Two patients infected with Ebola virus have now entered the U.S. for treatment, but they are in a highly controlled environment. However, while the press and the public have been very aware of this, we still have black market transfer of "bush meat", fresh animal flesh from Africa to other parts of the world, outside any regulation for potential disease transmission. Could it be that while the media and public focus on a contained and controlled situation that is unlikely to result in an Ebola outbreak outside Africa, we are largely ignoring a more significant Ebola threat via other means of introduction?
It is difficult for Ebola virus to survive in any country without a reservoir , which is the fruit bat . If it is to spread by the method you have suggested , it would have manifested by now . Though cases may occur in other countries through human to human contact , it may not persist for a long time . A lot more data are needed on the pathogenesis & management , from which guidelines can be evolved for better treatment & improving survival . This would remove the fear factor & help in better preparation for future management . The WHO has done a good job for management of severe dengue all over the world , with excellent guidelines . I hope the soon would be done by WHO for Ebola virus to both prevent & manage patients
David's question is valid. It is true that certain types of bat appear to act as a vector, and indeed, the possibility of bats being a reservoir (as with SARS) cannot be ruled out. Meanwhile, 'person-to-person' transmission must include 'primate-to-primate' and that is where bushmeat presents a viable pathway. Bushmeats include the partially dried/ cooked/ smoked carcasses of many species, but monkey, ape, and bat are common. Importation is of course illegal, but large quantities still seem to arrive in London, New York, and probably any large city with West African ex-pats, a suitcase at a time. Still-bloody specimens, noted not infrequently, would strongly suggest that the viability of the virus may have survived the preparation/cooking process.
Interesting question.
I think there is a determining factor that we do not know such as a reservoir that usually allows the strike on primates before humans. If bush meat is imported from an area with a concurrent outbreak (or prior), I suppose the risk of acquiring the disease would be higher. This is based on the observations of tracing the handling of bush meat to index cases in different outbreaks. Yet it is unclear why it has not been reported yet!
Before reported outbreaks, large numbers of apes usually are found dead in the forests—normally it is rare to stumble across the corpse of an ape. In 2001, about 64 carcasses of apes and duikers were reported over just 8 months in the Zadie region of Gabon, precisely where Ebola later struck. (Burton. Lancet 2004)
I also wonder whether anybody knows of any studies where the serum of bushmeat hunters have been tested for Ebola virus....?
I appreciate the thoughtful responses, and welcome others to join the discussion, especially now that the Ebola outbreak in Africa has grown beyond early expectations and has transformed in character as a major epidemiological event, leading us to re-examine transmission modes and control approaches. As with most issues involving the illegal, and thus unregulated, bushmeat trade, we simply don't seem to have good information on most pathogens. Of course, there are others besides Ebola virus that are of concern, and possibly have more potential for introduction to new geographical areas. However, the current situation with Ebola has brought issues of infectious outbreaks to a new point of public awareness, so it is a critical time to seek better ways to predict and control pathogen spread, while helping to control unnecessary public alarm.
I very much agree as a general policy with the need to walk a middle path between on the one hand inciting unnecessary panic, and on the other denying that there's anything to be concerned about. Since this thread started, as David mentioned, the outbreak has grown exponentially, and cannot be considered under any sort of 'control'. The lessons learned from this episode will be incorporated into discussions, policies, procedures and curricula for a long time. Already we can see that since at least the late 1990s, we have been watchful for the new and exotic virus, a new avian influenza or coronavirus, and have focused on how long will it take to identify the new virus, how long it will take to develop a vaccine. Ebola is still a mystery as to exactly where it retreats between human outbreaks, but the control method itself had been considered a 'known quantity'. The current outbreak is an example of a quite different breakdown, that of social, 'mechanical', and logistic barriers, which prevented effective "surveillance and containment" that all epidemiologists consider central to their tradecraft. The analogy is picking up a marble, a simple process. But empty 5000 marbles on the floor, and there simply are not enough fingers to contain and retrieve them all. The other great weakness identified this time is the lack of understanding the local belief systems, the perceptions and understandings of the population, and the very great potential for pushback, denial, and violence when that perception is ostensibly ignored by people in 'moon suits' who take relatives and neighbours away, never to be seen again. Where's an anthropologist when you need one?
Here is a link to a related discussion stream that those following this question may find informative.
https://www.linkedin.com/groupItem?view=&gid=1503767&type=member&item=5934272118249267202&commentID=5936237705900863488&report.success=8ULbKyXO6NDvmoK7o030UNOYGZKrvdhBhypZ_w8EpQrrQI-BBjkmxwkEOwBjLE28YyDIxcyEO7_TA_giuRN#commentID_5936237705900863488
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