On March 25th, the Ministry of Health of Guinea reported an outbreak of Ebola in the districts of Guekedou, Macenta, Nzerekore and Kissidougou. The outbreak resulted in the deaths of fifty-nine people prior to the official announcement of the epidemic. By the first of April, Guinea reported 122 probable cases with a case fatality rate of 65.6%. At this time, Liberia had acknowledged eight suspected cases, two of which were persons with recent travel history to Guinea. Suspected cases in Liberia and Sierra Leone were under investigation since the initial announcement of the outbreak in Guinea, and by the middle of April, Liberia reported over twenty cases; Sierra Leone and Mali are still currently under investigation.
Ebola, otherwise known as Ebola hemorrhagic fever, is an infectious disease marked by signature symptoms of fever and severe internal bleeding, with a typical outcome of fatality. The disease is spread through contact of bodily fluids that have been infected by a filovirus. The virus transmits from wild animals and spreads through humans. Symptoms of Ebola include fever, headache, muscle aches, sore throat, weakness, external and internal bleeding, rash and trouble breathing.
Analogous symptoms dually present in cases of cholera, hepatitis, malaria, meningitis and typhoid fever, making a correct diagnosis difficult in the onset. No licensed treatment or vaccine is readily available for use in humans or animals, contributing to its destructive and unstoppable course of obliteration. However, symptoms are managed through nutrition, oxygen, and intravenous electrolyte treatment. This rare but deadly infection strikes primarily in remote villages of Central and West Africa, correlated significantly with tropical rainforest areas, but has recently become prevalent in some African cities.
The current outbreak of Ebola hemorrhagic fever is one of the most difficult in the virus’ history. Doctors and health officials in the region do not have any personal experience with the virus and thus the incident is generating a great deal of fear and anxiety within the region and around the globe. Dr. Keiji Fukuda, the Assistant Director-General for health security at the World Health Organization proclaims this epidemic as “one of the most challenging Ebola outbreaks that we have ever faced.” Luckily, Guinea does not have to defend its nation alone; the World Health Organization has deployed approximately fifty staff members to work on preventing the spread of infection in health care facilities. Global organizations are also sending personal protective equipment to surrounding countries.
The world is slightly pessimistic over the Ebola outbreak and some question the likelihood of containment of the epidemic. Doctors Without Borders is calling the outbreak unprecedented because in the past, cases have been limited to a smaller area. Furthermore, this mutation of the virus has a longer incubation period, making it more deadly. In a recent study, it was discovered that the new mutation of the strain of the Ebola virus that has been identified in Guinea has been circulating in the area, undetected, for a significant amount of time. “There might be a lot of variety in these viruses. They might be in many different countries in West Africa and East Africa where we have not heard anything of outbreaks so far,” says virologist Jens Kuhn of the National Institutes of Health.
Unfortunately, it has been confirmed that the capital city of Conakry, Guinea is infected, of which has a population of two million people. Because there has not been a successfully developed preventative vaccine for the disease, the only way to protect exposed persons is to inform the population about the virus and its destructive nature. This unsatisfactory, temporary solution is not highly regarded among health care officials and world organizations are working actively to develop a vaccine to combat the virus.
In light of the recent outbreak, health care officials around the world are coming together in support of West Africa to develop an efficacious vaccine for the Ebola virus. The most promising medical development involves genetic splicing, in which parts of Ebola’s genes are inserted into an existing vaccine-ready virus. The purpose of this is to deliver a nonthreatening piece of Ebola’s genetics to trigger an immune response. This would create antibodies to protect against future Ebola infection. Alternatively, researchers at Thomas Jefferson University in Philadelphia are developing a vaccine based on the current rabies virus vaccine. This has been tested successfully on mice and primates and researchers are now working to produce a version appropriate for human usage.
The University’s vaccine uses a surface protein from Ebola to generate an immune response, instead of pieces of the virus’ genetic material. The United States National Institutes of Health has provided a grant for five years to develop clinical trials. Furthermore, therapies to help people who have contracted Ebola are in early stages of development. In Canada, the Public Health Agency is preparing studies for a monoclonal antibody. Several other nations equipped for such research are contributing to the ongoing effort to develop an operative Ebola vaccination agent.
The generous clinical contributions of both involved and uninvolved countries face one primary dilemma in their research efforts: initiatives will have to wait for a future outbreak to effectively test any vaccine or treatment for Ebola. Because the virus is rare with unpredictable outbreaks, widespread vaccination is an unfeasible proposal. The combination of the rabies and Ebola vaccine being developed in Philadelphia poses a practicable application because rabies is a significant problem in Africa; with a dual purpose treatment, there is stronger reason to vaccinate the masses. On the contrary, it is extremely difficult to predict where Ebola will next strike, thus making the determination of where to provide mass vaccinations a guessing game.
In the future, a major apprehension regarding the Ebola virus is its pattern of development. The recent outbreak in Conakry raises concern over the ability of a major city to become infected with the virus and also solidifies the need for a vaccine.
Reassuringly, those in the United States or other uninfected countries are confident in the assumption that the likelihood of Ebola spreading to regions where it has not yet been seen is less likely. Ebola is spread via direct contact with disease-ridden bodily fluids; this explains why serious cases have historical roots primarily in Africa. It is possible for the Ebola virus to spread intercontinentally by means of air travel, but the statistical significance of this hypothetical is minor because of strict safety measures in place. In upcoming years, it is likely that the Ebola vaccine will be successfully trialed on humans and subsequently become readily available for treatment of the general public in infected and at-risk nations. The future looks promising for the extinction, or at least the containment and maintenance, of the Ebola hemorrhagic virus, supported by historical patterns and advanced developments in preventative treatments.