Controlling the deadly spread of Ebola

August 18, 2014 by Rob Forman, Rutgers University
More than 1,000 people in West Africa have died during the current Ebola epidemic.

The outbreak of the deadly Ebola virus in West Africa has Americans concerned about their health and safety. The World Health Organization (WHO) has declared an international public health emergency in an effort both to contain the spread of the virus, which is considered 90 percent fatal, and to warn people about its seriousness.

A WHO official has said it is likely that the worst of the outbreak is yet to come.

At major entry points to the United States, including Newark Liberty and Kennedy International Airports, government workers are on alert in case incoming travelers who have been to West Africa show signs of illness and need to be quarantined. Federal, state and local health officials, as well as hospitals, have established detailed protocols for handling possible cases, taking advantage of a sophisticated public health infrastructure that poorer countries lack.

Rutgers Today asked Rajendra Kapila, an infectious disease physician at Rutgers New Jersey Medical School, and Janet Golden, a medical historian at Rutgers University-Camden, how concerned Americans should be about a potential outbreak in this country.

People arrive in the U.S. from infected regions of Africa every day, but the director of the Centers for Disease Control and Prevention says he is "confident that there will not be a large Ebola outbreak" here. Should he be?

Rajendra Kapila: I also don't think Ebola would spread widely among the general public. But it could severely harm individual Americans. Let's say someone comes here from West Africa. If that individual develops symptoms suggesting Ebola infection, and is spending time with friends and family, those people can be at risk.

At the first sign of such an illness, even a low fever that usually would be easy to ignore, such an individual should be immediately checked in a hospital.

What makes experts, including you, believe the general public is not at high risk in the U.S.?

Janet Golden: One is the nature of the disease. As awful as Ebola is, we are fortunate that it only spreads through contact with bodily fluids. That automatically makes it easier to control – especially with other rigorous measures in place – than the sources of past epidemics, where people were sickened through airborne transmission or by insect or animal bites.

Are there examples of epidemics that were not well controlled?

Golden: There was an outbreak of bubonic plague in San Francisco at the turn of the 20th century. People didn't understand then that the plague is transmitted from rats to fleas to humans. Officials put barbed wire around Chinatown, where they had seen many cases, and thought that would prevent the disease from spreading. Of course it did not stop the rats. During the 1918 influenza epidemic, the city of Philadelphia held a Liberty Loan parade and brought out 200,000 people to watch it. Since flu spreads readily through the air, death rates obviously spiked in the weeks that followed.

These episodes show how important it is to know the different ways diseases are transmitted and to respond in ways that take that into account. In this country I am actually more concerned about multidrug resistant tuberculosis, another disease that spreads through the air, than I am about Ebola. I think we have the right tools to handle Ebola.

When two American aid workers were flown from Africa to Atlanta for treatment, they received an experimental drug called ZMapp and it apparently helped both of them. Could that drug be the answer for Africans with Ebola?

Kapila: It impossible to know from just two cases whether a drug will benefit a larger population. Rigorous controlled studies are needed to show that the drug is safe and effective. At what stage of the disease do you use it? Who gets it? Who doesn't get the drug? All of these issues, and others – including liability, because it's also possible for the drug to have severe adverse effects – must be settled before medication can be distributed for wider use.

One added complication is that the experimental Ebola drug is in short supply. It is not easy to manufacture this medication. Fifteen years of tireless research have produced just a small quantity of the drug. It is a very complicated manufacturing process where specialized antibodies are developed in tobacco leaves. Many variables can threaten quality control, putting both safety and efficacy in doubt if labs try to produce large amounts of the without strict controls.

Explore further: Beware fake ebola treatments on the internet, FDA says

Related Stories

Beware fake ebola treatments on the internet, FDA says

August 15, 2014
(HealthDay)— As the death toll in the West Africa Ebola outbreak passes 1,000, the U.S. Food and Drug Administration is warning against products sold online that claim to treat the deadly disease or prevent infection.

How does Ebola virus spread and can it be stopped?

August 6, 2014
As a deadly Ebola outbreak continues in West Africa, health officials are working to calm fears about how the virus spreads, while encouraging those with symptoms to get medical care. Typically, outbreaks of the disease have ...

All doses of experimental Ebola drug sent to WAfrica

August 12, 2014
A US company that makes an experimental drug for treating the often deadly Ebola virus said Monday it has sent all its available supplies to West Africa.

NYC hospital testing patient for possible Ebola

August 4, 2014
A New York City hospital says it's performing Ebola tests on a patient who recently traveled to West Africa.

WHO: Ebola outbreak is a public health emergency (Update)

August 8, 2014
The World Health Organization on Friday declared the Ebola outbreak in West Africa to be an international public health emergency that requires an extraordinary response to stop its spread.

5 things to know about Ebola outbreak in W. Africa

July 28, 2014
(AP)—There has been panic and fear about the deadly Ebola disease spreading ever since Nigerian health officials reported Friday that a Liberian man sick with the disease had traveled to Togo and then Nigeria before dying. ...

Recommended for you

Creation of synthetic horsepox virus could lead to more effective smallpox vaccine

January 19, 2018
UAlberta researchers created a new synthetic virus that could lead to the development of a more effective vaccine against smallpox. The discovery demonstrates how techniques based on the use of synthetic DNA can be used to ...

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.