A deadly disease is set to hit the shores of the US, UK and much of the rest of the northern hemisphere in the coming months. It will swamp our hospitals, lay millions low and by this time next year between 250,000 and 500,000 worldwide will be dead, thousands of them in the US and Britain.
Despite the best efforts of the medical profession, there’s no reliable cure, and no available vaccine offers effective protection for longer than a few months at a time.
If you’ve been paying attention to recent, terrifying headlines, you may assume the illness is the Ebola virus. Instead, the above description refers to seasonal flu – not swine or bird flu, but regular garden variety influenza.
Our fears about illness often bear little relation to our chances of falling victim to it, a phenomenon not helped by media coverage, which tends towards the novel and lurid rather than the particularly dangerous.
Ebola has become the stuff of hypochondriacs’ nightmares across the world. In the UK, the Daily Mirror had “Ebola terror as passenger dies at Gatwick” (the patient didn’t have Ebola), while New York’s news outlets (and prominent tweeters) experienced their own Ebola scare.
Even intellectual powerhouses such as Donald Trump have fallen into panic, with the mogul calling for the US to shut off all travel to west Africa and revoke citizens’ right to return to the country – who cares about fundamental rights during an outbreak? Not to be outdone, the endlessly asinine “explanatory journalism” site Vox informed us that “If the supercontinent Pangaea spontaneously reunited, the US would border the Ebola epidemic”.
Ebola is a horrific disease that kills more than half of people infected by it, though with specialist western treatment that death rate would likely fall a little. It’s unsurprising that the prospect of catching it is a scary one. The relief is that it’s not all that infectious: direct contact with bodily fluids of a visibly infected person is required, meaning that, compared with many illnesses, it’s easily contained.
Even in the midst of the current outbreak – the worst ever – the spread of the disease has not been rapid in west Africa: around 400 new cases were reported in June, and a further 500 or so in July. This is a linear spread, meaning each person at present is infecting on average around (actually just over) one additional person.
Far more worrying are diseases that spread exponentially: if one infected person spreads the disease to two or more on average, the illness spreads far quicker and is a much more worrying prospect, even if mortality is considerably lower.
The 800-plus deaths from Ebola in Africa so far this year are indisputably tragic, but it is important to keep a sense of proportion – other infectious diseases are far, far deadlier.
Since the Ebola outbreak began in February, around 300,000 people have died from malaria, while tuberculosis has likely claimed over 600,000 lives. Ebola might have our attention, but it’s not even close to being the biggest problem in Africa right now. Even Lassa fever, which shares many of the terrifying symptoms of Ebola (including bleeding from the eyelids), kills many more than Ebola – and frequently finds its way to the US.
The most real effect for millions of people reading about Ebola will be fear and stigma. During the Sars outbreak of 2003, Asian-Americans became the targets of just that, with public health hotlines inundated with calls from Americans worried about “buying Asian merchandise”, “living near Asians”, “going to school with Asians”, and more.
Similarly, during the H1N1 “swine flu” outbreak, which had almost identical spread and mortality to seasonal flu, patients reported extreme fear, prompted largely by the hysterical coverage.
In the coming months, almost none of us will catch the Ebola virus. Many of us, though, will get fevers, headaches, shivers and more.
As planes get grounded, communities are stigmatised, and mildly sick people fear for their lives, it’s worth reflecting what the biggest threat to our collective wellbeing is: rare tropical diseases, or our terrible coverage of them.
British Airways has suspended flights to and from Liberia and Sierra Leone until the end of August amid concerns over the Ebola outbreak.
The airline normally has four flights a week from London Heathrow to Freetown in Sierra Leone, with a connection to Monrovia in Liberia.
BA said the move was due to the "deteriorating public health situation" in the two west African countries.
Customers can get a refund or rearrange their flight for a later date.
'Constant review'
The Liberian government said it regretted BA's decision, but added: "We fully understand that international airlines must keep the safety of customers and crew as their highest priority."
BA said in a statement: "We have temporarily suspended our flights to and from Liberia and Sierra Leone until 31 August 2014 due to the deteriorating public health situation in both countries.
"The safety of our customers, crew and ground teams is always our top priority and we will keep the routes under constant review in the coming weeks.
"Customers with tickets on those routes are being offered a range of options including a full refund and the ability to rebook their flights to a later date."
BA's move follows a similar suspension by two regional carriers last week.
Health checks
Since February, nearly 900 people have died from the disease affecting four west African countries - Guinea, Liberia, Sierra Leone and Nigeria.
The virus spreads by contact with infected blood and bodily fluids. The current outbreak is killing between 50% and 60% of people infected.
There is no cure or vaccine for Ebola but patients have a better chance of survival if they receive early treatment.
The Liberian government statement said all outgoing passengers were receiving mandatory health checks, and that it would "work around the clock" to ensure international entry points were secure from Ebola.
It added: "We will continue to engage openly and positively with regional and international carriers so that any suspended flights can be resumed as soon as possible."
The deadly Ebola virus could be used by terrorists to create a dirty bomb capable of killing large numbers of people in the UK, a Cambridge University disease expert has warned.
As fears grow over the spread of the disease across parts of West Africa, biological anthropologist Dr Peter Walsh said that although the risk of it reaching the UK was small, a group such as Al Qaeda could use the virus to create a weapon.
There is currently no vaccine and no cure for Ebola, which kills up to 90 per cent of its victims.
Although there have been calls for the introduction of fever-screening cameras at UK airports in the wake of the current outbreak, Dr Walsh told a newspaper that should an infected air passenger unwittingly bring Ebola to Britain, medical experts would be able to stop the virus spreading further.
'A bigger and more serious risk is that a group manages to harness the virus as a power, then explodes it as a bomb in a highly populated public area,' Dr Walsh told The Sun on Sunday.
Is that it? UK's two-bed ebola unit: MP calls for fever scans at UK airports... but we have just one isolation facility
'It could cause a large number of horrific deaths.
'Only a handful of labs worldwide have the Ebola virus and they are extremely well-protected. So the risk is that a terrorist group seeks to obtain the virus out in West Africa.'
The current outbreak of Ebola has already claimed 729 deaths from 1329 confirmed cases in the
West African countries of Guinea, Sierra Leone, Nigeria and Liberia. The fatality rate in the current epidemic is about 60 per cent.
The outbreak is unusual for West Africa as the disease is typically found in the center and east of the continent.
Early symptoms of an Ebola infection include fever, headache, muscle aches and sore throat, while in the later stages of the disease victims begin bleeding both internally and externally, often through the nose and ears, and suffer organ failure.
Among those infected are American doctor Dr Kent Brantly, 33, who contracted the virus while in Liberia. He has been brought back to the U.S. for treatment in a special isolation ward, and was today said to be improving.
However, the top U.S. health official Dr Tom Frieden, director of the U.S. Centers for Disease Control in Atlanta, has said it was still too soon to predict whether he would survive.
A second U.S. aid worker who contracted Ebola while working in the same facility as Brantly, 59-year-old missionary Nancy Writebol, will be brought to the United States on a later flight as the medical aircraft is equipped to carry only one patient at a time.
The virus is not airborne and is transmitted through direct contact with the bodily fluids of an infected person.
However, WHO director-general Margaret Chan has warned the virus is currently moving faster than efforts to control it.
She said: ‘This outbreak is moving faster than our efforts to control it. If the situation continues to deteriorate, the consequences can be catastrophic in terms of lost lives, severe socioeconomic disruption and a high risk of spread to other countries.’
Speaking at a meeting in Guinea’s capital Conakry, she told the presidents of Guinea, Liberia, Sierra Leone and Ivory Coast that the virus could be stopped, but warned that some cultural practices such as traditional burials were helping it to spread.
Emirates, the Middle East's largest airline, said today it had halted flights to Guinea because of concerns about the spread of the Ebola virus.
The Dubai-based carrier said flights to the Guinean capital of Conakry were suspended beginning Saturday until further notice.
The airline will continue flying to the West African nation of Senegal, which borders Guinea, saying it 'will be guided by the updates from international health authorities'.
The Foreign Office refused to confirm if British citizens who contract the virus abroad would be flown back for treatment, saying only: ‘Procedures are in place but we are not going to speculate on what we would do in any individual case.’
Labour MP and chairman of the Home Affairs Select Committee has urged ministers to consider introducing fever-screening cameras at UK airports as up to 10,000 passengers arrive in the UK every week on 30 direct flights from West Africa.
South Africa, which has fewer direct flights from the region than the UK, introduced infra-red thermal imaging cameras at two major airports in April, in an early response to the ebola threat, while Sierra Leone, Guinea, Ghana, and Nigeria have pledged to introduce temperature screening at airports.
However critics say the cameras can give ‘false positives’ – including people with minor illnesses and those who are hot after a dash through the airport.
Mr Vaz said: ‘As far as I’m concerned any measures – including additional screening – which are felt necessary to reassure the public should be taken.
‘Prevention is always better than cure: We don’t want to have our first taste of ebola before taking action.’
Prof Chris Witty of the London School of Hygiene and Tropical Medicine says the epidemic has already peaked in Guinea and will hopefully begin to decline across other countries in the near future. The end of the Ebola epidemic may be in sight, with the disease already peaking in the county where the outbreak originated, the Department for International Development’s chief scientist has claimed.
Chris Witty, a DFID advisor and Professor of Public and International health at the London School of Hygiene and Tropical Medicine, said Guinea had already seen the worst of the outbreak and cases were now beginning to decrease.
Although the number of infections is continuing to rise in Sierra Leone and Liberia, Prof Witty said the situation was likely to peak soon and then the epidemic would begin to decline.
“The outbreak is very unusual,” he said in a podcast.
“All previous outbreaks have tended to die out after a relatively short period of time and a much smaller number of cases. This is the largest outbreak of Ebola that so far has been recorded.“The situation is moving very quickly. The numbers are increasing in Sierra Leone but they appear to have peaked in Guinea where the epidemic first started.
“What we hope is that with good management and good control we should be able to start to see the peak of the epidemic and then it will start to decrease.”
The epidemic has, so far, claimed the lives of 826 people.
The UK has never had a case of Ebola but border staff are on alert to watch for signs of the disease at immigration points.
On Sunday night a woman in her 70s was tested for the virus after dying shortly after arriving at Gatwick Airport from West Africa. However the test came back negative.
Liberia and Sierra Leone have declared national emergencies with Liberia closing all schools and putting all non-essential government workers on compulsory 30 day leave.
Some airlines have stopped flying into infected West African countries, although British airlines said they would continue to travel.
Public Health England (PHE) warned health officials to be on the look-out for any unexplained illness in people returning from the affected countries.
The Royal Air Force is also on standby to bring back UK citizens infected with the disease in Africa.
Shipping bodies including the London based International Chamber of Shipping (ICS) issued new guidelines to merchant vessels yesterday.
Captains were told to give ‘careful consideration’ to allowing shore leave in ports affected by the disease.
Ebola first appeared in 1976 in two simultaneous outbreaks - in Nzara, Sudan; and in Yambuku, in the Democratic Republic of Congo. The latter was in a village situated near the Ebola River, from which the disease takes its name.
It is introduced into the human population through close contact with the sweat, blood, secretions, organs or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines.
The virus then spreads in the community through human-to-human transmission.
Symptoms begin with fever, muscle pain and a sore throat, then rapidly escalate to vomiting, diarrhoea and internal and external bleeding. The incubation period can be up to 21 days.
Health workers tackling the outbreak in the region have been especially vulnerable to contracting the disease.
“The biggest problem with Ebola is the panic is causes, and it tends to lead to people worrying about travelling. It can lead to people worrying about going to work,” added Prof Witty.
“It’s not possible to catch Ebola just from sitting next to someone, You can only catch it by coming into contact directly with them or their body fluids like vomit or diarrhoea.
“The great majority of people who live in the affected areas will not get Ebola at any point.
“So it’s much less infectious than many people imagine and just being in the same room as someone with Ebola is not actually a particular risk.”
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Source: The Telegraph (2014-08-01) Ebola outbreak: end of epidemic could be in sight, says scientist, Link to Original. Retrieval by Monica Green.
