#Ebola by the numbers = West Africa + Spain + USA

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In case you missed it, there have now been travel associated cases of Ebola in the United States and Spain. Hopefully with proper medical care and procedures, these will remain isolated cases. Or at worst, be limited to just a few cases.

On 9/30/2014, CDC confirmed, the first travel-associated case of Ebola to be diagnosed in the United States. CDC and partners are taking precautions to prevent the spread of Ebola within the United States. CDC is working with other U.S. government agencies, the World Health Organization (WHO), and other domestic and international partners and has activated its Emergency Operations Center to help coordinate technical assistance and control activities with partners. CDC has also deployed teams of public health experts to West Africa and will continue to send experts to the affected countries.

 Info on the Spanish case from the Guardian:

Health authorities announced on Monday that a Spanish nurse at Madrid’s Carlos III hospital who treated a patient repatriated from Sierra Leone had twice tested positive for Ebola.

Her husband had also been admitted to hospital and was in isolation, and a second nurse from the same team that treated both repatriated Ebola victims was also being tested. In this case, the nurse contacted the authorities on Monday complaining of a fever. She was in isolation in the Carlos III Hospital while authorities waited for the test results, a spokesperson for the Madrid regional government said.

Anti-science Bryan Fischer: HIV doesn’t cause AIDS because Ebola… and shingles

I can’t even with these tweets. A most basic understanding of virology completely accounts for why these different viruses cause distinct diseases, and have different incubation times and disease progression. UGH!

[tweet https://twitter.com/BryanJFischer/status/518064674584395777] [tweet https://twitter.com/BryanJFischer/status/517862958018621440] [tweet https://twitter.com/BryanJFischer/status/518053518377111552]

Representative Allen West thinks that #Ebola is just a ‘really bad flu bug’ – #ignorant of #science

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According to Rep Allen West, Ebola is a ‘really bad flu bug.’ If that’s true, maybe he would be willing to demonstrate his claims by volunteering to be infected. Oh wait, simple scientific facts prove him completely wrong. First of all, the Ebola virus is very very different in terms of the type of virus it is, and also in the symptoms it causes. The fatality rate of Ebola is somewhere between 50-90% (WHO). That means more than half of people who show symptoms will die from the virus. Even for a pandemic flu, like the infamous Spanish flu of 1918, the fatality rate was only 2%. Most flu pandemics and epidemics have fatality rates considerable below 0.5%. Last I checked, 50-90% fatality is a hell of a lot more than 2% fatality. So I would say Mr. West should do some fact-checking next time before he completely mischaracterizes a virus and its impact.

Seen by CauseScience on Maddow blog, along with a number of other political statements on Ebola!

@USAID to donate $75 million to fight #Ebola outbreak in Liberia!

The USAID reported on twitter that it will donate $75 million to fight the Ebola outbreak in Liberia. Bloomberg news has more info here.

The American aid agency announced Thursday it would donate $75 million to fund 1,000 more beds in Ebola treatment centers in Liberia and buy 130,000 more protective suits for health care workers.

 

The $75 million comes in addition to about $20 million the agency has already donated to fight the outbreak that was first identified in March in Guinea, and has spread to Liberia, Sierra Leone and Nigeria. The killer virus is spread through bodily fluids such as blood, sweat, urine or diarrhea.

#Ebola Quotable: MSF President Dr. Joanne Liu tells United Nations NOW is the time to act

Six months into the worst Ebola epidemic in history, the world is losing the battle to contain it. Leaders are failing to come to grips with this transnational threat. The WHO announcement on August 8 that epidemic constituted a ‘public health emergency of international concern’ has not led to decisive action, and states have essentially joined a global coalition of inaction.

 

Funding announcements and the deployment of a few experts do not suffice. States with the required capacity have a political and humanitarian responsibility to come forward and offer a desperately needed, concrete response to the disaster unfolding in front of the world’s eyes. Rather than limit their response to the potential arrival of an infected patient in their countries, they should take the unique opportunity to actually save lives where immediately needed, in West Africa.

 

The clock is ticking and Ebola is winning. The time for meetings and planning is over.  It is now time to act. Every day of inaction means more deaths and the slow collapse of societies.

Dr. Joanne Liu in an address to the United Nations

Dr. Liu is President of the international medical humanitarian organization Médecins Sans Frontières (MSF, aka Doctors without Borders).

Science Quotable: CDC Director Thomas Frieden gives grim reality and chilling warning about #Ebola outbreak

This isn’t just the countries’ problem, It’s a global problem. The level of outbreak is beyond anything we’ve seen—or even imagined.

 

The most upsetting thing I saw was what I didn’t see. No data from countries where it’s spreading, no rapid response teams, no trucks, a lack of efficient management. I could not possibly overstate the need for an urgent response.

 

For everyday that this continues to spread in West Africa, the likelihood of someone getting infected and transmitting it elsewhere increases. As long as Ebola is spreading anywhere, all of us need to be concerned.  Thomas Frieden, Director of the Centers for Disease Control and Prevention, during a press release (reported by Daily Beast).

@NIH Director’s blog: Using Genomics to Follow the Path of Ebola #science

Check out the most recent post on the NIH Director’s Blog by Francis Collins examining a recently published study examining the genome of the Ebola virus. This study pinpointed the outbreak and monitored how the genome has changed as the virus spreads. Sadly, a number of the authors on the study have contracted and died from the virus.

In a study just out in the journal Science, this fast-acting team reported that it has sequenced the complete genetic blueprints, or genomes, of 99 Ebola virus samples obtained from 78 patients in Sierra Leone. This new genomic data has revealed clues about the origin and evolution of the Ebola virus, as well as provided insights that may aid in the development of better diagnostics and inform efforts to devise effective therapies and vaccines.

 

To help advance such research, Sabeti’s team deposited its Ebola genome sequences, even prior to publication, in a database run by NIH’s National Center for Biotechnology Information’s (NCBI), which means the data is immediately and freely available to researchers around the world. Access to this genomic data should accelerate international efforts to figure out ways of detecting, treating, and, ultimately, preventing infection by this deadly virus.

Good news on the #Ebola outbreak for September : New diagnostic test and 2 unrelated outbreaks

While it seems that the Ebola outbreak in West Africa continues to spread, having now killed over 1500 people, there is some good news as September starts. First, a new non-PCR based diagnostic test for Ebola has been reported on Bloomberg News. Second, WHO reports that the Ebola cases that were assumed to have spread to the Democratic Republic of Congo, are actually part of a separate, unrelated Ebola outbreak (see on Forbes). This indicates that the virus has not spread quite as extensively.

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The method takes about 30 minutes or less and can be conducted in rural areas where there are no power cables, said Jiro Yasuda, professor of infectious diseases at Nagasaki University, today. The technique, initially reported in 2007 in Journal of Virological Methods by Yasuda and his colleagues, was modified to be used for the strain of Ebola that’s blamed for more than 1,550 deaths in West Africa.

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The World Health Organization has just confirmed that the newly-identified cases of Ebola Virus Disease (EVD) in the Democratic Republic of Congo is genetically unrelated to the strain currently circulating in Liberia, Guinea, Sierra Leone, and Nigeria.

A WHO collaborating research center in Franceville, Gabon, the Centre International de Recherches Médicales, had previously identified six Ebola positive samples sent to the laboratory. They report today that, “the virus in the Boende district is definitely not derived from the virus strain currently circulating in west Africa.”

Has the African Ebola virus outbreak spread to a Nigerian city of 21 million??

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Felix Onuah and Tom Miles for Reuters report that the government of Nigeria has confirmed that a man has died of Ebola virus in the megacity of Lagos, Nigeria (population: 21 million). However, the city of Lagos reports it is still awaiting official confirmation of the Ebola virus. Since February an Ebola outbreak in Guinea, Liberia, and Sierra Leone has killed 660 people. Apparently the man was quarantined upon arriving to Lagos, but was likely in contact with others while traveling to Nigeria. A spread to a major city may not be as bad as one might think:

“The fear of spread within a dense population would be offset by better healthcare and a willingness to use it, easier contact tracing and, I assume for an urban population, less risky funerary and family rites,” Ian Jones, a professor of virology at the University of Reading in Britain, said. “It would be contained more easily than in rural populations.”

It still can’t be good for viral spreading to have an outbreak in a major city. Check out previous posts from CauseScience about this Ebola outbreak. Including a terrific description of what it is like to have Ebola virus by Derek Gatherer and how likely the Ebola outbreak is to spread to the US and Europe. Obviously if the Ebola outbreak spreads to a large city in Nigeria, spread to other countries will become much more likely.

Viruses in the news: Andrew Shaw and Connor Bamford explain why for The Conversation

Why are emerging viruses here – and why now?

By Andrew Shaw, University of Glasgow and Connor Bamford, University of Glasgow

The US is on the brink of a new virus epidemic; a virus that wasn’t there ten years ago but which is now worrying officials. Chikungunya, which causes an incapacitating fever, is spread via Aedes mosquitoes and usually found across Africa and Eurasia. But it is now the most recent example of an emerging virus – viruses that are rapidly changing their geographic distribution and/or their incidence.

Other emerging viruses such as the Ebolaviruses – which go on to cause ebola haemorrhagic fever – and severe acute respiratory syndrome coronavirus (SARS-CoV), are less common while others like mumps virus, are re-emerging after a period of relative absence in the western hemisphere. These viruses arise, often unexpectedly, amid some level of mystery about where they come from and why they are spreading. Their origins are more complex than they might appear.

Arboviruses affected by climate

Viruses like chikungunya that are spread by arthropods (insects and arachnids, like ticks) are known as arboviruses (from arthropod borne)
and are affected by climate change and global warming, which directly facilitates their emergence. Global warming affects the distribution of arthropods, which act as vectors for the virus and increase the capacity for the viruses to grow within them.

An outbreak of Bluetongue virus – an infection of sheep and cattle that is spread by Culicoides midges – began in northern Europe in 2006, where it had never been seen before, and infected more animals than previously recorded.

Now, Chikungunya virus would appear set to spread across the US, much as West Nile virus did after it appeared in New York in 1999 – and which is still appearing. But not all emerging viruses are as predictable as the arboviruses.

Zoonotic viruses

A significant proportion of emerging viruses are zoonotic viruses, which spread from animals. These viruses are the most unpredictable, meaning that interaction between animals and humans is critical to their “spillover” into humans. The domestication of livestock has allowed multiple species – each with their own viruses – to come into close contact, which has created the right conditions for zoonosis.

Poultry and pigs are well known for a generation of new novel influenza viruses. However, it was also pig farms that ultimately resulted in the first cases of Nipah virus in Malaysia in 1999. Though harboured by flying foxes, the virus spread to pigs and then to humans causing around 100 deaths.

Human encroachment into new environments and the disruption of wildlife can also lead to humans being exposed to animals and their viruses. Outbreaks of ebolavirus haemorrhagic fever in African villages are often associated with the bushmeat trade.

A reproductive number

The myriad examples of virus emergence can be understood using the concept of the basic reproductive number, otherwise known as R0, which is a measure of the average number of new infections a virus produced from one single infection. An R0 of one means that an average of one new infection will arise from another, while a virus with an R0 of more than one will spread efficiently throughout a population. If a virus has an R0 of less than one it may eventually die out, as it fails to generate enough new infections over time – unless it is continuously re-introduced.

Processes that influence this number affect emergence. So while emerging viruses with an R0 of less than one may fail to efficiently infect and transmit within a new population, climate change and human behaviour could influence a virus’ R0 score in a given geographical area. Also important are virus-host interactions at the level of cells, which is a process governed by evolution. What makes viruses like chikungunya so worrying is that they require no further evolution to infect humans.

A suitable host

Viruses, as obligate, intracellular parasites that need hosts to spread, are composed of a protein or lipid coat that protects the viral genome, which encodes the instructions to make the viral proteins needed for infection. These proteins must allow entry of the virus into the host cell; make new copies of themselves; spread to more cells and evade your immune system. Differences in the efficiencies of these steps can all influence R0.

A virus’ genome can influence the fit between viral and host proteins; a virus with a better fit may be selected for and increase in frequency – which we can see as emergence.

Some viruses adapt and transmit easily, such as SARS-CoV and influenza (until we put a stop to them), while others fail to change their transmission, such as ebolavirus and the recent Middle-eastern respiratory syndrome (MERS)-CoV.

A constant worry is that an emerging virus may evolve to transmit efficiently within the human population but we do have means to prevent virus emergence. Intense monitoring of changes in virus distribution and novel human/animal infections lies at the heart of our strategy to combat emerging viruses.

For chikungunya and its relatives, targeting the mosquitoes that help it to spread and reducing the burden of climate change on at-risk areas may contain spread into new regions. The development of effective antiviral drugs and vaccines could also secure virus control. However, a challenge lies in predicting which viruses are most important and difficult in a global arena of continuing complexity and uncertainty.

The reality is that we have lived through this before with HIV/Aids and the spectre of once emerging but now-established viruses. This should continue to pique our interest in dealing with new ones that appear.

The authors do not work for, consult to, own shares in or receive funding from any company or organisation that would benefit from this article. They also have no relevant affiliations.

This article was originally published on The Conversation.
Read the original article.