As of August 20, there have
been 2,473 confirmed, probable or suspect cases of Ebola, and 1,350 patients
have been dead among them in West Africa: Guinea, Liberia, Sierra Leone, and
Nigeria. It just does not seem to stop. However, there should be hope in the
midst of these darkest days. USA TODAY reported breaking news today that there is no health risk from 2 U.S. Ebola
patients. American doctor Kent Brantly and nurse Nancy Writebol were
discharged from Atlanta’s Emory University Hospital today and last Tuesday,
respectively.
We do not know yet that an
experimental drug, Zmapp, has really cured their disease or not. Although 2
U.S. Ebola patients miraculously survived after receiving doses of Zmapp, a
Spanish priest who also received Zmapp died.
Every case, we always
consider minimum and maximum. According to WHO, 2014 Ebola outbreak survival
rate is 47%, which has been higher than previous outbreak. Even if there is no
confirmed treatment or vaccine for Ebola patients to cure, medical science has
been continually developed, and almost half of patients in Africa have survived
with even less sophisticated medical care. Many people may have heard that a
case fatality rate is up to 90%. If we look at the sentence carefully, there is
the expression “up to,” which means
maximum 90%. We may be freaked out this deadly virus’ destructive power and
take it quickly that 9 out of 10 Ebola positive people will die.
But, let’s think about it
more in detail, not simply being swayed by the press. Ebola has occurred only
in Africa, from 1976. One of the team who first co-discovered this virus is
Peter Piot, former Executive Director of UNAIDS and he is now the director of
the London School of Hygiene and Tropical Medicine.
27-year-old young Belgian
scientist, Peter Piot, traveled to the village of Yambuku, Zaire, now known as
the Democratic Republic of the Congo, with the team to discover a deadly
unknown virus in 1976.
"I wasn't scared. The excitement of discovery
and wanting to stop the epidemic was driving everything. We heard far more
people were dying from the disease than we originally thought and we wanted to
get to work."
All discoveries begin from
human’s strong sense of curiosity and adventure; in this case, we need to add
braveness, confidence and sense of duty. He investigated to unravel the mystery
of this virus with 3 major questions.
1. How did the epidemic evolve?
2. Where did the infected people come from?
3. Who gets infected?
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| Peter Piot's note in 1976: a map for investigating the transmission of virus |
The team found that injecting with used syringes spread the virus, and people who attended funerals were also getting ill. Once they discovered the infection route, they systematically went through village to stop further transmission of the virus; they put people who directly contacted with infected dead body into quarantine. Although 300 people died of Ebola, they successfully stopped the epidemic. The team named this virus after the closest river they could see, Ebola River. That was how this virus was found and got its name, Ebola virus.
<The virus detective who
discovered Ebola in 1976>
<The 27-Year Old Who
Co-Discovered Ebola Had No Idea What He Was Getting Himself Into>
So then, how up to 90% fatality rate came up? CDC shows
% of death for each Ebola outbreak from 1976 and up till now, a total of 33
cases. During the first outbreak in 1976, 280 out of 318 (88%) were dead in
Congo. In the same year, 151 out of 284 (53%) were dead in South Sudan. Again,
250 out of 315 (81%) in 1995, 128 out of 143 (89%) in 2002-2003, 29 out of 35
(83%) in December 2003, 187 out of 264 (71%), 15 out of 32 (47%) in 2008-2009
(47%), 13 out of 36 (36.1%) in 2012 were dead in Congo. There were cases for 3
times, 2011, 2012, 2012-2013, in Uganda as well. I can see the pattern where
Ebola appears, especially Congo and Uganda. It must be some problem about their
eating habits. People in remote villages may still never know what the Ebola
virus is and never abandon the habit of eating bush meat and bat meat. In spite
of containing Ebola, this virus has always recurred in the similar region, in
the same country due to poor medical infrastructure and lack of public health
education.
Surprisingly, African
people’s habit has never changed since 1976. Almost 40 years passed, they still
attend the funeral and got infected, spread the disease, fled from the
hospital, and family hide Ebola patients. So Ebola virus reoccurred; it newly
appeared in West Africa, more seriously, through the fragile borders and airplane,
so 4 African countries moan with deadly pain.
90% fatality rate is just
maximum possibility. It is not average. The reason why this rate increases to
90% is that there might be no health facility in Congo. If you get Ebola in
Congo, you have 90% of death possibility. My personal opinion is that if you
get Ebola in the U.S., death possibility would be much less than 47% because
U.S. health facilities is incomparable to those in West Africa. There are no specific vaccine, medicine, or treatment, but there are basic interventions to
increase the changes of survival by rehydrating, maintaining oxygen status and
blood pressure, and treat complications.
<Outbreak Chronology: Ebola
Hemorrhagic Fever>
What about the incubation
period of Ebola? WHO says “The incubation
period from time of infection to symptoms is 2 to 21 days.” Actually, I
have been holding my breath for 3 weeks to monitor my 21 days. Most Ebola cases
appears within 10 days, but it was still too soon to relax; I waited until my
possible incubation period to convince myself that I am Ebola-free. Since I
left Sierra Leone on July 29th, 21 days has already passed. I still
have no fever. Should I celebrate? Okay, but only for 10 seconds. I know all
WVSL staff and friends in Sierra Leone. I have to pray for them so that they
are also safe from Ebola.
It is all about the battle
with the statistics and possibility to prevent Ebola virus from spreading to
another person and another country. Experts say that Ebola is not air-born
disease; but let's read this sentence from WHO and think about it.
“In the 2014 Ebola outbreak, nearly all of the
cases of EVD are a result of human-to-human transmission.”
What is “nearly all”? Possibly, the other small
part that would not be included in the nearly
all category could be “air-borne.” We do not have exact information about
Ebola yet, and we may have not found the other existing transmission route.
Nobody knows. If the maximum days of incubation period are 21 days, let’s wait
until I spend 21 days, and see what my body says. Again, nobody knows. All we
can do as weak human beings is to discover
the phenomenon that has already existed or will have appeared some day. Only
God knows what is going on. We only calculate the minimum and maximum possibilities.
 |
| EBOLA VIRUS RAPIDLY SPREADING IN WEST AFRICA – USA TODAY |
http://www.usatoday.com/story/news/nation/2014/08/21/ebola-us-patients-brantly-writebol-atlanta/14376997/
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