Authors Note: I was first introduced to the Ebola virus in 1978 while attending California State University Long Beach. At that time, Ebola was just two years old and known in the scientific community as a Marburg-like virus (a virus first discovered in Marburg, Germany, in 1967. Since then the virus has hit Africa seven times.)
Ira Jones, Ph.D., the only African American natural science professor at CSU Long Beach, who was in charge of a vault filled with hazardous pathogens in the late 1970s, answered a White student’s question during one class session: “Why does Africa breed so many dangerous viruses?”
“Because the continent has no medical and public health infrastructure to fight such microbes and until that changes, it will always be a breeding ground for disease,” he replied. “Its people will suffer, and you will see a strange relationship between pharmaceutical firms doing research there and the United States military. And not one sick African will benefit from the cures discovered by such research.”
It was my belief during that time, that Professor Jones was discussing how Africa was being ravaged by the superpowers that were exporting minerals from the continent and preventing Africans from using those profits to provide clean water, clinics, and medicine for its people. I had no idea he would be describing a scenario taking place today in Africa with Ebola and the drug TMK-Ebola.
If you want to get an understanding of the African view of Marburg, Ebola and other such viruses, visit blogs like 103.5 Star Radio Sierra Leone. There you will find individuals passing on how to live and survive. Basic advice such as hand-washing, hydration and isolation are provided. There are also questions about how viruses such as Ebola emerged. Were they accidents or intentional?
For example, the Marburg virus appeared in Germany in 1967, and later in Africa in the mid-70s during the anti-apartheid wars. Because Germany and the U.S. were NATO allies, most Africans saw the Marburg virus as a direct attack on their countries using biological weapons that had been banned by the United Nations.
The Journal of Infectious Diseases, in its September 2007 issue, noted the Marburg virus was first detected and possibly created by breaches in laboratory safety. Monkeys were being used for research and to prepare a polio vaccine. These animals were imported from Uganda and were used mainly for the production of kidney cell cultures, which were needed for the propagation of vaccine strains.
Marburg has since surfaced in Africa in 1975, 1980, 1987, 1998, 1999, 2004, and 2005. It also surfaced in Russia, and was apparently a direct result of a laboratory accident where Nikolai Ustinov, Ph.D., a scientists with the Soviet biological weapons program, was working to put the Marburg virus in a missile warhead. He accidentally infected himself while injecting guinea pigs with the virus, according to the international think tank GlobalSecurity.org.
Breaches in safety have also taken place in the United States at Centers for Disease Control (CDC) laboratories, and in tropical regions in Africa that are serving as locations for CDC laboratories, said Time Magazine and Bloomberg news.
For example, in March of this year, an experienced researcher working in a CDC lab in the United States sent a sample of bird flu virus classified as low-pathogenicity (not lethal) to the United States Department of Agriculture (USDA) lab. Unknowingly the harmless virus had been contaminated with a dangerous strain. The lab discovered the mistake when test chickens died. It was also discovered that a scientist did not follow proper decontamination protocols (cleaning with a sterilizing agent).
According to a CDC released report, the worker was “being rushed to attend a laboratory meeting at noon” and was also under a “heavy workload” as his or her team hurried to generate data for a February vaccine meeting at the World Health Organization, WHO. Handling the harmful strain requires enhanced biosafety-level 3 conditions, which includes safety measures such as workers wearing protective suits and respirators. Stanford University microbiologist Tim Lieberman said in an interview that he believes this could have been a fatal safety breach, but does not recall any other breaches.
The above incidents may be responsible for African’s distrust of foreign government laboratories in zones that are currently being ravaged by the Ebola virus.
One of only two Ebola testing centers in Sierra Leone closed recently according to the think tank Global Research, an international organization of scholars that is often critical of U.S foreign policy. According to Global Research, Tulane University conducts bioweapons research on behalf of the U.S. Army Medical Research Institute of Infectious Diseases (USAMRIID) in the lab. African news sources said the government of Sierra Leone forced the closure of the facility. At the same time, Western media has reported that the facility was closed at the request of the U.S.
In fact, an article by Vanessa Blanchard, which ran in the Daily Digest News on Aug. 26, noted that the Ebola testing lab was closed by WHO, following the infection of one of its staff.
An announcement made that same day said the lab had been vacated as a result of a Senegalese epidemiologist contracting Ebola. The remaining lab will be left open but a reduction in aid, including cuts to a $15 million contract by the National Institutes of Health, could hinder containment efforts for the virus.
In a recent article for the Africa Report magazine, Curtis Abraham as well as virologists, initially placed blame for the virus’ return on fruit bats which carry the disease. Epidemiologists initially believed that Patient Zero, the first person researchers believe contracted the disease in the latest outbreak, was someone in a remote, mountainous area in southern Guinea, a country with just one doctor per 10,000 people.
Experts believed that he or she contracted the virus by eating bush meat (likely fruit bats, which are considered a delicacy in the region), died, and then passed on the virus at the funeral, where mourners traditionally touch the deceased body before burial.
However, epidemiologists now suspect the initial Patient Zero was a 2-year-old boy who contacted Ebola by eating fruit or infected meat. He died on Dec. 6, 2013, just a few days after falling ill in a village located in southeastern Guinea. The area borders Sierra Leone and Liberia where the disease eventually traveled.
A week later, it is believed that Ebola killed the boy’s mother, then his 3-year-old sister, and later his grandmother. They all suffered from fever, vomiting and diarrhea, but no one knew what had sickened them. Two mourners, who scientists suspect touched the body at the grandmother’s funeral, apparently took the virus home to their village. A health worker carried it to still another village. He died, as did his doctor. They both infected relatives from other towns. By the time Ebola was recognized in March, dozens of people had died in eight Guinean communities, and suspected cases were popping up in Liberia and Sierra Leone, according The New Africa magazine.
The Ebola virus infection is transmitted by direct contact with the blood, body fluids and tissues of infected animals or people (dead or alive), and its symptoms include high fever, debilitating fatigue, and uncontrollable bleeding from the eyes, the nose, and the mouth. There is a two to 21-day period before you can specifically identify the disease.
There are five strains of the Ebola virus, each named after countries and regions in Africa: Zaire, Sudan, Tai Forest, Bundibugyo and Reston. The Zaire strain is the deadliest, with a mortality rate of 90 percent. It is the strain currently spreading through Guinea, Sierra Leone and Liberia.
Healthcare workers can only provide supportive assistance in isolation. Doctors in protective gear administering rehydration salts and fluids, nutritious food, and isolation, are used to prevent the spread of the disease.
“As it is becoming clear now, dying in isolation, surrounded by healthcare workers resembling aliens in space suits without the prospect of medical innovation is neither attractive to patients nor their families,” says Dirk Haussecker, biologist and medical consultant with RNAi Therapeutics, a company that works with viruses.
Consequently, news reports have shared stories of relatives of some half dozen patients infected with Ebola in Sierra Leone snatching their kin from the isolation wards and, presumably, returning to their ancestral villages for better care. (Not surprisingly, one report said that the death toll in Sierra Leone doubled in a week.) Perhaps worse for the patient’s loved ones, is knowing that not everybody suspected of having Ebola has it, and putting them together with others that do, exposes everyone.
Haussecker goes on to say, “what’s particularly disturbing about the present crisis, is that some infections could have been prevented. For years, the United States has been developing preventatives and treatments for Ebola, which would both provide defense if the virus was used in warfare and reduce the spread of an outbreak of the disease. But, despite lobbying from scientists amid this latest outbreak, the drugs have not been put to the test.
Haussecker believes the United States’ interest in Ebola has less to do with humanitarianism than with national security. The Ebola virus is classified by the CDC as a Category A bioterrorism agent—the same category as anthrax. For more than a decade, the U.S. Department of Defense (DOD) has been funding research into developing effective Ebola vaccines and cures.
Haussecker is questioning whether the U.S. government has stepped up interest in infectious diseases such as Ebola because of their potential use as weapons of mass destruction by terrorist organizations. The CDC owns a patent on a particular strain of Ebola known as “Ebo Bun” which was awarded in 2010.
It’s worth noting that Ebo Bun is not the same variant currently believed to be circulating in West Africa. Haussecker said, “the CDC needs to expand its patent portfolio to include more strains, and many believe it may be why American Ebola victims have been brought to the United States in the first place, to cultivate the strains.” It appears the missing link is the difficulty of performing clinical studies under outbreak conditions. Almost all data on the pathogenesis of Marburg and Ebola viruses have been obtained from laboratory experiments employing mice, guinea pigs, and a variety of nonhuman primates.
Biomedical researchers working with DOD’s USAMRIID is partly funded by the U.S. Department of Defense’s Joint Project Manager Transformational Medical Technologies Office, have been developing preventative and curative drugs to combat possible bioterror threats from Ebola and other viruses.
The drug has shown a 100 percent success rate in monkeys. In January, Canada-based Tekmira announced that it had given the first trial dose to a healthy human in the form of TKM-Ebola. In March, the USDA granted TKM-Ebola fast track status to speed up the drug’s development.
Some scientists have argued that the latest outbreak in Africa should have been seen as an opportunity to put drugs like TKM-Ebola to the test.
“It is fair to assume that TKM-Ebola, the most advanced Ebola antiviral in development, will do more good than harm in a disease without alternatives besides supportive care,” Haussecker recently argued. “If I were the U.S. government, I would be eager to take advantage of the unique opportunity at testing efficacy before spending billions on an agent for which there is only theoretical human efficacy.”
The prospect of selling an Ebola drug to a relatively small number of poor Africans is not an enticing enough financial incentive, speculates Haussecker.
He goes on to note pharmaceutical companies are, first and foremost, businesses whose aim is to turn a healthy profit and keep their shareholders happy. So the prospect of them financing a drug like TKM-Ebola for mainly rural Africans is a long shot.
Rather than rely on one approach, some believe that multiple approaches should be combined.
“Western medical science has long dismissed African indigenous medical theories as superstitious gibberish, unworthy of consideration,” according to Edward C. Green, an American medical anthropologist.
But contrary to this belief, Green explained that Africans are not simply helpless victims of Ebola. He said many villages are proactive in controlling the spread of the disease at its onset, a practice that wasn’t taught by modern physicians, but passed on by herbalists and village medicine men. He believes medical aid agencies from the United States and Europe aren’t familiar with traditional cultural practices used by Africans during times of infectious disease outbreaks. However, if observed closely, elders who realize their village is suffering an Ebola outbreak instruct residents to conduct a type of indigenous protocol for its prevention and control.
What’s very interesting is that the elders are able to determine it is Ebola and use methods different from the treatment and control of other illnesses such as flu or fever, said Green. This particular protocol included the identification of homes of Ebola victims. Ebola patients were isolated and kept a distance of at least 100 meters from the homes of others. Visitors were strictly forbidden. Strict limitations were placed on people’s movements. Dietary and sexual restrictions were also placed on them to control the deadly disease, said anthropologist Green.
American anthropologist Barry S. Hewlett, author of the book “Ebola: Culture and Politics–The Anthropology of an Emerging Disease,” has shown that local populations have long been aware of the disease and have their own cultural logic to explain it and social protocols to deal with it.
These include practices of isolation and care that have proved so effective that agencies such as WHO have incorporated them into their own response strategies. In fact, some experts are warning that global efforts to curb the spread of potentially deadly emerging zoonotic diseases (illnesses that jump from wild animals to humans) as well as the re-emerging of contagious and infectious ailments such as tuberculosis and leprosy in Africa, need a strategy rethink. Public health officials involved in international development are reportedly turning a blind eye to cultural models for disease control and prevention that exist in Africa, said Hewlett in his book.
If effective intervention is to be achieved, say researchers, then an awareness and understanding of these indigenous strategies can play a practical role in containing and preventing diseases that are presently killing millions on the African continent and have the potential to affect global health.
Many aid agencies are still unaware that traditional cultural practices across Africa offer what Western medics would consider to be effective means of disease control and prevention.
Health-care workers need to be aware that such cultural models exist, says Hewlett. He believes that once these positive aspects are identified, epidemic control teams can build upon them.
In terms of bioterroism, Haussecker believes a suicide bomber could infect himself or herself with blood-borne agents such as HIV or Ebola and spread the infection by detonating himself or herself in a crowded area.
And this, rather than saving lives say many Africans who are blogging about the situation, is the reason the U.S., Canada and other foreign countries are on the continent conducting research on the viruses.