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Ebola now threatens national security in west Africa

The virus remains unchecked because of the lack of a global effort to implement emergency public-health measures.

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Health care workers in Monrovia.

An article by Scientific American.

The Ebola virus outbreak entrenched in west Africa has become a real risk to the stability and security of society in the region, the top US Centers for Disease Control and Prevention official said today after returning yesterday from a visit there.

Failure to tamp down Ebola’s spread is stressing the infrastructure of countries stricken with the disease that must still continue to provide basic health and security services and promote routine commercial activity. Fear of its spread is also hindering care for other maladies and may increasingly put the stability of neighboring nations at risk, said CDC director Tom Frieden in a press conference today. “It’s a problem for the world and the world needs to respond,” he said. The outbreak has spread from Guinea, Sierra Leone, Liberia and Nigeria to include Senegal. Fortunately, a separate smaller Ebola outbreak in the Democratic Republic of the Congo does not appear to be related to the west African cases.

Meanwhile, Ebola is also hindering all other medical care because health workers are afraid to go to their jobs, Frieden said. And paradoxically, attempts to help tamp down the virus by canceling flights to countries with the virus are actually making it more difficult to send in essential personnel and supplies, he said. “I could not possibly overstate the need for urgent response,” he said. “The window of opportunity really is closing.”

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CDC is calling for a scale-up of needed medical supplies, technical experts in health care management and a coordinated, global approach to the outbreak. Right now, there are not even enough beds for sick patients nor enough data coming in to help track cases. Surveillance and tracking of those who were possibly exposed to Ebola remain inadequate. Frieden urged people with specialized health care skills to volunteer with organizations like Doctors Without Borders who have the expertise to aid in the response. Such efforts do not come without risk. SIM USA today announced another American missionary doctor has tested positive for Ebola. This physician was not treating Ebola patients but instead was treating obstetrics patients at a facility in Monrovia, Liberia.

In the weeks ahead, to help shore up the response in the area, the World Health Organization has put out an appeal for $490 million dollars. And this week clinical trials for a potential Ebola vaccine will be starting at the National Institutes of Health. An experimental drug called ZMapp has also shown promise in helping cure Ebola in monkeys, although it has not yet been tested in clinical trials in humans. But in the interim, every day the disease goes unchecked may make it harder to stop it as the outbreak’s scale grows, Frieden said. Moreover, it is possible that genetic mutations that the virus accumulates over time could potentially make it more lethal or easily transmissible among humans.

The epicenter of the outbreak, the densely forested region at the intersection of these countries’ porous borders, is home to about one million people, Frieden said. Scaling up existing health care programs there like malaria control could help reduce disease burden and increase the population’s trust level, but that will be a slow process. Right now, he said, “we need a no regrets policy,” where we will not look back and say we should have done more.

Journal name:
Nature
DOI:
doi:10.1038/nature.2014.15834

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