Africa

Is Ebola airborne ?

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Ebola has become an uncontrolled epidemic in Africa. I have previously posted on Ebola.

UPDATE: A new CDC report has now been provided on precautions. Somebody is worried. The document, itself, is here (pdf)

Now, we are going to send 3,000 military personnel to Africa to help. I sure hope none of these US people are infected. They did not volunteer for this and the training to protect themselves will take time.

Now the German epidemiology community has concluded that Liberia and Sierra Leone are lost.

Jonas Schmidt-Chanasit of the Bernhard Nocht Institute for Tropical Medicine in Hamburg told DW that he is losing hope, that Sierra Leone and Liberia will receive the neccessary aid in time. Those are two of the countries worst hit by the recent Ebola epidemic.

“The right time to get this epidemic under control in these countries has been missed,” he said. That time was May and June. “Now it will be much more difficult.”
Schmidt-Chanasit expects the virus will “become endemic” in this part of the world, if no massive assistence arrives.

With other words: It could more or less infect everybody and many people could die.

This, of course, is from a German site and our own CDC is unwilling to say it.

For Sierra Leone and Liberia, though, he thinks “it is very difficult to bring enough help there to get a grip on the epidemic.”

According to the virologist, the most important thing to do now is to prevent the virus from spreading to other countries, “and to help where it is still possible, in Nigeria and Senegal for example.”

Of course, it is already in Nigeria.

In the balance therefore, the probability is that the virus is not airborne — yet — but it is more dangerous than its predecessors. This would account for its ability to slip through the protocols designed for less deadly strains of the disease. It’s not World War E time, but it’s time to worry.

And: This may be a new strain with more virulence.

The results of full genetic sequencing suggest that the outbreak in Guinea isn’t related to others that have occurred elsewhere in Africa, according to an international team that published its findings online in the New England Journal of Medicine (NEJM). That report was from April 2014.

Now, we have more news. From 2012, we know transmission in animals may be airborne.

While primates develop systemic infection associated with immune dysregulation resulting in severe hemorrhagic fever, the EBOV infection in swine affects mainly respiratory tract, implicating a potential for airborne transmission of ZEBOV2, 6. Contact exposure is considered to be the most important route of infection with EBOV in primates7, although there are reports suggesting or suspecting aerosol transmission of EBOV from NHP to NHP8, 9, 10, or in humans based on epidemiological observations11. The present study was design to evaluate EBOV transmission from experimentally infected piglets to NHPs without direct contact.

The study of this potential explosive development showed:

The present study provides evidence that infected pigs can efficiently transmit ZEBOV to NHPs in conditions resembling farm setting. Our findings support the hypothesis that airborne transmission may contribute to ZEBOV spread, specifically from pigs to primates, and may need to be considered in assessing transmission from animals to humans in general.

Now we have more articles appearing about this.

The second possibility is one that virologists are loath to discuss openly but are definitely considering in private: that an Ebola virus could mutate to become transmissible through the air. You can now get Ebola only through direct contact with bodily fluids. But viruses like Ebola are notoriously sloppy in replicating, meaning the virus entering one person may be genetically different from the virus entering the next. The current Ebola virus’s hyper-evolution is unprecedented; there has been more human-to-human transmission in the past four months than most likely occurred in the last 500 to 1,000 years. Each new infection represents trillions of throws of the genetic dice.

If the New York Times is publishing this, somebody is worried.

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Why Ebola will not stay in Africa.

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Today’s Belmont Club has a good explanation of why Ebola will not stay in Africa.

UPDATE: Patrick Sawyer was planning to visit Minnesota when he got sick.

UPDATE #2: More from Belmont Club.

In the balance therefore, the probability is that the virus is not airborne — yet — but it is more dangerous than its predecessors. This would account for its ability to slip through the protocols designed for less deadly strains of the disease. It’s not World War E time, but it’s time to worry.

And: This may be a new strain with more virulence.

The results of full genetic sequencing suggest that the outbreak in Guinea isn’t related to others that have occurred elsewhere in Africa, according to an international team that published its findings online in the New England Journal of Medicine (NEJM). That report was from April 2014.

His wife, Decontee Sawyer, said that she had spoken to him a week earlier and that he had made plans to be stateside in early August to celebrate the birthdays of two of his three young daughters. She said the couple had been separated.

He is believed to be the first American to have died from the current outbreak, which has killed 672 people since March, according to World Health Organization figures.

He was American, not African.

The man who brought the Ebola virus to Nigeria probably knew he was infected. Surveillance video of Patrick Sawyer before boarding his flight at Liberia’s James Sprigg Payne’s Airport showed “Mr. Sawyer lying flat on his stomach on the floor in the corridor of the airport and seemed to be in ‘excruciating pain.’ The footage showed Mr. Sawyer preventing people from touching him.”

He collapsed upon arrival in Nigeria, after a layover in Togo and was rushed to a Nigerian hospital. Upon being told he had Ebola, he acted with what the Nigerians called “indiscipline”; a burst of rage and despair against the world and everyone in it.

Upon being told he had Ebola, Mr. Sawyer went into a rage, denying and objecting to the opinion of the medical experts. “He was so adamant and difficult that he took the tubes from his body and took off his pants and urinated on the health workers, forcing them to flee.

Amazingly, he was even then in the process of being sprung by his political connections before death intervened. Had he lived Sawyer might have gotten out and protected by the juju of expensive watches and status symbols, mingled among the muckety-mucks of ECOWAS.

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“What Bono doesn’t say about Africa”

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Celebrities like to portray it as a basket case, but they ignore very real progress.

William Easterly in the LA Times (Op-Ed from 2007.)

The real Africa needs increased trade from the West more than it needs more aid handouts. A respected Ugandan journalist, Andrew Mwenda, made this point at a recent African conference despite the fact that the world’s most famous celebrity activist — Bono — was attempting to shout him down. Mwenda was suffering from too much reality for Bono’s taste: “What man or nation has ever become rich by holding out a begging bowl?” asked Mwenda.
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Perhaps Bono was grouchy because his celebrity-laden “Red” campaign to promote Western brands to finance begging bowls for Africa has spent $100 million on marketing and generated sales of only $18 million, according to a recent report. But the fact remains that the West shows a lot more interest in begging bowls than in, say, letting African cotton growers compete fairly in Western markets (see the recent collapse of world trade talks).
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Today, as I sip my Rwandan gourmet coffee and wear my Nigerian shirt here in New York, and as European men eat fresh Ghanaian pineapple for breakfast and bring Kenyan flowers home to their wives, I wonder what it will take for Western consumers to learn even more about the products of self-sufficient, hardworking, dignified Africans. Perhaps they should spend less time consuming Africa disaster stereotypes from television and Vanity Fair.

The excerpt came up (I brought it up) in this comments thread at Small Wars Journal.

Another commenter, Jason Thomas, made the following interesting comment in the same thread:

….A locally driven solution is so important. However, we have created a national government that reflects the deep seated nepotism and corruption endemic at the local level. But the local people dont feel like they are being led by example. How many local Afghas know who their national Member of Parliament is compared to their unelected Governor and District Governor. [sic]
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Historian Arthur Schlesinger, Jr., astutely pointed out in his 1977 biography of Robert Kennedy, the notion that reforms can be carried out in a wartime situation by a beleaguered regime is “the fatal fallacy in the liberal theory of counterinsurgency, with the United States so often obliged to work through repressive local leadership, the reform component dwindled into ineffectual exhortation.”