Ebola Virus: The need to take some preventive measures

Ebola Virus Disease (EVD) is a viral infectious disease. This virus has caused a number of outbreaks since its discovery in 1976 but the current West African outbreak is the biggest of all.1,2 Currently five countries in the West Africa are affected by this deadly disease viz, Liberia, Sierra Leone, Guinea, Nigeria and Mali. Mali is the newest to join the list of the affected African nations. Meanwhile the virus has also travelled to other nations in the world by the effected travelers. This spread of the virus by unchecked travels across the globe is currently one of the emerging threats. In the past, outbreaks of the Ebola virus were limited to the isolated villages in Africa. But this current outbreak is out of its limits mainly because it is spreading to the major cities of the affected countries from where it is finding its way out through air and sea travels. Some international doctors and nurses mainly American and Spanish, who flew to West Africa to help patients recover, were also infected by this virus. They were flown back to their countries and they recovered from the disease. It should be kept in mind that there is no cure for this deadly disease until now and recovery is only based on symptomatic treatment with best medical facilities. Three experimental drugs “ZMapp” (an experimental biopharmaceutical drug comprising three chimeric monoclonal antibodies)3, “TKM-Ebola” (an RNA interference drug)4 and Brincidofovir (an antiviral drug)5 have been approved by the FDA to be used for American people who are infected but these drugs are not subjected to human trials. Two vaccines have been chosen as candidates for Phase 1 Clinical Trials, “cAd3-ZEBOV” (developed by GlaxoSmithKline in collaboration with the US National Institute of Allergy and Infectious Diseases) and “rVSVZEBOV” (developed by the Public Health Agency of Canada).6 The American vaccine “cAd3-ZEBOV” has cleared safety tests and it does produce strong immune reaction against the virus in healthy subjects. These results have been published in New England Journal of Medicine.7 Micheal T. Osterholm wrote an article “What We’re Afraid to Say About Ebola” in The New York Times (Dated: Sept 11, 2014) where he quotes “What happens when an infected person yet to become ill travels by plane to Lagos, Nairobi, Kinshasa or Mogadishu — or even Karachi, Jakarta, Mexico City or Dhaka?”.8 His fear was not wrong at that time because those of us who have some idea about the principles of public health in terms of infectious diseases epidemics and outbreaks, such large metropolitan cities like mentioned above are a fruitful ground for the virus to reside itself and ultimately spread itself in the community based on the its characteristics of transmissibility like reproductive number, generation time, serial time etc. This fear of ours, unfortunately, recently got true when a middle aged Pakistani national resident in Liberia flew out of its capital to Karachi.9 Officials 1. Mohammad Dilawar Jan, 2. Rafay Ahmed, 3. Urooj Zafar, 1-3: Student, Final Year MBBS, Dow University of Health Sciences, Karachi, Pakistan.