Exposing the Origins of the Ebola Outbreak: Urging for a Shift in Response From Reactive to Proactive
Akhtar A, Befkadu E, Basu P, Kumar P
Am J Infect Dis Microbiol. 2014;2:1-18
Exposure to Ebola virus can occur through direct or indirect contact with organs or bodily fluids of humans or animals with symptomatic Ebola virus disease (EVD). Hence, early recognition of EVD's signs and symptoms is essential for its prevention and eradication. Although multiple candidate vaccines and antiviral therapies are currently in development, preventive public health interventions involving risk communication and implementation of proper protective principles continue to be effective in mitigating the spread of EVD.
The key to understanding how to treat EVD may lie in observing how the Ebola virus replicates. Previous studies of bat genomes suggest that resistance to viruses is imparted by different genes involved in early immune response. In humans, on the contrary, the Ebola virus initially activates rather than attacks the immune system. Various studies of Ebola's immune evasion mechanisms report that during the early phase the virus diminishes the host's immune response, which allows for increased viral replication and reduced antibody production.[2,3,4] Once the virus has taken over, the immune system activates and creates an exaggerated immune response that results in more harm than benefit to the infected individual, destroying vital organ function. Therefore, a sound understanding of how and why bats have evolved to resist fatality in the face of the Ebola virus could provide a viable means for resolution of the outbreak.
The 2013-2014 West African Ebola epidemic is the largest in the history of the virus. Contributing to the success of the virus is the delayed identification of the outbreak, which initially spread unsuspected to neighboring regions. This paper's analysis of the growth dynamics of the epidemic suggests variations in trends and final outbreak size among Sierra Leone, Guinea, and Liberia, which share common cultural and geographic traits. Studies analyzing the patterns underlying the emergence of Ebola outbreaks in humans hint towards a possible association among various environmental and nutritional factors like temperature, humidity, seasonal patterns, deforestation, and micronutrient deficiency.
Clinical manifestations of EVD and screening/early detection methods are also explored, along with promising anti-Ebola drugs and vaccines and their mechanism of actions. Additionally, there are a number of proactive approaches to eliminate EVD through effective vaccination, precautionary infection control, and the preparation of healthcare facilities, providers, and patients. The ethical controversies associated with quarantine of infected population and treatment administered locally vs internationally (which would delay treatment and expose more people to the risk for infection) and the use of experimental therapy are also discussed.
Since its discovery in 1976, Ebola has emerged as one of the deadliest pathogens causing hemorrhagic fever syndrome in both humans and nonhuman primates. The World Health Organization reported that at least 5160 lives have been lost to the virus as of November 12, 2014. This study emphasizes that rather than reacting to EVD with fear, the global community should strengthen the arsenal of EVD-fighting treatment options and precautionary measures in an attempt to shift the response from reactive to proactive.
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Cite this: Priyank Kumar, Paramita Basu, Katherine K. Knapp. Overview of Ebola Outbreak Stresses Proactive Solutions - Medscape - Jun 26, 2015.