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Tuesday 29 July 2014

EBOLA: DEADLY, CONTAGIOUS AND INCURABLE - COULD IT LEAVE AFRICA

Personally,I will never thought there is going to be a more deadly virus even worst than HIV/AIDs in the world

There was nothing unusual-looking about the passenger arriving at Heathrow from Lagos.

He was carrying one of the most deadly diseases known to mankind, but it wasn’t noticed by overstretched Nigerian airport officials before departure, nor by attendants on the flight, despite their special training to watch out for feverish passengers.

Because Ebola is a disease that has an incubation period of between two and 21 days, it’s more than likely that the final line of defence — immigration staff at Heathrow — failed to notice anything untoward about him either.

It wasn’t as if he was so unsteady or unwell that he couldn’t answer basic questions.

And so he was waved through.

Little did anyone realise that his initial flu-like symptoms — fever, headache, achy limbs, sore throat — would soon become something much, much worse.

Ebola, a disease which is fatal in 90 per cent of cases and for which there is no vaccine and no known cure, was now in Britain for the first time.

It would soon be spreading across the country, killing almost everyone it touched.

Fortunately this is an imaginary situation, but an Ebola epidemic is the nightmare scenario which inspires Hollywood disaster movie writers and keeps public health officials awake at night.

However, there is now widespread alarm among experts that it could actually happen, because the deadly disease has spread for the first time from remote jungle villages to claim its first victim in Lagos, one of Africa’s most sophisticated cities, with air links to major cities worldwide, including London.

And woe betide anyone who comes in close contact with an Ebola victim.

While the virus’s one virtue is that it isn’t as easily transmitted as, say, an airborne influenza, it is highly contagious if you come near enough to be infected by any sort of bodily fluid.

This means not only contamination from vomiting and diarrhoea — the next stage after the fever and headaches — but saliva from a kiss, sweat from a mopped brow, or even, it is thought, a sneeze.

If a sufferer is looked after by loved ones, only the most ruthless sanitation regime will save them. If he or she seeks medical help, risks could be even greater.

As one British expert told me yesterday, if an Ebola victim was misdiagnosed and ended up being admitted to a normal hospital ward, the ‘consequences would be disastrous’ as nurses and doctors unwittingly passed the virus to other patients and colleagues.

The final stages of the disease are hideously unpleasant as the virus punches holes in veins, often causing massive internal haemorrhaging and bleeding from the eyes, ears, mouth and other orifices.

Death is generally caused by multiple organ failure.Just as well, then, that no one ever gets Ebola beyond a handful of unlucky souls in the remote rural villages of equatorial West and Central Africa, where locals ignore warnings and still eat the fruit bats and monkeys that are the chief carriers of the disease.

At least, that’s what public health experts have been saying for years.

Suddenly, though, they are changing their tune.

The latest outbreak of the disease is not only to be the worst ever by number of deaths, it has also been the first to spread to people living in major urban centres, including national capitals.

The risk of it spreading across the world is now very real, experts warn.

Since the outbreak started in Guinea in February, spreading to Sierra Leone and Liberia, the virus has infected more than 1,200 people, killing 672 of them so far.

A cruel irony of Ebola is that those caring for its victims often contract the disease themselves. Recent casualties included one of Liberia’s most respected doctors and two Americans — thought to be Ebola’s first Western victims.

Dr Ken Brantly was the medical director of a Christian aid charity, Samaritan’s Purse, who had been working in Liberia since October.

He contracted the disease despite wearing head-to-toe protective clothing while treating sufferers.

Nancy Writebol, a Christian missionary, had also been working with Ebola victims in the Liberian capital of Monrovia when she became infected.

Dr Brantly, at least, may yet defy Ebola’s grim statistics.

Early treatment improves a patient’s chances of survival, and he recognised his own symptoms and got immediate care.

His wife and two young children were with him in Liberia until flying home to the U.S. a few weeks ago, but they have not yet shown any signs of the disease.

On Sunday, Liberia took the drastic step of closing its borders but it may be already too late.

In Lagos, Nigeria’s commercial capital, a Liberian man who tested positive for Ebola died on Friday.

Patrick Sawyer, a civil servant, collapsed at Lagos Airport as he returned from the funeral of his sister, who had also died from the disease.

He changed plane in Togo and was vomiting on board, prompting fears the disease has already spread to a fifth country from just one outbreak.

Nigeria’s government says all ports of entry are on high alert.

The situation is getting more and more scary,’ conceded Tolbert Nyenswah, Liberia’s assistant health minister.

Hugh Pennington, emeritus professor of bacteriorology at Aberdeen University, warns: ‘If the disease gets going in Nigeria, it would be cause for concern.

'Nigeria has close links with the UK and many other countries.’

Professor Pennington, an international expert, said yesterday that he was hardly reassured by current efforts to contain Ebola’s spread.

‘This is a very big outbreak, and I get the feeling that whatever is being done to control it is not being done very well.

'Once you get a fairly large number of cases, it gets a momentum and becomes more and more difficult to control.

‘This is now crossing international borders.’

Professor Pennington, who criticised the UK government over its handling of mad cow disease, warned that Britain would be ill-equipped to cope with a sudden influx of Ebola victims.

Isolating them is critical, he said, but ordinary hospitals simply don’t have the facilities or the necessary highly trained staff.

The specialist hospitals that dealt with such diseases have largely closed.

‘If [Ebola] came into London, I honestly don’t know where they’d put the patients,’ he said.

‘We could cope with one or two, but more than that? Let’s hope we don’t have to.’

The big problem with Ebola, he stressed, is diagnosing it. The disease looks much like common flu until it’s too late. Even the rash that sufferers get after about five days could be confused with other less serious ailments.

‘Ebola patients can often go under the radar, but if they ended up in hospital, giving blood samples and coughing over everyone, it would be potentially disastrous,’ he said.

He adds that it was crucial for British GPs and hospital doctors to start watching out for Ebola.

‘If someone is coming in with flu-like symptoms, it’s crucial to ask them where they’ve been — and whether they’ve been to Africa.’

Surprisingly, scientists are still not clear exactly where Ebola comes from.

The first known outbreak was in 1976 in a remote village near the Ebola river in what is now the Democratic Republic of Congo.

Although most of the cases are understood to have been transmitted from human to human, each Ebola outbreak is initially caused by someone coming into contact with the blood or body fluids of an infected animal, such as a fruit bat, monkey or pig. (The bats are believed to carry the disease without being infected by it.)

The chief cause is the popularity of ‘bush meat’ — animals trapped in the wild.

Bats and monkeys are frequently dried and then eaten without being cooked.

Since bush meat is now being smuggled into London and Paris, scientists warn this could be another source of infection in Europe.

According to Dr Ben Neuman, a virologist at Reading University, the disease is spreading so rapidly now because people are ‘rescuing’ Ebola sufferers from hospitals or snatching their dead bodies so they can wash them in accordance with religious custom.

In the first case of an infection in Sierra Leone, a hairdresser in Freetown, the capital, was forcibly removed from hospital by her family, sparking a frantic search to find her before she infected others. She died on Sunday.

Dr Neuman also fears officials in the UK may be hard-pressed to keep out every Ebola sufferer if their numbers become too great.

‘We have to hope they do, though, as in the late stages of infection, you have enough virus in your body to infect everyone on Earth maybe three times over.’



 

An Ebola virus virion
An Ebola virus virion
The current outbreak of Ebola has spread to at least four countries in West Africa since the start of the year.
So far, it has claimed 672 victims, and infected 1,093.
Countries affected include Liberia, Guinea, Sierra Leone, and Nigeria.
The disease spreads through contact with blood, body fluids or contact with tissue from infected people or animals. It has only a 10 per cent survival rate.
U.S. health authorities have warned the deadly virus can spread 'like a forest fire'.
Stephan Monroe of the Centers for Disease Control and Prevention said yesterday that 'Ebola poses little risk to the general U.S. population.'
However, he told AFP: 'The concern is that the outbreak can be reseeded, much like a forest fire with sparks from one tree. That is clearly what happened in Liberia.'
Civil servant Patrick Sawyer collapsed at Lagos airport in Nigeria on July 20 after flying in from Liberia, where he had attended the funeral of his sister, who had also succumbed to the disease.
His plane also landed in Togo on its way to Nigeria, prompting fears that the virus may have also reached a fifth country.
Nigeria, Guinea, Liberia and Sierra Leone are now screening air passengers – but doctors say this may not be effective because Ebola has an incubation period of two to 21 days and cannot be diagnosed on the spot.
Symptoms include high fever, bleeding and damage to the nervous system. There is no vaccine or cure. It is spread by contact with infected blood or other bodily fluids.
All outbreaks since 1976 when Ebola was first identified have been in Africa, with the previous highest death toll being 280.

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