Ebola can be stopped!
Rachael Irving, Contributor
Ferocity has come to symbolise the growing risk from emerging and re-emerging pathogens. Dr Sheik Humarr Khan and his team in Sierre Leone, Africa, thought they had broken the back of Lassa fever and reduced the mortality rates seen in previous outbreaks of the Ebola virus.
Ebola rebounded with increased virulence at ground zero, killing Khan and colleagues. They died in June 2014, months before the data and samples collected from 78 victims of the disease were analysed by their Harvard and MIT colleagues in the United States.
The Ebola virus is known to have jumped species - from natural hosts to monkeys and humans. In 1976, an Ebola-related Marburg virus made the first jump from monkeys imported from Uganda to humans in Germany. Quick cauterisation of this outbreak in Europe reduced the mortality rate to a mere 24 per cent.
In 1994, there was a monkey to monkey transmission in Virginia, USA. The USA euthanised all the infected monkeys and prevented the transmission to humans. The world is now up in arms as to the pattern and geographical virulence of this new Ebola outbreak classified at biosafety four, to indicate the highest possible level of danger to life.
Humans have destroyed animal habitats and the world is more interconnected than before. We can expect pathogens that cause human disease to be detected in the future at an accelerated rate due to increased species jumps. Infectious diseases at biosafety levels three and four are popping up every 12-18 months. These contagious diseases can cause significant morbidity and mortality and must be worked with at higher containment levels.
Under section 361 of the United States Public Health Service, the US Secretary of Health and Human Services is authorised to take measures to prevent the entry and spread of infectious diseases from foreign countries into the USA. Not only the USA, but most countries have passed laws to secure their borders.
JAMAICA WILL BE CUT OFF
If there is an outbreak and non-containment of biosafety levels three and four pathogens in Jamaica, we may be cut off from the rest of the world. All of Jamaica from Cherry Gardens to Trench Town will be severely impacted. Jamaica's health infrastructure needs urgent attention. While Jamaica seeks to urgently prioritise health, we should learn from the missteps seen in America's response to its first Ebola patient in Texas.
The technologically and medically advanced USA, with the world's best Emerging Infectious Diseases Laboratory and the Centers for Disease Control and Prevention erred in not being clinically thorough at the presentation of the patient in Dallas.
The European Union has since moved to protect countries in the union because of the changing dynamics of the Ebola crisis. Canada has its own disease control centres and has produced ZMapp, which has been the most effective drug to date in treating Ebola Viral Disease (EVD) and is most advanced as regards clinical trials.
Japan has taken a pre-emptive step in producing its own drug, Avigan and has stockpiled for 20,000 persons in case of an outbreak at base. Cuba, with limited resources, formed Siam Bioscience, a joint Thai-Cuban pharmaceutical company geared at producing an antibody treatment for Ebola.
There have been 33 previous outbreaks of various Ebola viruses on record, all of which have been contained and stopped with fewer deaths than this one. In spite of our inadequate health infrastructure, Jamaica cannot be caught off guards like Liberia and Sierra Leone.
It is not a Jamaica Labour Party or People's National Party health system. The infectious disease fight knows no party, therefore, legislators should come together with citizens in a town setting to map out a minimum casualty plan.
Cuba has mapped a health plan without a case on its shores. Nigeria nipped Ebola in its tracks by using the blood of those who were infected and survived to treat those at risk to die. The developed world cautioned Nigeria against that method of treatment. Nigeria had no choice as the approximately 1,000 doses of ZMapp donated to Africa are elsewhere because the logistics of getting the drug there are yet to be worked out. The method of using blood from infected persons who survived is now part of the standard treatment.
DEVELOP OUR OWN VACCINE
Countries like Jamaica need to lobby the World Health Organization and the Pan American Health Organization for a more concerted effort to get Ebola medicines into advanced testing and to make them available in the field.
I implore established companies like Cari-Med and LASCO Pharmaceutical to explore the option of getting a few vials of these experimental drugs into a cold storage facility in Jamaica.
Now is an opportune time for Jamaican pharmaceutical companies to get into development of new drugs for emerging tropical diseases. Jamaica might not be able to afford many thermal scanners but Jamaica needs to import at least two stationary high-traffic fever scanners for passengers coming through the two major airports. Nigeria, South Africa, USA and Europe are buying these multiple-purpose fever detectors to pick out passengers with fever as they randomly move through the airport. Jamaica needs to identify a cadre of security officers to be trained in epidemic intelligence tracking (disease detectives) in case quarantine laws need to be enforced.
Jamaica should also stockpile a few high grade Hazmat suits to protect those outside of the average health-care workers who might come in contact with Ebola or suspect cases. There may be itinerary cleaners and garbage collectors who might get exposed. We must have a contingency plan to protect the most vulnerable.
Ebola is in Europe, USA and Africa and is spreading. Jamaica's health-care system must be made ready. All Jamaicans and visitors to our shore should be guaranteed a fighting chance in case of health eventualities while ensuring full protection for all workers in the sector. Pathogens are everywhere; it will be how Jamaica reduces risks of infection that will ultimately determine the viability of our tourism product.
Rachael Irving, PhD, is a Senior Research Fellow in the Department of Basic Medical Sciences, Faculty of Medical Sciences, University of the West Indies, Mona