Ebola

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Let’s Welcome the Bombali Virus to the Ebola Family

The Sierra Leone government has announced the discovery of a sixth Ebola species, the Bombali virus, named after bats found in the Bombali region. According to Amara Jambai, a senior ministry of health official, “At this time, it is not yet known if the Bombali Ebola virus has been transmitted to people or if it causes disease in people but it has the potential to infect human cells.”

Like any good scientist, Tracey Goldstein, of the One Health Institute at UC Davis, described the discovery as “exciting” but cautioned that “I think we have a lot of work to do to really understand if it is a pathogen and whether it does or doesn’t pose a threat.”

There are five other known Ebola viruses, four of which can cause the disease in people: Zaire ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus, Bundibugyo ebolavirus, and Reston ebolavirus, “known to cause disease in nonhuman primates and pigs, but not in people.”

Reston ebolavirus, for those of you living in the U.S., is notable not only because an outbreak occurred in Reston, Virginia not far from D.C., but also because it was the inspiration for one of my favorite books: The Hot Zone. Highly recommended bedtime reading.

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Ebola is Back

Actually it never left. Ebola is endemic in the Democratic Republic of Congo. The government has declared an outbreak after 17 people in the town of Bikoro are suspected of dying of the gruesome disease. The WHO statement says:

All cases were reported from iIkoko Iponge health facility located about 30 kilometres from Bikoro. Health facilities in Bikoro have very limited functionality, and rely on international organizations to provide supplies that frequently stock out…We know that addressing this outbreak will require a comprehensive and coordinated response. WHO will work closely with health authorities and partners to support the national response.

According to BBC News, “this is the ninth time an Ebola outbreak has been recorded in the DR Congo. The virus was first discovered there in 1976 (when the country was known as Zaire) and is named after the Ebola river.”

Ebola is thought to be transmitted to humans via contact with infected animals such as the fruit bat, or eating infected bushmeat. However, it is worth noting that scientists aren’t exactly sure how Ebola is spread, at least initially, so let that thought fester. Once a person is infected, the virus can be spread through blood or body fluids or objects contaminated with body fluids.

The biggest outbreak of Ebola occurred in West Africa from roughly 2014 to 2016 and killed over 11,000 people. According to the CDC, “Many of these survivors suffer from persistent medical conditions after recovery from Ebola, including joint pain, eye problems, headaches, and other chronic health issues.”

 

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What is Disease X?

Forget about preparing for zombie outbreaks. We should all be preparing for Disease X instead. Each year the WHO meets to create a list of diseases that pose a serious international public health risk “because of their epidemic potential and for which there are no, or insufficient, countermeasures.”

Many of the diseases listed are routine players, such at Ebola, Lassa Fever, SARS, and Zika. But this year, the WHO added “Disease X.” According to the WHO, “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease…”

John-Arne Rottingen, a scientific adviser to the WHO committee says:

“Disease X could be be sparked by a zoonotic disease – one that jumps from animals to humans – and then spreads to become an epidemic or pandemic in the same way H1N1 Swine flu virus did in 2009…As the ecosystem and human habitats change there is always the risk of disease jumping from animals to humans. It’s a natural process and it is vital that we are aware and prepare. It is probably the greatest risk.”

So what does the WHO recommend? Sure, worrying helplessly might seem fun, but they suggest better diagnostics, existing drugs & vaccine improvements, and more research.They do not explicitly suggest a zombie preparedness kit, but you could certainly use your imagination for what Disease X may turn out to be, and plan accordingly.

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Ebola’s Friend: Lassa Fever

A large outbreak of Lassa fever in Nigeria has people worried. The area is observing an unusually high number of cases this year. As of February 18, there have been 913 cases and 73 deaths, compared to 733 cases and 71 deaths in all of 2017.

Like Ebola, Lassa fever is a hemorrhagic fever, though considered less serious than Ebola. According the WHO, Lassa fever usually starts with a fever and progresses to a headache, muscle pain, nausea, vomiting, and diarrhea. In severe cases there may fluid in the lungs, and bleeding from the mouth, nose or other areas. In the most advanced stage of the disease shock, seizures, and coma may occur. In fatal cases, death usually occurs within 14 days of the onset. The drug Ribavirin, given via IV, is considered an effective treatment for Lassa fever if given within 6 days of the onset of symptoms.

What’s causing such a large outbreak? According to Dr. Chikwe Ihekweazu, director of the Nigeria Centre for Disease Control, a couple things may be at play: Improved detection, and that Nigeria’s growing population has brought people closer to the disease host: the infamous rat.

According to NPR:

“West Africa’s dry winters push rodents closer to people to scavenge for food. Virus-carrying rats may defecate or urinate in grains and other food; people can pick up the virus from contact with contaminated products. The virus can also spread between people via bodily fluids. And there are a lot of rats – which means there’s a lot of potential for outbreaks.”

The WHO is scaling up its response to the outbreak, and heath officials are urging people to keep food in sealed containers, as well as limit the proximity of garbage to homes.

 

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CDC Downsizing Work in 39 Countries

The CDC is preparing to downsize its work in 39 countries starting in 2019. Much of the funding for the CDC’s work that helps developing countries detect and respond to outbreaks comes from a five year emergency package that Congress approved as a response to the 2014 Ebola outbreak in West Africa. The money is set to run out in 2019, and there are currently no plans to replace the funding. If you’re thinking this sounds like the start of any number of scary outbreak movies you’d be right. According to the Atlantic:

“These changes would make the world—and the United States—more vulnerable to a pandemic. “We’ll leave the field open to microbes,” says Tom Frieden, a former CDC director who now heads an initiative called Resolve to Save Lives. “The surveillance systems will die, so we won’t know if something happens. The lab networks won’t be built, so if something happens, we won’t know what it is. We can’t be safe if the world isn’t safe. You can’t pull up the drawbridge and expect viruses not to travel.”

The CDC will narrow its focus to 10 “priority countries.” They are India, Thailand, Vietnam, Jordan, Kenya, Uganda, Liberia, Nigeria, Senegal, and Guatemala. Countries where the CDC is scaling back “include some of the world’s hot spots for emerging infectious disease, such as China, Pakistan, Haiti, Rwanda and Congo.” According the The Washington Post:

“The risks of deadly and costly pandemic threats are higher than ever, especially in low- and middle-income countries with the weakest public health systems, experts say. A rapid response by a country can mean the difference between an isolated outbreak and a global catastrophe. In less than 36 hours, infectious disease and pathogens can travel from a remote village to major cities on any continent to become a global crisis.”

Let that thought fester in your head as you work on your bunker.