Ebola Outbreak Foretells of its Resurgence


Michael Ransom, Senior CorrespondentLast Modified: 01:28 a.m. DST, 28 March 2014

Man on Floor of Hut, Guinea, West Africa, Photo by Dawid

WEST AFRICA -- While the animals that play host to the Ebola haemorrhagic fever (EHF) rarely show warning signs of contamination, the same cannot be said for the humans infected with the virus. In three West African countries, the outbreak continues to manifest in the form of rashes, bruises, bleeding, muscle pain and widespread fear. For those infected, these ailments will later compound with more serious internal indicators, including blood clotting, organ failure, seizure and coma.

The process of diagnosis is a difficult one, given the analogous traits of the Ebola virus and Marburg virus disease (MVD). Another confounding variable in the effort to contain the spread of Ebola is the relatively long incubation period of the deadly viral agent, estimated at about two weeks. This makes it nearly impossible for officials and doctors to estimate the size and the scope of the threat.

But some statistics are widely accepted in the international community. At least 63 deaths have been linked to the Ebola outbreak since the virus materialized in Guinea last month. This week, neighboring Liberia and Sierra Leone have both attributed deaths to Ebola. The medical aid organization Medecins Sans Frontieres, known as Doctors Without Borders in the English speaking world, is actively combatting the lethal contagion with increased medical provisions and treatment centers.

There is hope for the future of Ebola treatment. In clinical studies, a vaccine has proved effective in safeguarding mice from the virus. Another test drug has successfully immunized primates that would otherwise traffic the disease across vast regions. Researchers name fruit bats and primates as the disease's primary carrier, and recently warned against the consumption of these animals, which are dietary staples in some communities.

Since Ebola was first recognized in Zaire and Sudan in 1976, outbreaks have occurred regularly in remote African communities that are home to tropical environments. The disease has claimed over 2,000 lives over the past 40 years. While the efforts of local officials and doctors, international aid programs and medical volunteers should be commended, we should also acknowledge that food security poses a larger threat to those living in Guinea, Liberia and Sierra Leone, many times over.

Across the globe, six million people will die this year alone due to starvation and hunger related illnesses. It will do little good to discuss the Ebola threat without examining the continued risk of malnourishment in the impacted regions. Food security remains an underreported serial killer in Africa and across the world. Rural, impoverished areas that win the war against Ebola will still face the reality of food insecurity in the months following the current media attention.

Gender inequity, violence, food provisions and medicine are interwoven issues, and it does little good to magnify one issue to such a degree that the others are left out of the snapshot. And sadly, the discrimination against women and single-parent families will continue to threaten the health and wholeness of Africa and the globe. A perspective that highlights the interplay between the short-term Ebola danger and the ongoing discussion of human rights progress will be more advantageous towards lasting change in the West African region.

Follow Michael on Twitter Twitter: @nahmias_report Senior Correspondent: @MAndrewRansom

First War, Now Elephantiasis


Ayanna Nahmias, Editor-in-ChiefLast Modified: 23:55 PM EDT, 30 January 2012

UGANDA - When I was a child I first encountered a person afflicted with Elephantiasis when we moved to Nigeria. I wrote about this encounter in my post The Road to Naijiriya which details my arrival in Lagos as we embarked on our new life in Ile Ife.

Now, this disease is once again in the media as health services in Southern Africa have alerted the region to the need for increased preventative measures and prophylactic treatment options.

The 20-year civil war in Uganda has left severe scars on the economy, infrastructure, health and human services, and most of all on a populace that no longer has access to basic necessities such as potable water, food and medical treatment.

Lymphatic filariasis, commonly known as Elephantiasis, "afflicts over 25 million men with genital disease and over 15 million people with lymphoedema. Currently, more than 1.3 billion people in 72 countries are at risk. Approximately 65% of those infected live in the WHO South-East Asia Region, 30% in the African Region, and the remainder in other tropical areas." (Source: World Health Organization)

With proper medical treatment, the condition, which is caused by a parasite that is part of the roundworms family, can be cured. The parasite is usually transmitted to its human host through a mosquito bite. It subsequently invades and proliferates throughout the lymphatic system where it blocks and disrupts the immune system. "The adult parasites live for 6-8 years and, during their life time, produce millions of microfilariae (small larvae) that circulate in the blood." (Source: WHO)

Although, quite disturbing, this condition is easily treatable for patients with access to proper health care. However, in countries like Uganda, which has a long history of civil unrest and unstable governments; this disease remains unchecked in its transmission and infection. In addition to the excruciating physical pain caused by the disease, there is the accompanying psychological and sociological impact.

People afflicted by this disease remain ostracized by society and their communities much like lepers in previous centuries. They are also unable to earn a living because of the crippling disfigurement caused by the symptoms of this disease. The adult worms can be successfully killed usually with one treatment, however, the disfigurement suffered by the individual remains unless they can arrange to have surgery to remove the tumors.

It is sad that the Ugandan people who have been victimized by a series wars instigated by despotic rulers, the most egregious being Idi Amin, must now face a new marauder in the form of this parasite.

To learn more about the disease watch the Voice of America video below.


Malaria Vaccine | Bill & Melinda Gates Foundation


Ayanna Nahmias, Editor-in-ChiefLast Modified: 22:08 p.m. EDT, 22 October 2011

I narrowly survived an infection of cerebral malaria when I was 10 years old.  We lived just outside of Dar es Salaam, the capital of Tanzania, and because my father did not believe in Western medicine, he forbade my mother from seeking treatment for me when I fell ill.  If treated at the immediate onset of symptoms the chances of recovery are quite high.

However, by the time she took me into Dar to the hospital, I beyond the threshold of medical intervention. The doctors told my mother to take me home and prepare for my death.  My mother did take me home where I lapsed into a coma while she tried everything she knew to break the fever and bring me back.

Through her valiant caring and prayer I awoke from my coma I remained critically ill for many months afterward.  I was one of the lucky few who survive cerebral malaria in which mortality rates for patients is as high as 50%.  This particularly pernicious disease  is the number one killer in the world today with a 90% percent of malaria-related deaths occurring in sub-Saharan Africa.

The PATH Malaria Vaccine Initiative (MVI) was funded in large part by the Bill & Melinda Gates Foundation and conducted trials on 6,000 children at 11 sites across sub-Saharan Africa.  The trials  showed that three doses of the RTS,S vaccine reduced the risk of children experiencing clinical malaria and severe malaria by 56 percent and 47 percent respectively.

Research is continuing, and efficacy and safety results in 6 to 12 week-old babies are expected by the end of 2012. Information about the longer-term protective effects of the vaccine, 30 months after the third dose, should be available by the end of 2014.

"A vaccine is the simplest, most cost-effective way to save lives," says Gates.

"These results demonstrate the power of working with partners to create a malaria vaccine that has the potential to protect millions of children from this devastating disease."

"These results confirm findings from previous Phase II studies and support ongoing efforts to advance the development of this malaria vaccine candidate," says Tsiri Agbenyega, a principal investigator of the trial and Chair of the Clinical Trials Partnership Committee.

"Having worked in malaria research for more than 25 years, I can attest to how difficult making progress against this disease has been. Sadly, many have resigned themselves to malaria being a fact of life in Africa. This need not be the case."

The team is now working towards approval by regulatory authorities. If the Phase III trials go well, the World Health Organization (WHO) has indicated that it could recommend the RTS,S malaria vaccine candidate as early as 2015, allowing African nations to include the vaccine in their national immunization programs.

Follow Nahmias Cipher Report on Twitter
Twitter: @nahmias_report Editor: @ayannanahmias

Wildly Artistic in the Wilderness of Bipolar (Part 1)

I long ago abandoned the notion of a life without storms, or a world without dry and killing seasons. Life is too complicated, too constantly changing, to be anything but what it is. And I am, by nature, too mercurial to be anything but deeply wary of the grave unnaturalness involved in any attempt to exert too much control over essentially uncontrollable forces. There will always be propelling, disturbing elements, and they will be there until, as Lowell put it, the watch is taken from the wrist. It is, at the end of the day, the individual moments of restlessness, of bleakness, of strong persuasions and maddened enthusiasms, that inform one's life, change the nature and direction of one's work, and give final meaning and color to one's loves and friendships. ~ Kay Redfield Jamison

Read More

King Tut died of Malaria

It is a little disappointing to learn the truth of King Tutankhamun's death, because like so many others, I reveled in speculations of palace intrigue, royal malfeasance, murder and usurpation. Today the world learned that King Tut was merely a boy, one who had access to and buried with the riches of ages, but a frail boy nonetheless who died from a very treatable infection. Watch the video here.

Read More