The fatal Ebola disease is spreading fast in 4 west African countries, mainly because of tribal practices. Families are admitted into hospitals to comfort their loved ones and are allowed to hug their dying parents/children/spouses. Finger nails are removed according to the belief patterns of some peoples, and one drop of blood from an infected person is enough to lead to an awful death. There is no known cure.
Dr Ian Jones, Professor of Virology in the School of Biological Sciences at the University of Reading, Dr. John R. Palisano, Professor of Biology, Sewanee: The University of the South, and Prof. Janusz Paweska, at the National Institute for Communicable Diseases, Head of the Center for Emerging and Zoonotic Diseases in Johannesburg shared their opinions with Radio VR.
What is Ebola?
Dr. Ian Jones: A virus that is found in bats in Central Africa. It occasionally transfers into people via contamination, usually by urine or saliva, or food sources. It can also transfer into people by the direct consumption of bats in a bushmeat trade. But when it does so, it doesn’t cause any issue in the bats. But when it transfers into men, it gives a very severe hemorrhagic disease which can kill up to 90% of those infected.
Is there any reason that this outbreak has occurred at the present time? Has a man been doing something that he shouldn’t be doing or something unusual he doesn’t usually do, to create such a cross infection from bats to human beings?
Dr. Palisano: It is hard to establish at this point since we don’t know who the first person was, who became sick. So, we can’t backtrack to find out what was going on. It could be someone just to handle a bat and pick up the virus on his hands, and then transferred it into his mouth or digestion track. Or, as Dr. Jones said, someone might have eaten one of these bats or eaten a fruit that the bat had been feeding on. So, at this point we don’t know. I doubt it was anything intentional; it is one of those accidental crossings between humans and wild animals.
How contagious is Ebola? I gather it is not an air-born contagious disease.
Prof. Paweska: As far as we know, the air-born transmission, if occurs, it is not the main mode of a transmission between animals and humans, and definitely not from human to human. The transmission occurs through the very direct and unprotected contact with either sick animals or dead animals, or sick or dead people.
Obviously, the numbers, which are provided now form this outbreak, they will change on a daily basis, because the data bases on all the cases. And the cases include the suspect cases, the probable cases and confirmed cases. So, it will take some time to establish what the exact fatality of this outbreak was. But, yes, it is very dangerous.
If I get this right then, this can be spread by touching somebody who’s came down with the disease or handling an animal that has become sick.
Dr. Ian Jones: That’s generally correct. One of the points to note is that individuals are not particularly infectious until they are showing overt signs of a disease. And so, in the early stage, they may be infected, but they may be able to travel, they may feel relatively well and, luckily, for the human population, they are not infectious at that stage. It is really when they suffer febrile illness, when they are sweating, when they are body fluids, that the contagion is possible. And, as you rightly said, John, it has to be a very close contact – normally handling the individual, so that you become actually contaminated with body fluids.
Is this a political problem, that the relevant authorities are not communicating the right information at the right time to the right people?
Prof. Paweska: I think the major problem is obviously the collaboration of the society with the health system. I know that the health system is very fragile in West Africa. The communication doesn’t collaborate and, as a matter of fact, we hear more and more often about the hostile situation. As you might remember, in 1995 some Gabonese teachers, which were trained how to send the health information and then were involved in the education campaign, they were stoned to death.
So, this is something which has to be dealt seriously with. And that’s why the local communities, I think, they probably require more psychological and anthropological discussions and support. This is really an issue in controlling this outbreak.
Would you advocate then richer countries sending out teams of medical workers, experts to advise and help people on the ground?
Prof. Paweska: As far as I know, the WHO teams, especially the coordination center is providing anthropological support and also psychological support. I don’t know to what extent it is implemented, but that has been discussed on many occasions.
There is nobody cleansing the body. In some cultures people do remove, for example, fingernails and toenails, and they remove also the hairs. And obviously, that might cause many problems. This virus replicates too extremely high levels and one drop of blood would be a real source of potential infection.
Will closing borders help, because that’s one of the suggestions? The WHO is suggesting that, it says it might help, but it won’t be exhortative or foolproof. Would you agree with that?
Dr. Palisano: Sure! I think that closing the borders would be helpful. But, as you just said, it is not foolproof, because it is difficult to quarantine people, let alone a country. The past example, when we had a person in America who had a resistant TB, he was told not to travel and he immediately got on an airplane, because he had a business meeting and travelled all over the country to Europe, if I remember it correctly.
So, quarantine is difficult to establish. And in this day and age of global communication and travel because of business, as Dr. Ian said, I think it is unrealistic at this stage. I think the trick is for people to be aware where the virus has been reported. And when you come and contact with someone who looks sick, no matter how minor the symptoms are, just to make sure that you don’t touch him.
It is kind of like trying to avoid the flu during the flu season. I just stay away from anyone who has runny eyes or is sneezing and coughing. In this case, I wouldn’t come in physical contact with people who seem to be sick, whether it is Ebola or not. And I think that that makes the travels relatively safe.
