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Monday, October 13, 2014

The Ebola Virus Disease At Its Source

Link: CDC Information On The Ebola Breakout

You know the old expression, "When it rains, it pours"?  I was unable to locate the origin of the expression, but I'm sure its one of the most popular in the English language.  Throw a dart at a map of Africa, and more than likely you will hit a country that is suffering from some event that justifies the use of "when it rains, it pours".  Liberia and Guinea are two nations located on the Gold Coast
(southwest coast) of Africa.  The name Gold Coast refers to the belief that in colonial times the region was rich in Gold deposits.  Other countries on the Gold Coast include Sierra Leone, Cote d'Ivoire, Ghana, Nigeria, Togo, Benin, and Cameroon.  At present, the eyes of the world are focused on this part of Africa because of an outbreak of the Ebola virus in Guinea and Liberia.  Both Guinea and Liberia are attempting to rebuild and recover after decades of civil strife.  At one time or another during the same period, Sierra Leone and Cote d'Ivoire were also engaged in civil wars.  Recently, though, a wave of tremendous hope and optimism had been taking hold in west Africa.  Change was the order of the day, highlighted by serious efforts at reconciliation and fraud-free elections.  Aid was pouring in, and Chinese companies seemed to be everywhere, building dams and roads into the jungle.  Serious discussions were taking place which would hopefully result in the elimination of African debt, and there was talk of education, healing, national soccer teams in the World Cup, and creating a tomorrow that is better than today.

And then Ebola shows up to put a wrench into the works.  The Ebola virus is very contagious and has a mortality rate of 90 percent and higher. This particular outbreak first appeared in a small village in Guinea and has now spread to Liberia and Sierra Leone, choosing a target population that is ill-equipped to fight back. The people in this region are the poorest in the world.  The average daily caloric intake as compared to western nations is miniscule (and, for the western nations, shameful).  The body that is healthy is best able to avoid catching the virus, and the body that is healthy is best able to recover from infection.  Simply put, the people of Guinea and Liberia do not eat enough to stand a chance against this virus.  The governments of Liberia and Guinea, in concert with numerous international health organizations, have done a very respectable job limiting the outbreak to particular provinces.  Given the lack of resources available, this fact is impressive.  The best news for all is that for the most part the international community has reacted swiftly and without fear.  To the physicians, nurses, and other health workers who have traveled to Guinea and Liberia, the struggle is not only to limit and smother the outbreak, but to save the lives of those already affected.  During previous outbreaks, persons who had contracted the virus were frequently left to die.  A determination of infection was a death notice, because no one wanted to treat someone who was carrying such a highly contagious and deadly virus.  I'm relieved to say that my contacts in both countries report that persons who have tested positive are treated with respect and humanity, and every effort is being made to help their bodies fight the virus.

Currently, vaccines are being tested in Mali and Cote d'Ivoire.  There has been serious concern (and a bit of panic) that the virus would spread from Guinea and Liberia into Mali and Cote d'Ivoire; as of 12 October 2014, no cases of Ebola have been confirmed in either country.  The World Health Organization (The United Nations) has been highly visible in Bamako, Mali and in Abidjan, Cote d'Ivoire, as has Medecins Sans Frontieres (Doctors Without Borders).  The United States Center for Disease Control (CDC) has also made its presence felt.  Finally, the international community is reacting to a health crisis as it should; with resources, manpower and sacrifice.  Earlier today (at Mass, no less), a friend asked me why the international community does not respond to famine and genocide with the same vigor and generosity.  The answer is quite simple.  Famine and genocide are not contagious.  Two million persons at risk from starvation in Eritrea and Ethiopia cannot result in even one case of hunger in the United States.  Warlords slaughtering innocent villagers in Somalia and Sudan does not lead to someone getting shot or stabbed in Copenhagen or Osaka.  In the United States, this current Ebola strain has resulted in the death of one Liberian national in Dallas and the positive infection of a health worker.  The degree of separation gets smaller and smaller, and people realize this.  So smothering this recent outbreak of Ebola at the source makes perfect sense.  The wealthier nations are happy to spend the money, and if locals are cured as well, then all the better.

I'm confident that this particular outbreak of the Ebola virus has reached its peak of infection.  Vaccines have arrived, and people are learning what they must do to avoid contamination. Although 4033 persons have died from this episode, I believe more and more infected persons will recover, as medicine and health care starts to take effect.  West Africa is a hot spot for all sorts of nasty diseases, and I'm optimistic that the current governments in this part of the world will make health education a priority.  The numerous companies involved with mining in Guinea, Cote d'Ivoire and Mali should not suffer too much from the slow down, and hopefully cocoa production will not be affected.  I realize I am being very optimistic, but doesn't it sound more pleasant than the non-stop media cacophony about one person with the flu in Baton Rouge and another person sneezing in Des Moines?  In 1994, Richard Preston wrote a fictional novel called "The Hot Zone", about a hemorrhagic fever outbreak in the United States.  For the longest time, it was all people could talk about.  I'm glad to say that Preston's book remained fictional.  But it did serve as a warning to our various health and disease-related organizations that we had better have a game plan.  I think this Ebola outbreak in West Africa has demonstrated that we do have a plan, both domestically and internationally.  Because we have fifty states and hundreds of international ports-of-entry, mistakes will happen.  But overall, I'm impressed with our response.

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