport on Friday, left alone for long stretches and given only a granola bar when she said she was hungry.
Ebola Vaccine, Ready for Test, Sat on the Shelf
Almost a decade ago, scientists from Canada and the United States reported that they had created a vaccine that was 100 percent effective in protecting monkeys against the Ebola virus. The results werepublished in a respected journal, and health officials called them exciting. The researchers said tests in people might start within two years, and a product could potentially be ready for licensing by 2010 or 2011.
It never happened. The vaccine sat on a shelf. Only now is it undergoing the most basic safety tests in humans
Nina Pham, Dallas Nurse Who Had Ebola, to Be Released From Hospital
Ebola Vaccine Trials Planned for December
Participants in Liberia and Sierra Leone would receive experimental vaccines that could lead to mass inoculations by spring, health officials said Friday.
Graphic: Retracing Dr. Spencer’s Footsteps
Obama’s Ebola Response Draws Scrutiny of House
Hospital to Discharge Dallas Nurse Who Had Ebola
Live Updates: New York’s First Reported Case of Ebola
Ebola Crosses New Border as Mali Confirms a Case
A toddler from next-door Guinea who lost a parent to the disease has tested positive.
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