The Ebola virus epidemic in west Africa has now infected up to 12,000, and killed more ( at least 2,400 ), than all the others combined, with regular updates including last week’s edition of " Horizon " .


• This is uncharted territory - but the epidemic appears right now to be out of control . Liberia’s existence as a country is claimed to be " seriously threatened ". World Health Organization thinks there may be 20,000 cases before this epidemic can be contained and controlled, perhaps within 6 – 9 months. Other diseases like malaria – with similar symptoms – of course continue to need treatment.


• Good news is that the Bill and Melinda Gates Foundation is to spend $50 million ( on top of $10 m already committed ) to support emergency responses . Of course this is a tenth of what is claimed by UN to be needed, and a tiny proportion of the Foundation’s money – but every little helps !



• New treatments and vaccines are now urgently being sought. Until now it was confined to poor African countries and largely containable with strict infection control. The possibility of international spread is a factor in this burst of activity. However, countries with good health services SHOULD be able to identify and isolate cases, preventing further spread.



• Already across Africa there is " economic contagion " – the whole continent is suffering the stigma of the disease, even though it’s largely affecting only three countries in west Africa . South Africa’s ailing economy, for example, can do without this, when it’s so far from the affected countries and has no known cases.



• The genetic code of the Ebola virus is RNA – like HIV and influenza. Increasing human-human transmission ( rather than its natural hosts, animals like fruit bats ) gives it the chance to become more " transmissible ". Every time it replicates, new mutations appear. If these reduced the human death rate, it could spread more easily – like common colds – but never be completely eliminated.



• The other good news is that there are several human trials of vaccines that have shown promise in animal tests . Usually a more cautious approach requires " Phase I " trials ( testing if a drug / vaccine is safe in healthy individuals ), followed by another series of trials over time. But these will be offered to health workers, and then others, in infected areas, sooner rather than later.


• One vaccine uses a chimpanzee " cold " virus to deliver Ebola genetic material, which triggers an immune response. Other viruses which readily infect cells could similarly be used to deliver Ebola viral proteins into cells and cause an immune response.



• Blood may also be given from Ebola " survivors " ( containing antibodies ) to existing patients – hopefully resulting in " passive immunity " ( as with other infections ).


• " ZMapp " is a cocktail of antibodies made by genetic engineering which appears to protect against Ebola ( 2 out of 4 infected people who have received it recovered ) – but supplies have run out for now. Existing drugs used for other conditions may also be tried - not the usual cautious, " evidence-based " approach, but justifiable if health care workers and patients are willing to try them.


• Resources of ALL kinds, from hospital beds to protective gear, and health care workers ( either local, or working for agencies such as Medecins San Frontieres ) are in short supply. But almost 40 years since discovery, the fight back against Ebola virus disease has at last become serious .




http://www.bbc.co.uk/iplayer/episode...rch-for-a-cure


http://www.bbc.co.uk/news/world-africa-28754546