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Global issue 20

Arena Science Dr Peter Piot co-discovered the Ebola virus in 1976 Asked if he was confident that the international community was doing all it needed to do to control the spread of Ebola, he replied: “Yes.” A few days later, an editorial in The Times suggested that NATO should take over the fight against the deadly virus. Charlie Cooper, health correspondent of The Independent, said West Africa was just 60 days away from a human catastrophe, with the Disasters Emergency Committee (DEC), which links 13 major British charities and fund-raising organisations, launching an unprecedented appeal to secure millions of pounds to fund the fight against Ebola, now branded by the WHO as “the most severe public health emergency in modern times”. As we wait and see what happens in 2015, Africa’s tourist sectors are under threat – even as far away from West Africa as Tanzania – as well as its fragile medical services, even its political stability. But while we wait and worry and condemn the apparent slowness of an organised international response to a disaster in West Africa, we should collectively honour one of the truly great men in the fight against Ebola – Dr Peter Piot, director of the London School of Hygiene and Tropical Medicine. In 1976, fresh from medical schools in Belgium and Holland, and just 27 years of age, he co-discovered the Ebola virus in Zaire (now the Democratic Republic of Congo). As the epidemic widened at the end of 2014, killing thousands of unprotected men, women and children, Piot issued a warning aimed at the heart of ancient cultural and religious practices throughout West Africa – the practice of touching, and sometimes kissing, the corpse of a loved one at funerals. In an interview he said that in many parts of Africa there are strong traditional beliefs that the whole family should touch the dead body. Various steps, he explained, had to be taken by religious and cultural leaders to make sure that the spirit of a dead person went from this material world to another spiritual place where the dead would live again in another form as ancestors. Touching and The disease with no cure The speed with which Ebola spread throughout West Africa in late 2013 and 2014 has revealed how little is known about the virus itself. The natural carrier, or reservoir, of the Ebola virus is not known, nor are the reasons why outbreaks occur when they do. The strongest evidence suggests that the disease is carried by bats, including fruit bats, that are not themselves infected, but spread the virus to other animals and humans. Bats were suspected to be behind the first identified outbreak in Sudan in 1976, as well as the major outbreak in Zaire (now the Democratic Republic of the Congo) in the same year. Several smaller outbreaks have occurred in Sub-Saharan Africa in the years since. Ebola is transmitted between people through direct physical contact of bodily fluids, including blood, urine, faeces and vomit. In acute cases, transmission by saliva is also possible, and semen and breast milk remain infectious for several months after symptoms have receded. The rapid spread encountered in Guinea, Liberia and Sierra Leone has also been attributed to local traditional funeral rituals, which involve close contact with dead bodies that are still infectious. One difficulty in initially identifying an Ebola outbreak is the similarities its symptoms share with influenza viruses. The first symptoms of an infection only appear after an incubation period of two or three weeks, beginning with fever, sore throat and headaches, before escalating to include vomiting and diarrhoea. This is followed by internal, and less commonly external, bleeding. Death follows from blood and fluid loss. There is no approved vaccine against Ebola, or a cure. Instead, treatment concentrates on the various symptoms, such as keeping fever and pain down. It is advised that patients with suspected or confirmed infections are kept in isolation and that health workers wear protective clothing, including masks and gloves. All medical clothing and waste, as well as patients’ bodily waste, must be disinfected or disposed of safely. kissing the corpse are part of the ritual – but dead bodies carry the deadly Ebola virus until they are buried or burned. His warning received a good response from responsible civic and religious leaders. Churches across the region have been closed. Rites of worship have been changed, including the practice of passing round a cup from person to person during the Christian Holy Communion sacrament. Piot, who has done so much to help Africans through science, has provided those striving to contain an epidemic threatening the world with practical advice, the kind not normally handed out to American, European doctors, nurses, or other health workers, or soldiers from NATO who might soon be asked to go to war against an enemy they cannot see. See ‘Out of Africa’ on page 13 for comment on Ebola’s impact Trevor Grundy is a British journalist who lived and worked in Central, Eastern and Southern Africa and represented Time magazine, the BBC’s Focus on Africa, Deutsche Welle and the South African broadcasting Corporation SABC. Today he is a researcher and author based in Kent, and an active member of the Commonwealth Journalists Association www.global global f i rst quar ter 2015 -br ief ing.org l 47


Global issue 20
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