Deaths in heaps, fashionably called foreign policies have always been attributed to human atrocities. Make no mistake; humans have always killed humans, be it by second nature or by default. But if anyone or anything can be called more ferocious than humans in terms of its killing instincts, then it had to be viruses.
From Spanish flu to swine flu viruses have decimated humans at will. Fast and furious, they have wiped off roads, emptied cities and turned societies into hollow spaces. A Caesarian contempt that ridicules the pride of science time and time again. Ubiquitous, omnipresent, and infinitely small, these RNA or DNA (but never both) obligate intracellular parasites can be attached and detached at will.
Consider the following traits:
Unlike living organisms, viruses can be crystallized, and then be put back together and be called “viable”! They cannot reproduce independently, but with supreme dexterity can take over a host’s reproductive machinery and reproduce at will. Possessing excellent genetic programming, they can mutate, evolve (now you know why it isn’t easy making an AIDS vaccine) and prevail at will.
Genesis of this parasite is equally disturbing with hypothesis suggesting that viruses may have evolved from fragments of cellular nucleic acids that acquired special “packaging.”
It is thus but natural that something so close yet so alien could and would hurt humans with effortless ease.
Now let us turn our attention to our latest panic on Ebola virus and watch its trajectory and the tragedy it inflicts across the borders.
Coming from the family of Filoviridae (taken from the Latin “filum”, meaning thread-like), the genus Ebola virus is divided into five different species (the Zaire, Sudan, Ivory Coast, Bundibugyo, and Reston agents), which differ in their virulence for human. This 2014 outbreak, by far the worst and the most virulent is currently occurring in West Africa with the Zaire species of the virus.
Unlike previous Ebola outbreaks that had its beginning from Central Africa, this outbreak started in the West African nation of Guinea in late 2013 and subsequently leapt across its borders to Liberia, Sierra Leone, and Nigeria. One of the deadliest ever seen, this virus kills about 90 percent of its victims.
It’s not a pretty death to begin with. Exhibiting gross bleeding symptoms typical of any hemorrhagic fever, patients often have blood in urine and feces and may even bleed from the gastrointestinal tract.
What are the challenges facing us?
By far the greatest mysteries regarding the filoviruses has been the identification of their natural reservoir and the mode of transmission from the reservoir to wild apes and human. Contrary to previous beliefs, recent studies have shown Ebola viruses are maintained in species of small animals that serve as a source of infection for both humans and wild primates. Of these bats seem to head the list.
The better news is that these agents rarely, if ever, spread from person to person by the respiratory route. Neither are they carried by mosquitoes or other biting arthropods. On the contrary, transmission occurs through direct contact with virus-containing body fluids (eg, blood, vomitus, urine, feces and probably sweat) from a person who has developed signs and symptoms of illness.
This is reassuring but by no means relieving as theoretically there could be enough viruses in sweat or saliva to pass it on through an airplane armrest or even a breath close sneeze.
Here’s the greater challenge.
The beginning of an Ebola viral attack may not carry any of the gruesome bleeding disorders and instead present with the typical innocuous flu signs and symptoms of weakness, headache, fever and chills.
Thus, like many other diseases, awareness, sharp and razor must be the fulcrum of any management. And for this virus in rage, awareness itself has to be contagious. From airport personnel to health care workers, all will need education and training. All health facilities must be supplied with infection-control equipment like gloves, gowns, and masks to prevent the spread.
No thoughts are absurd, including the fear of bioterrorism.
Because of their virulence, stability, and high infectivity as small-particle aerosols, Marburg and Ebola virus are classified as Category A bioterror agents by the Centers for Disease Control and Prevention (CDC) and the National Institute of Allergy and Infectious Diseases (NIAID). Thus the occurrence of even a single human infection outside of Africa must be considered a public health emergency warranting immediate investigation.
For all practical purposes it could signal the silent, sharp edge of a leaping outbreak.
So, what’s the buzz word?
Communication. These global outbreaks cannot and should never be managed by health sectors only. Awareness must percolate from the hazy high to the rock bottom.
Helmed by modern technology, recognition of outbreaks and the identification of patients have become possible. However, the success of an outbreak intervention is solely built on effective communication with the local populace to explain the absolute necessity for monitoring, sample collection and testing, isolation, and other allied infection control measures. Thus, not just politicians, scientists and physicians, but social workers and even anthropologists should be considered priceless members of response teams.
Together, and only together, we can contain these viral rages.