There is good news about Ebola virus disease ( EVD ) !


• Only 2 confirmed cases were reported in the last week ( 1 in Guinea, 1 in Sierra Leone ) – the lowest since March 2014.


• The first large-scale trial of a vaccine, in Guinea, showed NO EVD cases in over 2,000 volunteers who were vaccinated immediately, but 16 cases in a similar number where vaccination was delayed for at least 21 days. A single injection produces a rapid immune response against a surface protein of EV. The vaccine is not yet licensed, but in future every contact at risk of infection will receive it immediately.


• The technique used in the trial was " ring vaccination " – a new design where contacts of each newly diagnosed EVD case were vaccinated and monitored. The vaccine is also being trialled against frontline health workers.


• If we needed reminding, EVD has infected about 28,000 and killed over 11,000 – almost all in Guinea, Liberia and Sierra Leone - including over 500 health workers. Apart from this, these countries’ healthcare systems were severely disrupted, with far more cases of malaria, and it took a terrible toll on their economies.


• There have only been a handful of EVD cases elsewhere in Africa, and worldwide. But it could have been much worse ! A year ago a Liberian man infected with EVD flew into Lagos, Nigeria. This megacity has 21 million inhabitants and the virus could have spread there – then ( Lagos being an international travel hub ) beyond . Luckily Nigeria does have the capacity to tackle such outbreaks, and there were just 20 infections ( 8 deaths ).


• More good news . The EVB outbreak in West Africa has alerted the world to the possibility of another epidemic or pandemic of a disease spreading much more easily than Ebola. It happened with influenza in 1918, killing up to 50 million people. Smallpox may have killed 300 million before eradication in 1980. The Ebola epidemic has spurred World Health Organization and others to recognise and react more quickly to an emerging outbreak, hopefully having – or developing – drugs and vaccines to deal with it.


• We don’t know what / when the next disease will be, and the risks need to be kept in perspective ! History has shown that new " bugs " posing a large epidemic threat are RARE. The last one was " SARS " ( severe acute respiratory syndrome ) over a decade ago ( over 8,000 infections, nearly 800 deaths ).


• Many " new " human diseases have come from animals, with a spectrum of types :-


1. Animals only ( possible future threats because of similar past behaviour ).
2. Limited spread from animals to humans ( H5N1 flu, rabies ).
3. Small outbreaks ( MERS / Middle East Respiratory Syndrome )
4. Large outbreaks ( Ebola ).
5. Humans only / originally animals ( HIV/AIDS ).


• Most infections, such as drug-resistant TB and malaria, evolve SLOWLY, but are ultimately more serious than the acute outbreaks attracting more attention ( 7 separate Forum threads on MERS ! ).


• Of course 2/3 diseases in the world are non-communicable, such as heart disease and cancers ( 90% in UK ; 60% in Philippines ). Together with improved outlooks for most " non-communicable diseases ", let’s hope the lessons learned from Ebola will better prepare the world for any future outbreaks, whatever the cause




http://www.nature.com/news/how-to-be...-ebola-1.18114