Ebola: 4,033 dead and the rate is only increasing

Dr. Bracha Reger asks in an article for Scientific American Israel what is the origin of the Ebola virus and how can its damage be minimized? When Reger wrote the article, the number was 1,600, and it was less than two months ago

See new update: 18/10/2014 The World Health Organization: an opportunity was missed to curb the spread of Ebola

Update by Avi Blizovsky, editor of the site of the science as of 13/10/2014
At the time of writing this column, an outbreak of the Ebola epidemic is taking place in West Africa, mainly in Guinea, Sierra Leone and Liberia, and recently several cases have even been discovered in Nigeria. So far more than 4,000 deaths have been reported and the virus is still spreading (the numbers are correct as of 13/10/2014. When Reger wrote her article only 1,600 deaths from the disease were announced and that was only about two months ago AB)
Yesterday, Israeli Prime Minister Benjamin Netanyahu held an emergency discussion at the cabinet meeting, at the end of which it was decided to tighten the checks among passengers arriving from countries infected with Ebola.

The World Health Organization raised the number of deaths attributed to the Ebola outbreak in Africa to 4,033 - as of October 13, 2014. The United Nations declared the outbreak the most dangerous epidemic of the modern era. All but ten cases were in the most affected countries - Liberia, Sierra Leone and Guinea, one in Spain and one in the USA. A nurse who took care of the Spanish missionary in Madrid contracted Ebola after not observing the precautionary rules.

Recently, the US military forces established a special 25-bed hospital for health workers who contracted Ebola during their work in Liberia, the country most severely affected by the epidemic. Liberia has recorded 2,316 deaths since the Ebola outbreak, more than any other country, according to the World Health Organization. Elaine Sirleaf's government imposed a state of emergency three months ago, but the measure did not help, also imposing a lockdown on the capital and the largest city in the country, Monrovia, caused unrest.
Today, about 300 American marines are stationed in Liberia, accompanied by planes that help with air transport and distribution of supplies to overcome the traffic in Monrovia and the disrupted roads outside the capital. The Americans plan to supervise the construction of 17 treatment units with 100 beds each

The 101st Airborne Division is expected to deploy 700 soldiers by the end of October. The US may send up to 4,000 troops to help with the Ebola crisis.

A spokesman for the Ministry of Health in Mali said that two more people had joined the first phase of research into a possible Ebola vaccine. No cases of Ebola have been recorded in Mali, but it borders the outbreak area. Researchers from the University of Maryland announced last Thursday that the first study to develop the vaccine is underway and that three health workers in Mali have received experimental injections developed by the United States government. The results of the experiment, in which 20-40 volunteers are expected to participate, are expected to be received next month.

David Navarro, the UN special envoy for the fight against Ebola, said that the number of Ebola cases doubles every three to four weeks and the response needs to be 20 times stronger than today. added He warned the UN General Assembly that without a massive mobilization of the world to support the affected countries in West Africa, "it will be impossible to achieve control of the disease and the world will have to live with the Ebola virus forever."

Navarro said that the UN knows what needs to be done to slow down and reverse the rapid progress of Ebola "and together we are going to do it. Our commitment to all of you is to stop the epidemic within a few months," he said.

Reflections - The Ebola virus strikes again / Bracha Reger

The current outbreak is of a very deadly strain of Ebola and the mortality rate from it may reach 90%, although there is concern that the true mortality rate is even higher than that. Since at this stage there is still no drug treatment for the disease or a vaccine against it, the most effective way to avoid infection is to maintain hygiene and avoid contact with the sick.

Many countries, mainly in the West, are currently recommending to avoid flying to countries where the epidemic is taking place, and many countries have announced the closure and isolation of passengers coming from these countries. However, when the contact is necessary, as in the case of health system workers who come to help patients, maximum precautions must be taken. So far it is not known, despite the suspicions, that the virus has spread to Europe and the USA, and in cases where it became clear that people came into contact with sick people, they were immediately put into isolation. In Israel, the Ministry of Health issued a circular in which it recommends that Israelis avoid traveling to Guinea, Liberia and Sierra Leone as much as possible, but those who nevertheless need to go there must avoid contact with patients and their secretions as well as animals, and avoid eating meat and visiting health institutions. The Ministry of Health recommends that people returning from these countries go to the emergency room immediately if they develop an illness with a fever within 21 days of their return to Israel.

The Ebola virus belongs to the group of filamentous viruses and is very similar to the Marburg virus that was isolated from monkeys in the city of Marburg in Germany. It is difficult to know exactly what the origin of the Ebola virus is. The first recorded outbreak was in Zaire in 1976, by the Ebola River, hence its name. In that outbreak, 397 patients died out of 602 diagnosed cases. In the same year, the disease also broke out in Sudan. From those outbreaks, two different strains were isolated: Ebola-Zaire and Ebola-Sudan, and the strain isolated in Sudan is considered the least virulent. It is hypothesized that the natural hosts of the virus are fruit bats. An interesting description of direct infection from a fruit bat appears in Richard Preston's book "The Hot Zone", (Mater Publishing, 1995). And so Preston describes in his book:

"..a single white man living in a bungalow in Kenya, where he worked as an overseer on the water pumps of the Nazoya Sugar Factory. He was a nature lover and especially a cave lover and would occasionally visit the caves on Mount Elgon which was close to where he lived. The cave served as a habitat for bats and elephants. After one of his visits to the cave in January 1980, he fell ill with hemorrhagic fever. Since the medical staff at the local hospital did not know the disease or the treatment for it, he was sent to the hospital in Nairobi, sick and bleeding. The doctors first suspected that it was the Marburg virus, but later it turned out that it is a new virus that does belong to the Marburg virus group, but probably originated in fruit bats..."

Since the first outbreak, the Ebola disease has broken out from time to time in different countries in West Africa and three strains of the virus have been isolated. The virus spreads between humans only by direct contact, therefore the sparse population and avoidance of direct contact with the sick and their secretions caused the outbreaks to be localized and the virus returned as soon as it came to its natural habitat. However, in the latest outbreak, for reasons that are not clear, the virus appeared simultaneously in several countries in a more violent form and also spread more quickly. In order to understand and learn how it will be possible to protect the population, there is an urgent need to invest a lot of resources in research, in the development of medicines and vaccines, and in prevention. Currently, there are several drugs in development for the Ebola disease, but it is not yet known how effective they are. Unusually, the ethics committee of the World Health Organization allowed these drugs to be used before they were approved as usual, and it is hoped that they will prove themselves.

More on the subject

Ebola — Underscoring the Global Disparities in Health Care Resources.

on the notebook

Bracha Reger, Emeritus Professor of Microbiology and Immunology at the Faculty of Health Sciences at Ben Gurion University, President of Ort Israel and Chairman of the Academic Council of Ort Israel. Served as the chief scientist of the Ministry of Health and was a member of the Council for Higher Education.

The article was published with the permission of Scientific American Israel

More of the topic in Hayadan:

• The mass curfew may cause the spread of the virus to accelerate
• Ebola: the epidemic is accelerating
• Unprecedented new insights into the Ebola virus

The article was published with the permission of Scientific American Israel