Ebola outbreak – updates and links

By Siouxsie Wiles 03/08/2014

As the Ebola outbreak worsens, the WHO has announced a US$100 million response plan to help bring the outbreak under control by scaling up control measures and helping neighbouring at-risk countries prepare for any cases.

According to the latest WHO update, between 24 and 27 July, a total of 122 new cases of Ebola and 57 deaths were reported from Guinea, Liberia, Nigeria, and Sierra Leone. This brings the number of cases up to 1323 with 729 deaths. Sadly, it would seem that healthcare workers are still becoming infected, with reports that Sierra Leone’s top Ebola doctor has died.

Ian Mackay is charting all the data from the WHO’s Ebola updates while the UK’s Channel 4 have made a clicable map of the outbreak here.

A scary development has been the death of a man in Nigeria – he arrived in Lagos by air via Lomé, Togo, and Accra, Ghana. The man was symptomatic when he arrived in Nigeria which means he would have been infectious at least on his last flight. Officials are now trying to trace all he may have come into contact with on his travels. According to the report, 59 contacts (15 from among the airport staff and 44 from the hospital) have been identified so far.

The fact the man was American, of Liberian decent, and due to return to his family in Minnesota has now put the Ebola outbreak firmly on the radar of the US press. There are also now reports that two infected US aid workers are going to be evacuated from Liberia for treatment in Atlanta.

There is a good article here looking at how easily infectious diseases spread on planes. The answer from simulations seems to be ‘not very’, suggesting only those in the few rows around the infected person are at risk. As Ebola is spread through bodily secretions, this would also mean the potential for transmission by touching surfaces also touched by someone infectious.

And finally, Daniel Bausch and Lara Schwarz speculate on why Guinea and why now in a paper just published in the open access journal PLOS Neglected Tropical Diseases. In an nutshell, it’s likely to be due to the movement of bats and poverty driving people further into remote areas looking for resources to survive. Add to that porous borders and impoverished and neglected healthcare systems and you get an outbreak of this magnitude.

0 Responses to “Ebola outbreak – updates and links”

  • I saw this article this morning in the Herald, about an experimental ebola treatment: http://www.nzherald.co.nz/world/news/article.cfm?c_id=2&objectid=11304326

    In my mind, this has raised some interesting ethical questions that I don’t know how to answer.

    Generally, I think (and if anyone disagrees please let me know) that the ethical approach to new experimental treatments like this seems to be testing them rigorously (i.e. including randomisation) against the standard of care as part of a clinical trial. However, as far as I’m aware there is no existing standard treatment for ebola.

    Does this mean the ethical thing to do is to try the experimental treatment and compare it to whatever is being currently done in the absence of a treatment? Or should it be compared with a placebo? Or some other option?

    How does the fact that this is an epidemic change the ethics around testing potentially lifesaving new treatments?

  • Mark,
    I think when you are dealing with a disease that has such a high fatality rate that the need for placebo’s is unnecessary. If a treatment works, the results tend to be obvious.
    Also there are precedents for rushing through and minimising approval procedures. An example would be some of the earlier HIV treatments which went through an unprecedented rapid approval process to address a disease which at time had no adequate treatments.

  • Okay, that sounds reasonable to me, and interesting to hear that about some of the earlier HIV treatments. I assume those treatments then become the standard that later treatments were tested against?

    I think I’ve become quite accustomed to looking at potential treatments that are either quite implausible or unlikely to make more than a small difference, in which case a placebo or sham control is usually very appropriate. Makes it interesting to think about cases like this that are really quite different.