Ebola outbreakThe Ebola Virus Disease (EVD) has ravaged countries in sub-Saharan Africa since its identification in 1976. Overall, there have been 34 outbreaks of Ebola in Western Africa, 11 of which have occurred in the Democratic Republic of Congo (DRC). The largest Ebola outbreak, considered a global pandemic, lasted from 2014 to 2016. It mostly affected countries like Sierra Leone, Liberia and Guinea. At the time, a total of 11,310 deaths were reported due to the disease.

The fatality rate for Ebola has ranged between 25% and 90%, depending on the severity of the outbreak and on the healthcare infrastructure of affected countries. The more modern and accessible these systems were, the more efficient the surveillance and treatment options. The second-largest outbreak of Ebola began in the Kivu region of the DRC on Aug. 1, 2018, and was only declared over as recently as June of 2020.

Containment in the DRC

Comparing the 2014 Ebola outbreak with the one that occurred in 2018 reveals a relative improvement. From 2014 to 2016, there were 28,616 EVD cases that resulted in 11,310 deaths. On the other hand, from 2018 to 2020, there were only 3,481 cases and 2,299 deaths reported.

DRC’s commendable public health response to the 2018 Ebola outbreak led to this outcome. Pre-existing infrastructural inadequacies and a lack of trust in health care officials have been the major challenges faced during Ebola occurrences. Though many of these problems continue, the better use of surveillance, contact tracing, prevention strategies and safe burial practices have greatly shaped how the most recent outbreak developed. Additionally, the global health community has made strides in vaccine development and treatment programs, making the defeat and containment of this epidemic possible.

Safe and Dignified Burials

Because the virus is transmitted through direct contact with an infected individual (living or deceased), traditional burial practices that require family members to wash the body pose a significant risk to communities during Ebola outbreaks.

In 2014, rural populations of Sierra Leone experienced surges in reported Ebola cases as a direct result of community members’ attending funerals and touching infected corpses. Since then, the CDC, the Sierra Leone Ministry of Health and Sanitation and the WHO have provided guidelines for safe protocols when handling potentially infected corpses. These protocols involve trained personnel and extensive personal protective equipment (PPE). During the recent contained Ebola outbreak, 88% of funerals utilized safe and dignified burial practices.

Vaccination Efforts

As a result of the most recent epidemic, 16,000 local responders and 1,500 WHO health workers collaborated to provide effective vaccines to 303,000 people. Individuals were considered eligible for vaccination if they had previous contact with an infected individual or were a frontline worker in an affected or at-risk area. Treatment centers, field laboratories and an Ebola national care program were also set up to care for patients, providing weekly test samples and follow-up with survivors.

EVD versus COVID-19

The world has seen other deadly viruses before COVID-19. SARS, Ebola and even the annual flu are some examples. COVID-19 stands out because it is easily spreadable and the rate of asymptomatic transmission is high. Asymptomatic transmission occurs when individuals don’t know they are infected and, as a result, spread the virus without knowing. Even though Ebola is highly contagious toward the end of the infection period, infected individuals show intense symptoms, so it is not easy for the virus to fly under the radar as COVID-19 tends to do.

Moreover, while health responses against Ebola are significant in fighting the spread of the virus, the vaccine and treatments are the real superheroes in protecting large populations and infected patients from the virus. As the world witnessed in the 2014 outbreak, Ebola left a devastating death toll in its wake without a vaccine. There are currently no viable vaccine or treatment options for the coronavirus, although development is currently in progress.

Moving Forward

Because preparedness plays a large role in within-country health responses, it is hopeful that future Ebola outbreaks will be contained. The health responses, vaccination programs and treatment options utilized by the DRC are applicable to other countries as well. Aid from WHO and other health agencies will lessen the threat of Ebola in Western Africa and the world.

– Nye Day
Photo: Flickr


The Link Between Poverty and EpidemicsWhen Bill Gates, the famous humanitarian, entrepreneur and founder of Microsoft, was asked in an interview with Vox about the greatest threat to humanity in the coming decades, his answer was scientific, reasonable and startling. Rather than mentioning the kinds of threats usually brought up in such discussions, dangers such as nuclear weapons, climate change and planet-killing asteroids, Gates pointed to something else with a much higher likelihood of occurrence but with the potential to be just as devastating.

A widespread pandemic is the most likely cause of a mass extinction event in the 21st century, yet despite its relatively high probability of occurring, it remains less discussed than many flashier topics like war and environmental disaster. The last time the risk of pandemic sparked widespread fear and discussion was in 2014, with the spread of the Ebola virus devastating communities in West Africa, and, in rare cases, spreading to other countries as well.

Though the topic has since faded from national conversation, the threat remains real. Even more important, unlike reducing carbon emissions or preventing nuclear proliferation, one major remedy for disease is relatively straightforward and within our capability. The human race could significantly reduce the likelihood of a pandemic disaster by eliminating extreme global poverty.

In 2014, West Africa suffered an outbreak of the Ebola virus, which devastated communities and killed more than 11,000 people by 2016. It also shed international light on the link between poverty and epidemics. Ebola became such a threat in 2014 because the region was impoverished and lacked the basic healthcare infrastructure necessary to fight the outbreak. This allowed the disease to spread at a fierce pace, risking a worldwide epidemic and sparking fears around the globe. Many patients were at first handled without proper caution, which led to an increase in cases and the rapid spread of the virus throughout the region.

If the United States invested more in these countries, especially toward improving their medical infrastructure and quality of life, such spending would not only create a new market for American exports, but it would also decrease the likelihood that a virus-like Ebola could spread without proper defensive strategies from the medical community. If healthcare infrastructure in West Africa had been better in 2014, the outbreak could have been contained much faster and the death toll reduced drastically.

The way in which a given disease spreads and becomes an epidemic is a complicated issue that depends on many factors. Poverty, however, has been shown to be a major determinant of how many people will be infected and how quickly. A World Health Organization report found that poverty in Africa correlated with an increase in the likelihood of contracting HIV, which researchers speculated was due to poor sexual education and high levels of economic disparity in impoverished regions. Similarly, the National Health Institute found in a 2012 report that communicable disease and poverty were linked to one another.

Though correlation did not imply causation, the researchers stressed that it would be foolish to disregard the link between poverty and epidemics, and that environmental conditions like economic status played a major role in the spread of disease. They argued that the link was likely caused by poor education, crippled healthcare infrastructure and the lack of clean water and food, all of which are common in areas suffering from extreme poverty. By investing in the healthcare infrastructure of other nations, the United States could help both itself and the world by reducing the likelihood of a major global pandemic, as the link between poverty and epidemics is a major risk that could become even more dangerous to the future of humanity than nuclear warfare.

– Shane Summers

Photo: Flickr

Nearing the conclusion of the First World War, both Western Europe and the United States were swept up once again in mass casualties. However, this time it was not mustard gas or trench warfare, but rather it was the spread of a highly virulent virus that quickly moved from epidemic to pandemic proportions. Known as the Spanish Influenza, this virus emerged from the prairies of the United States and quickly spread throughout the ravaged cities of war-torn Europe, causing catastrophic levels of death and human suffering. Much has changed in the subsequent century since the Spanish Influenza pandemic, most notably increased coordination between governments in regards to global health concerns and early warning systems of epidemics. And if current trends continue, the end of global pandemics may finally be a reality.

Primarily due to the growth of social media and greater governmental cooperation, local epidemics are being reported to World Health Organization officials at a much quicker rate, allowing for the deployment of huge networks of heath workers aimed at both containing and studying a disease prior to it mutating and becoming a pandemic. Innovative health care workers and research scientists are now utilizing the full potential of social media, and have managed to decrease the detection time of possible pandemics to 23 days, possibly ushering the end of global pandemics.

In regards to the end of global pandemics, TEDMED speaker Dr. Larry Brilliant recounted the eighty countries that came together to end smallpox which lasted for more than two centuries. “Today, we are finding diseases faster than anyone ever imagined,” he comments. “Innovations in early detection, early response and global cooperation can put an end to pandemics.”

A future free of disease-causing viruses capable of inflicting huge losses of life are primarily due to the impressive scientific advances in global health and social media that have occurred over the last decade. Moreover, as early detection times continue to decrease, will this generation be the first one to see the end of global pandemics? If health scientists such as Dr. Brilliant continue to forge ahead with their efforts, it’s more than likely a possibility. Dr. Brilliant comments that “We are closer every day.”

Brian Turner
Source: CNN
Photo: Healthcave