JAMA review - possible upcoming Ebola epidemic in Africa

NO, IT ISN'T THE END OF THE WORLD, OKAY?

No, it's not being done deliberately as experiments -- got that?

As I do my homework for my graduate anthropology classes, I come across interesting articles. I'm posting summaries of some of the interesting stuff as I have time.

Snippets of an article from JAMA - The Journal of the American Medical Association

Paul D Thacker. JAMA. Chicago: Jul 16, 2003. Vol. 290, Iss. 3; pg. 317, 3 pgs

AN EPIDEMIC OF EBOLA HEMORrhagic fever has sputtered along unabated since October 2001 in the dense jungles that span the northern border between Gabon and Congo, raising questions about how health officials respond to outbreaks of the deadly infection.

Officials at the Centers for Disease Control and Prevention (CDC) state that unlike "traditional" Ebola outbreaks. . . . . . this epidemic involves possibly seven or more independent infections. Well over 100 deaths have been recorded in the area, but the true number is unknown. . . . . . CDC scientists say that the agency has been too overburdened responding to outbreaks of severe acute respiratory syndrome (SARS), West Nile virus, and monkeypox to closely monitor the situation.

(snip)

"What it suggests is that the series of events that passes the virus from the reservoir into primates and humans occurs much more frequently in this area," explained Arthur, who formerly worked in the Department of Communicable Disease Surveillance and Response at the World Health Organization (WHO) in Geneva.

(English version of that statement -- Ebola seems to move from animals to humans more frequently in this area of Africa.)

"From anecdotal evidence, it appears that hunters who handled sick animals got sick [but] not necessarily the ones who ate [the sick animals]," said Eleni Galanis, MD, associate director of the field epidemiology training program at Health Canada, based in Ottawa, Ontario. But what really is going on in the region is unclear, she adds, because no data have been released and there has been no formal paper documenting the outbreak.

The CDC wrote up an initial report for its Morbidity and Mortality Weekly Report (MMWR), but then never published when it became evident that the epidemic had continued and spread into Congo. (note for all conspiracy theorists) Releasing data on outbreaks can be a grueling task, involving the coordination of participating scientists from various agencies in multiple countries who speak different languages. Approval also must be sought from the host governments of countries where data were collected.

...which I thought was interesting. Each nation considers the information on its people to be its property (we discussed this in the History of Anthro class earlier this week) and you have to have permission to get and release the data.

As press time, Arthur said that the CDC planned to release a new MMWR on the epidemic in coordination with the WHO and the latter's Weekly Epidemiological Record, although the report could be delayed by the process of obtaining permission from the Gabonese or Congolese governments.

A NEW APPROACH NEEDED?

Dan Bausch, PhD, a medical epidemiologist with the CDC, said it is time to rethink how Ebola is handled in these isolated areas of Gabon and Congo.

The article goes on to talk about the lack of coordinated international efforts that's hindering things and how hard it is for busy medical units to stop treating patients and get data together for shipping it off to the CDC -- and (yes, it's true) to get researchers to yell at other researchers to quit researching and Publish The Data Darnit!



...and that's the interesting tidbit of the week from JAMA.

[Edited on 27-8-2003 by Byrd]