Putting Ebola in Perspective Influenza, Tuberculosis, Dengue Fever, Malaria . .

By Templeton, David | Pittsburgh Post-Gazette (Pittsburgh, PA), August 19, 2014 | Go to article overview

Putting Ebola in Perspective Influenza, Tuberculosis, Dengue Fever, Malaria . .


Templeton, David, Pittsburgh Post-Gazette (Pittsburgh, PA)


Health preparedness and procedures in the United States should prevent a domestic outbreak of Ebola, whose death toll in western Africa now has topped 1,000.

But a University of Pittsburgh virologist warns that the nation should focus on its vulnerability to other foreign viruses that are less deadly but far more contagious than Ebola, with a potential impact similar to seasonal influenza.

Some already have arrived. Other viruses well established in Africa, the Middle East or Asia could show up on the next boat or plane and spread by airborne disease particles, mosquito bites or contact with humans or livestock.

Yes, the African Ebola outbreak should generate international concern with a death rate as high as 90 percent of all cases.

"But I would also issue a word of caution that the public should have some perspective on this," said Amy L. Hartman, an assistant professor at Pitt's Graduate School of Public Health. "Even though this is the largest Ebola outbreak ever, there are other infectious diseases that cause millions of deaths per year - influenza, tuberculosis, dengue, malaria - but do not have the urban legend status of Ebola."

But that level of concern and fear has led to development of a potential arsenal of antiviral weapons, including the drug favipiravir.

Ms. Hartman, who developed animal models to test the drug, said it's undergoing final-stage human clinical trials before the U.S. Food and Drug Administration can approve it for human use. So far, the drug has been highly effective against the flu and better than current medications such as Tamiflu. But there's also growing evidence of effectiveness against Ebola and many other viral infections.

"Favipiravir could have an impact on other viruses including West Nile," Ms. Hartman said.

While there are no FDA-approved vaccines for Ebola, the National Institute of Allergy and Infectious Diseases is working to develop one. Efforts are underway to expedite a first-phase safety trial on an Ebola vaccine this fall, while supporting development of an Ebola/Marburg virus vaccine by Crucell, and Ebola vaccine by Profectus Bioscience. The National Institutes of Health and the Thomas Jefferson University in Philadelphia are collaborating on an Ebola vaccine based on an already established rabies vaccine, the CDC reports.

Zmapp, an experimental Ebola treatment, has yet to be tested for safety but is available for compassionate use in Liberia in an attempt to bring the epidemic under control. The CDC said it's too early to tell if the drug is effective. The FDA issued a warning last week about products being sold online that claim to prevent or treat the Ebola virus, ever since the outbreak in Africa occurred.

What some believe to be exaggerated fears of an Ebola outbreak in the United States are bolstered by the World Health Organization's description of it as "one of the world's most virulent diseases." It also can be spread by direct contact with an infected person. The viral hemorrhagic disease causes fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, lack of appetite and abnormal bleeding, the CDC says. Most common symptoms appear eight to 10 days after exposure.

But control is possible because a person must have symptoms to be contagious. The United States also has a strict protocol in place to monitor sick patients en route to the United States and isolate those with the disease in biomedical containment centers to prevent the virus from spreading.

"Whenever airline officials determine that a sick patient is aboard a plane destined for the United States, the CDC is notified to investigate whether the ill travelers might require isolation and assure the plane is disinfected. Such procedures were initiated during the 2003 outbreak of severe acute respiratory syndrome, or SARS, in Asia that eventually infected 8,273 people, including 27 cases in the United States, but none of whom was among the 775 deaths. …

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