In his blog overnight, Dr. Ian Mackay adds Senegal to his Ebola outbreak map, and makes an important point about the uniqueness of each disease outbreak, the human variables that drive them, and the danger of assuming that the public health responses of the past will always suffice in the future.
First a link to Ian’s blog, then I’ll be back with a comment.
According to it's Minister of Health, Awa Marie Coll Seck [1,2], a case of Ebola virus disease (EVD) has been imported from Guinea and it is confirmed by testing at the World Health Organization's collaboration Centre, the Pasteur Institute in Dakar.
Interesting that this occurred one week after Senegal closed its borders (again) with Guinea.[3,4] The infected Guinean student travelled on 29-August to Dakar where he presented to a hospital but did not admit to being in contact with known EVD cases. Senegal had closed its borders around 22-August.[5,6].
After forty years of outbreaks – all of which were geographically limited and comparatively small – Ebola had gained the reputation of being a horrific killer – but basically only of `local concern’.
Conventional wisdom said that it killed too quickly to allow those infected to spread the disease far. The virus simply didn’t have the `legs’ to spark a major outbreak.
Fast forward to 2014, and those assumptions are taking it on the chin. Not because the virus has changed, but because Africa has changed (a major point made in Michael Osterholm’s WaPo Article Aug. 1st).
Remote villages aren’t nearly as remote as they once were. Cars, busses, trains, even airplanes are far more common today in Africa than they were in 1976 when the virus was first detected. Society is more mobile today than ever before, and that applies to just about everywhere on this planet.
The world was caught flat-footed in its initial response to this Ebola outbreak – no doubt lulled by earlier successes in containing the virus - and that has allowed it to spread unchecked. Given its lack of `airborne’ transmission, I fully expect it will eventually be brought under control, albeit at a terrible cost.
The takeaway lesson here goes beyond Ebola, and well beyond the continent of Africa.
As the world changes, so do the capabilities of its pathogens. A side effect of modern society is that it has become the great enabler of infectious disease. A novel virus or resistant bacteria can hitch a ride in New Delhi or Shanghai this morning and can be in London, or New York by tonight.
Which means that we no longer have the luxury of ignoring `small disease outbreaks’ anywhere in the world, no matter how remote.
Because the next pathogen to crawl out of the woodwork may be far more `pandemic-ready’ than Ebola could ever be.