Ebola ( named after a river in Democratic Republic of Congo ) is only ONE of the " viral haemorrhagic fevers " which include dengue and yellow fever. The present outbreak has caused huge publicity because of its high fatality rate. About a thousand have died so far – several thousand since its discovery in 1976.


It’s rightly being taken seriously. A multimillion dollar international strategy to bring the outbreak under control ( successful with previous outbreaks ) has been launched by WHO ( World Health Organization ) and affected countries. WHO declares Ebola an international emergency.


The problems, now well known, are :-

• Transmitted to humans from wild animals and then human-human transmission ( through close contact ) ;

• No licensed specific treatment or vaccine;

• Stigma – local resistance and hostility based on ignorance.

• Lack of facilities and health workers ( themselves at risk, over 60 have died helping others ).

• Incubation period ( time from infection to symptoms ) is between 2 – 21 days. Many other diseases causing fever need to be ruled out ( including malaria, typhoid, and other viral causes of fever like dengue ).



Every infection gives Ebola a chance to better adapt to humans, but a future global pandemic is UNLIKELY :-

1. It can ONLY be spread by close contact.

2. It kills a large proportion of its victims, LIMITING its ability to spread.

3. It’s thought that " urbanisation " is a contributory factor in this outbreak – previously village outbreaks remained small, and victims ( sadly ) died without ever going to hospital.



The diagnosis can be proved in the laboratory by a variety of blood tests and/or viral culture. There are five different virus types. The most lethal ( Zaire ebolavirus ) is causing this outbreak.


There is a PHILIPPINES connection. One subtype, the Reston Ebolavirus, has caused severe outbreaks in macaque monkeys farmed in the Philippines and imported to the USA ( including Reston, Virginia ) for research. It may also infect pigs without causing symptoms. NO illness or death in humans has been reported to date.


Ebola has raised questions about whether medicines / vaccines that have never been tested on people should be used in this outbreak. " ZMapp " – a drug produced in genetically engineered tobacco plants - has apparently been given to two US health workers. WHO this week has convened an " ethical review of experimental drugs " – knowing there will be far too few in the near future to treat the general population.


" Innovative " medicine is to be encouraged generally, whether for severe infections, cancer or dementia - but ideally it needs :-


• Informed consent from the patient ( difficult with no evidence of effectiveness );

• Explanation of risks and benefits ( also difficult because not known );

• Record of the outcome ( success or not, only known once large scale trials have been carried out ).


The Ebola epidemic is small in absolute numbers – compared to measles ( over 120,000 deaths in 2012 ) and the millions affected by malaria and tuberculosis. But it is a test for the future of public health interventions in Africa.


The world is now waking up to antibiotic resistance and fears of bioterrorism. We must hope that this particularly nasty viral haemorrhagic fever is contained in Africa, brought under control, and the pharmaceutical industry can be encouraged to come up as soon as possible with effective vaccines and treatment.


http://www.who.int/mediacentre/factsheets/fs103/en/


http://www.thelancet.com/journals/la...322-2/fulltext


http://www.thelancet.com/journals/la...319-2/fulltext


http://jid.oxfordjournals.org/conten...pl_3/S757.full


http://businessmirror.com.ph/index.p...he-philippines


http://www.bbc.co.uk/news/health-28708632