Disease outbreaks often follow an 'iceberg' pattern where visible cases represent only a fraction of the total, with health worker deaths indicating a more developed outbreak than initial numbers suggest; urban environments pose the greatest risk for disease spread due to close population proximity, and effective response requires parallel development of vaccines and therapeutics while mobilizing infection control resources, with research priorities often influenced by historical outbreak frequency of specific disease variants.
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Should we be worried about the latest Ebola outbreak? | 7.30Added:
An outbreak of Ebola in Central Africa has been declared an emergency of international concern by the World Health Organ at World Health Organization. That's below pandemic level. There have been around 250 suspected cases and 80 deaths in the Democratic Republic of Congo and Uganda.
Jane Halton previously led the Federal Health Department. She's now the chair of the Coalition for Epidemic Preparedness and joins me from Geneva.
Jane Halton, welcome.
Evening, Sarah.
Information is obviously coming in even as we speak. How wide could the outbreak already be? Usually health worker deaths suggest a more developed outbreak than the numbers suggest.
That's right. And we actually think this one is in common with other outbreaks we've had a bit like an iceberg. So, what we see at the top of this and you've already gone through the numbers as best we know them at the moment. But, what we know is there's a much larger and disguised volume of cases and we actually believe deaths as well that we haven't yet got full visibility of. So, it's already pretty wide and it's certainly very worrying. And what happens if this particular strain of Ebola takes hold in the cities in Central Africa?
Well, of course, any very congested urban environment is the worst kind of place these outbreaks can get into because it's very difficult to actually provide the sort of the protections that we need not just for health care workers, but also for ordinary people going around their daily businesses.
People live very close to each other.
This particular virus spreads through bodily fluids and whilst it's not like a respiratory virus and everyone's familiar with that when we had COVID, but this is still a very easy environment in which this kind of virus can spread. And because this particular variant isn't something we currently got a vaccine for. Even treatments, we're not quite sure what to do. That means if it spreads in urban environments, we have an enormous problem on our hands.
So, this may not be a question you can answer, but how long would it take to develop either vaccines or specific therapeutics for this strain?
Well, it won't surprise you to know that here in Geneva that is exactly what we are talking about and what everyone is talking about. Uh we believe there are a couple of what we call pre-clinical candidates, one of which we have an interest in. And so, there are already steps being taken. In fact, I've been in a meeting about this already today to make sure that we start the manufacturing work of some of these candidates whilst we actually do the other scientific and investigation work.
In other words, we don't waste any time.
Now, I do want to make the point and this is always the case with the work we do. We never use something without doing all the proper testing. But, we we If we wait, if we wait, we will delay anything that we have that's successful being available and that's what we're doing.
And it's the same with therapeutics. So, people are all over these issues, working really, really hard to see how we can speed up to provide people with the kind of help that they need at this very difficult time. There have been various outbreaks of Ebola over the years. They have been contained. Why not this time?
Yes.
Well, again, think about this. When we first discovered Ebola and it's probably about oh, maybe 35, 40 years ago now, there were no vaccines and nobody had any idea about treatments. We now know what we need to do in terms of infection control, but absent a vaccine and because this particular variant, the Bundibugyo variant, is not one that has happened to have outbreaks very often. So, it's been lower down the research priority and that's why everyone is now scrambling. And containment takes effort. It takes healthcare workers. It takes the kinds of materials for infection control. And all of that is being mobilized as we speak. But these are difficult environments, remote, very traditional people, and very very hard to get to. So talking about though you mentioned them earlier but the healthcare staff in Congo now and and over the border in Uganda, do they have access to the kind of protective clothing they need to deal with people with this with this type of disease?
Well, yes, they do have access. Whether they've got enough access is something that people are focused on.
The African Center for Disease Control, Africa CDC, is working with the governments in those countries plus all other international partners to make sure that we mobilize exactly those supplies.
Of course, healthcare workers are right on the front line and we already know that we've got cases in the healthcare worker population coming from those very early cases before this was identified.
So that we can scramble to deliver and do that pretty quickly. It's the longer-term therapeutics and vaccines that we really are going to have to focus on for the next little while. And And just briefly in the meantime, will there be any consideration of limiting travel from those parts of Central Africa to the rest of the world?
Well, this is something which every country thinks about. We encourage all countries to be transparent so people can understand those things. And obviously managing things like symptoms and making sure information is widely available. There aren't travel restrictions being discussed at the moment. If the outbreak gets very much wider, obviously those conversations will happen but certainly not right at this moment. Jane Halton, thank you very much indeed for talking to us this evening. I appreciate it.
Pleasure.
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