The emergence of Ebola as a global health security threat: From ′lessons learned′ to coordinated multilateral containment efforts

Abstract

First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV) causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA) in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public health threat. Here we present a review of EBOV infection in an effort to further educate medical and political communities on what the Ebolavirus disease entails, and what efforts are recommended to treat, isolate, and eventually eliminate it.

Assessments of Ebola knowledge, attitudes and practices in Forécariah, Guinea and Kambia, Sierra Leone, July–August 2015

“…In addition, around the time of data collection, the Kambia District Ebola Response had recently launched ambulance tours during which communities and their local leaders had the opportunity to go through the 'Ambulance Project' and see that they were safe, clean and staffed by caring professionals [23]. Cultural practices such as traditional burials that involved washing and touching of the corpse were another high-risk behaviour that contributed to Ebola transmission [24]. The similarities in preferred alternatives to traditional burialssuch as having a religious leader say a prayer and allowing family members to observe the burial from a safe distance-highlight practical opportunities for incorporating culturally and religiously accepted alternatives into medical burials during future Ebola or haemorrhagic fever outbreaks in these settings.…”

Zika Virus: An Emerging Worldwide Threat

“…However, there is no solid evidence about the response and persistence of IgM antibody-mediated neutralization. The data of other mosquito-borne flaviviruses suggest that formation of IgM antibody takes places within 10 days after onset of clinical illness and can persist for more than 2 months (Kalra et al, 2014). The greatest challenge in the diagnosis of ZIKV is the cross-reactivity of the flaviviruses.…”

The somatic-security industrial complex: theorizing the political economy of informationalized biology

“…A succession of pandemic threats such as H5N1 and SARS have inspired similar and often critical takes on influenza or surveillance and response (Avery et al, 2008;Davis, Stephenson, & Flowers, 2011), and even work on otherwise 'neglected' infectious diseases such as cholera and tuberculosis have been incorporated into the emerging diseases worldview (King, 2002;Koch, 2008;Lee & Dodgson, 2000). Most recently, the Ebola outbreaks in Western Africa have been unpicked by health security scholars, pointing to the enmeshment of military response with a potential pandemic, and high level focus on the infection as a security threat of global import that would also undermine normal circulatory systems in the global economy (Heymann et al, 2015;Kalra et al, 2014;McInnes, 2016;Nunes, 2016).…”

“…Despite the welcome and inevitable focus on infectious disease affecting low income regions of the worldespecially sub-Saharan Africa and HIV/AIDS - (Elbe, 2006;McInnes & Rushton, 2013)there has been almost no commensurate investment and resources regarding health systems capacities to deal with any pandemic threats, or even routine outbreaks of infectious disease. Thus for many, the emphasis of Western GHSA has been on surveillance and containment in resource poor countries, rather than in building badly needed capacities to deal with very real threats (Fauci, 2014;Heymann et al, 2015;Kalra et al, 2014;Ooms et al, 2017). In contrast, the US and other Western states have devoted substantial resources toward protecting their own citizens and borders from pandemic threats, via global disease surveillance, stockpiles of medical countermeasures, and investments in medical and virological research (Bell & Figert, 2012;Elbe, 2011;Elbe et al, 2014).…”