Don't press panic button; India’s threat from Ebola is non-existent

Sanchita Sharma, Hindustan Times

So, India successfully whisked away the first person who arrived with traces of the Ebola virus, thus ending the threat, however remote, of his potentially infecting others.

What made it easier for health officials at Delhi airport was that the 26-year-old man, who was returning home from Liberia, produced a certificate from the Liberian ministry of health stating he had been treated and cured of the disease in September.

Fresh blood tests returned negative for Ebola. He also showed no symptoms– infected persons become contagious only when they develop symptoms – but the ever-vigilant health workers decided to go a step ahead and also test his urine and semen for residue virus, traces of which remain in some people for up to 90 days after recovery. The man tested positive.

So he was put away in an isolation ward till his body was completely free of the virus, which has infected close to 14,500 people and killed more than 5,000.

If you look beyond the self-congratulatory back-thumping by health ministry officials, India’s threat from Ebola is non-existent. The ministry says at much in the press-release fineprint.

“It is reiterated that the person concerned is a treated and cured case of ebola. No cases of relapse of ebola have been documented. All necessary precautions are being taken at the isolation facility. This would rule out even the remote possibility of the disease spreading through the sexual route. The situation is under control and there is no need for alarm,” said a health ministry statement late on Tuesday night.

New epidemics

And this once, the Union health ministry got it right. If handled right, epidemics can be contained. Despite the World Health Organisation’s many alerts, the world hasn’t seen a major pandemic since the Hong Kong flu (H3N2) of 1968, which killed one million people worldwide.

Over the past decade, humanity has been living on the brink of not one but five brand new pandemics: Severe Acute Respiratory Syndrome (SARS) that peaked in 2003, H5N1 (avian) influenza in 2005 and 2006, H1N1 (swine flu) in 2009, Middle East Respiratory Syndrome (MERS) in 2012, and Ebola Virus Disease (EVD) 2014. That’s not counting HIV that causes AIDS, which has also been given pandemic status by World Health Organisation (WHO) in several of its reports since the early 1980s.

Ebola morphed into a global threat this year when a localised rural outbreak that started in March with the epicentre in the shared borders of Guinea, Sierra Leone and Liberia rapidly spread to peri-urban and urban centres, from where it spread to eight countries within months.

Ebola is a highly-contagious haemorrhagic virus that breaks down the epithelial cell wall of blood vessels to trigger extensive internal bleeding and external. Initial symptoms include sudden onset of fever, muscle pain, weakness, headaches, a sore throat and vomiting and diarrhoea.  Infection spreads through body fluids and can spread after death, which makes decontamination and treatment in isolation wards essential. As the infection worsens, bleeding – both external and internal -- causes those infected to die from shock.

There are no effective drugs or vaccines to treat the virus, but supportive treatment of the symptoms work. Fewer people have died in the current outbreak than the 26 outbreaks in 10 countries since the virus was first identified in the Democratic Republic of Congo in 1976. Case fatality (deaths of those infected) is down from 88% in the past outbreaks to 36% in the current one.

(http://healthintelligence.drupalgardens.com/content/chronology-ebola-virus-disease-outbreaks-1976-2014)

The containment has been done using traditional public health measures, such as identifying those who are sick, tracking down everyone they could have exposed, monitoring them during a 21-day "fever watch" to spot early symptoms, then treating people in isolation until they are no longer contagious,

Mutant virus fears

Ebola jumped from fruit bats to humans, but then, viruses jumping from animals to humans is not a new phenomenon. According to the World Health Organistion (WHO), as many as 75% infectious diseases that have affected humans over the past 30 years have originated from animals (zoonoses).

Among those thriving among humans are influenza A from wild birds, MERS from camels, HIV from chimpanzees, plague from rodents, hepatitis B from apes, malaria from macaques and dengue from primates.

On average, one new disease has emerged every year over the past 20 years, mainly in Africa and Asia, and the WHO has predicted pandemic more than a few times. So far, none have.

But going by WHO data, you are more likely to die of the common flu than an exotic new disease. Seasonal flu, caused by the ubiquitous influenza viruses that give us fever, sore throat, cold and bodyache more than once a year, kills between 250,000 and 500,000. That is about 20 times more people in a month than the total deaths caused by bird flu and SARS combined.

So, don’t let the Ebola headlines scare you, humans have beaten back several infections.

And many more will come. If you escape one outbreak, there’s always something else around the corner. All you can do is stay alert to symptoms and ensure you get tested and treated at the first sign of symptoms.