The Ebola Virus Infection epidemic seems out of control and has evolved into a major humanitarian crisis that has finally mobilized the world, with responses ranging from an emergency health mission launched by the United Nations Security Council to proposed military-style interventions and the global provision of emergency aid. There is a very real danger of a complete breakdown in civic society, as desperate communities understandably lose faith in the established systems. This epidemic was an avoidable crisis and a prompt response to an emerging outbreak is critical in order to contain it before it becomes too vast in terms of both numbers of cases and geographic reach. The epidemic, which is in grave danger of spiraling out of control, must remain the primary focus of our efforts. Without a massive increase in the response, way beyond what is being planned in scale and urgency, alongside the complementary deployment of novel interventions, it will prove impossible to bring this epidemic under control. A large-scale, coordinated humanitarian, social, public health, and medical response, combining classic public health measures with safe and effective interventions including behavioral changes, therapies, and when possible, vaccination is need of the hour. What needs to be done on a "war-footing" and act more effectively to prevent this epidemic from devastating the Global Economy?
As an academic and a global citizen I first ask myself, what can I do to mobilize action to support the urgent need for a global response to this humanitarian and public health crisis? I presented the recent call from MSF to my students and challenged them to use social media and crowd sourcing strategies to raise funds for those on the front lines. One of the first things citizens can do is support the organizations already in action.This small step is pragmatic as it will help to raise public awareness of ways in which any citizen can provide their support. First we all called to act globally. Second, I am considering leveraging organizational support (lobbying public health organizations, professional bodies etc.) to pressure my government (the Government of Canada) to make a larger commitment to the immediate deployment of fiscal, human and medical resources. What are others doing to take action?
I believe that information is the missing link. The involved communities are frightened and their lives have been torn apart by a disease they do not understand very well. These are also communities with lots of myths and folk lore about any disease they encounter. I feel that if they and their neighbours got all the information related to the disease packaged in a way they can understand and relate to , these communities will then JOIN in the fight instead of feeling that outsiders are coming in to do something to them.Somehow fighting Ebola needs to become something everybody wants to do...from those infected, those affected and those at risk.
1. Awareness campaigns to spread information in public places.
2. People are supposed to be alert of the disease and how to react immediately.
3. Enough resources must be allocated towards the outbreak of Ebola.
This is both a simple question, and one that is complex. The simple answer is that at least since the 17th century there have been models of containment that can be deployed during epidemics. And, too, in areas where an outbreak is fierce procedures and protocols for both care of the sick and the maintenance of those who are quarantened. The difficult question is who is responsible when local outbreaks become a pandemic threatening pandeic status.
Some of the issues on containment and treatment are in my book Disease Maps: Epidemics on the Ground. And a recent article by me in Harvard's Remedia Magazine may offer some further background, and guidance:
http://remedianetwork.net/2014/09/22/ebola-epidemics-pandemics-and-the-mappi
ng-of-their-containment/
Practical answer that addressed Botswana's HIV infections and AIDS epidemic between 1990 and 2002 was HIV/ADS Education (AIDucation). A combination of ingredients from The AIDS Support Organisation (TASO - Noerine Kaleeba) of Uganda; the Chikankata Salvation Army AIDS Programme, Zambia (Dr Ian Campbell) and Teaching aids At Low Cost (TALC-Prof David Morley, Dr Cathy Vaughan and Dr Wendy Holmes).
Same principles used last night on 31st October 2014 at Ni Chema's Annual General Meeting (AGM) in Norwich, England. There was a 40 minutes "Ebola-AIDucation: Ebola in a World of AIDS" presentation through 70 colour slides:
History of AIDS (TALC-Prof David Morley); & history of Ebola (Dr Peter Piot)
- History of AIDucation - teaching with colour pictures. Pictures talking!
- Maps of AIDS and Ebola ("river")
- Myths, beliefs, poverty issues; conspiracy theories and stigmatisation
- Types HIV Type 1 & 2 features; Ebola Zaire, Sudan, Bundiguyo, Reston...
- Transmission of HIV infection and Ebola
- Clinical manifestations and how the two viruses differ in behaviour
- Laboratory tests
- Prevention and infection control for AIDS and Ebola
- Medecins Sans Frontieres (MSF) "Fighting the killer virus" poster with the Ebola 'spacesuit' seen in 5 of the colour slides.
- Protective suit (£16.41); Rubber boots (£9.22); Plastic goggles (£5.16); Plastic apron (£4.05); Chemical resistant .
It is all about community mobilisation with serious political commitment.
Edwin
Dear Dr Syed,
I am sharing few important links from CDC, Lancet on Ebola that could provide some answers that you are looking for.
1. http://www.cnn.com/2014/10/20/health/ebola-outbreak-roundup/index.html
2. Lancet links (You could retrieve these articles using google search):
a. Ebola: what lessons for the International Health Regulations?
The Lancet Published Online First
b. Comment
The Institut Pasteur network: a crucial partner against Ebola
The Lancet Vol. 384, Issue 9950, p1239–40
c. Ebola: from disease outbreak to humanitarian crisis
The Lancet Infectious Diseases Published Online First
d. Correspondence
Ebola and compliance with infection prevention measures in Nigeria
The Lancet Infectious Diseases Published Online First
e. Ebola: a call for blood transfusion strategy in sub-Saharan Africa
The Lancet Published Online First
f. Ebola: an open letter to European governments
The Lancet Published Online First
g. Containment in Sierra Leone: the inability of a state to confront Ebola?
The Lancet Published Online First
h. Priorities for Ebola virus disease response in west Africa
The Lancet Published Online First
3. WHO Statement on Ebola: http://www.who.int/csr/disease/ebola/en/
4. CDC: http://www.cdc.gov/vhf/ebola/
To sum it up, I think we need to orient Health care Administrators, Physicians, primary care doctors and people who are involved in screening of disease for its early signs. The first level of screening criteria (say fever) could have low sensitivity since we do not want to lose any un-detectable case but next level should be highly specific so people who do not have the disease could be screened out. Another thing is high level of surveillance is key to not miss any case and cases who are lost to follow up (dead) should also be investigated for potential contacts (including treating health workers in direct contact).
Best
Manpreet
Dear Professor Syed
Viral infections like Ebola which mutate can never be completely eliminated.
Animals such as bats, primates etc can carry the virus which may not be fatal to these species may be fatal to humans.
Education and containment measures will help but becomes difficult in poor third world counties. Intervention by foreign workers in Space Suits and experimental vaccines and treatments can create fear which may result in infected people avoiding these interventions.
One of our areas of research involves the blocking of Viron entry into Host cells which limits the disease progression and can allow time for the development of natural immunity.
The published viral literature for Influenza and Ebola virus shows that Bafilomycin a Proton Pump Inhibitor blocks the entry of these virons into host cells. Bafilomycin however is too toxic for use in humans.
A simple formulation based on the Proton Pump Inhibitor Omeprazole which is acid stabilised with N-Acetyl Cysteine has been developed for EBOLA.
Both Omeprazole and N-Acetyl Cysteine are low cost and readily available with a long history of safe use in humans.
Attached is a typical PROVIR formulation which can be made by any hospital Pharmacy dealing with Ebola Patients or health workers exposed to Ebola.
Regards
John
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