Possible cure of ebola virus

On 22 July 2014, the first case of the dreaded Ebola
virus arrived in Nigeria via an Asky aircraft.
However, no one knew it at the time. How did this
happen? How had this patient been screened at his
port of departure, that is Liberia airport? We can
also ask ourselves yet another question. Why is it
taking so long to curtail the epidemic? For instance,
the World Health Organisation (WHO) recently
announced that as at 23 July 2014, the Ebola
epidemic had claimed 672 lives. Furthermore, there
are currently 1201 suspected and confirmed cases
across West Africa. In terms of intervention, the
current strategy appears to be related to the use of
universal precautions: case isolation, hand-
washing, and health worker protection and palliative
treatments (such as pain management, and
rehydrating fluids).
In theory, this strategy may be quite effective. This
is because epidemic control strategies usually aim
to reduce person-to-person transmission through
avoidance related methods (WHO, 2014). In this
case, persons at risk will need to avoid contact with
the body fluids of infected person, including sweat,
semen, vomit, faeces, urine, blood and saliva
(Infection Control for Viral Hemorrhagic Fevers,
WHO 2014).
In practice, avoidance techniques may not work, as
in reality, these are the most basic of preventive
measures. Firstly, a high level of hygiene is required
and this may be relatively impossible in the urban
slums and rural areas of many African countries.
Secondly, isolation centres will need to be stationed
in every single district or local government area. In
many developing African countries, such centres
may not be adequately manned, suitably stationed,
or reasonably equipped. So, invariably, many
infected persons are nursed at home or buried at
home. Hence, the cycle of transmission continues.
What then can be done?
From a Public Health perspective, there are several
ways that epidemics may be subdued: 1). Interrupt
the cycle of transmission e.g prevent cross-
contamination 2). Protect the susceptible host e.g
through vaccination or 3). Eliminate the reservoir of
infection e.g. kill all animals that harbour the Ebola
virus.
Starting from the third option, we immediately
encounter the difficulty of which animals to
slaughter. Unlike Avian flu, it isn’t clear which
animal is involved here? Bats? Rodents? Monkeys?
In addition, the Ebola virus has no vaccine to date;
so that leaves only one other option: interrupt the
cycle of transmission. The question then is ‘Has
this been effectively done? How have other nations
contained similar epidemics?
On 21 September 2008, a woman was admitted at a
South African hospital for fever, vomiting and
diarrhea, “followed by a rash,” and signs of organ
failure (Keeton, 2008). The woman died the next
day. Three more cases were reported, in quick
succession, to the National Institute for
Communicable Disease in South Africa. They all
died within a few days of admission. Three of the
patients were medical staff. Researcher Keeton
(2008) noted that all cases presented with “ flu-like
illness (in a similar way to Ebola) and had fever,
headache and muscle pain. When the fifth patient
surfaced, the institute had diagnosed an outbreak of
an old world arena virus infection. While this
specific virus did not cause internal bleeding, it
belonged to the same class of viruses that did, e.g
West African LASSA fever causes fever and
bleeding (Keeton ,2008). According to Keeton (2008),
the fifth patient (a nurse) was “treated with
Ribavirin, which has been effective in patients with
LASSA fever, and she has since made a good
recovery” (Keeton, 2008).
Ribavirin then was the deciding factor in this case.
All other palliative methods failed, intravenous
fluids, etc. Why then should we expect such
interventions to work now in 2014? Surely an
antiviral, which worked in a similar situation six
years ago, should also be a consideration in this
case? The virus isolated in South Africa had never
been subjected to Ribavirin in a research setting
(Keeton 2008). In effect, there was no guarantee
that it would work. But this was nevertheless the
most logical approach to the impending threat.