Friday, September 12, 2014

Osterholm: What We’re Afraid to Say About Ebola



# 9067


Epidemiologist and CIDRAP director Michael Osterholm, in an editorial that appeared last night in the New York Times, outlines two possible scenarios that `should keep us up at night’  in West Africa’s Ebola outbreak, should it not be brought under control soon.  Helen Branswell also published an interview this morning with Osterholm.


  • The first is that the Ebola virus spreads from West Africa to other developing nations, and begins to spread in megacities like Lagos, Nairobi, or even Mexico City or Karachi.
  • The second, even more ominous scenario, would see the virus mutate into an airborne pathogen, and begin spreading like an influenza pandemic around the world.

While Ebola has remained relatively stable over the nearly 40 years it has been studied, outbreaks in humans have been limited, and long chains of infections have been rare.  With this current outbreak, the virus is getting  unprecedented practice in adapting to the human host as it spread from human-to-human-to human. 


What adaptive changes might arise from this prolonged and unprecedented serial passage experiment are impossible to predict, but the potential exists for something to emerge we really, really don’t want to see.


This is a possibility we broached a couple of weeks ago in Study: Ebola Virus Is Rapidly Evolving, and was also briefly mentioned by CDC Director Dr. Thomas Frieden last week in a CDC Press Briefing On Ebola. 


It was also alluded to in yesterday’s Eurosurveillance Journal editorial (see Stopping Ebola & R0 Calculations) and in Tom Clarke’s blog (see Conventional Wisdom And Epidemic Disease Spread) featuring Professor John Edmunds.


First a link to the NYTs piece, then Helen’s interview.  Both are well worth reading in their entirety.


What We’re Afraid to Say About Ebola


THE Ebola epidemic in West Africa has the potential to alter history as much as any plague has ever done.

There have been more than 4,300 cases and 2,300 deaths over the past six months. Last week, the World Health Organization warned that, by early October, there may be thousands of new cases per week in Liberia, Sierra Leone, Guinea and Nigeria. What is not getting said publicly, despite briefings and discussions in the inner circles of the world’s public health agencies, is that we are in totally uncharted waters and that Mother Nature is the only force in charge of the crisis at this time.

There are two possible future chapters to this story that should keep us up at night.

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September 12, 2014 Updated : September 12, 2014 | 6:24 am

Where is Ebola outbreak going? Nowhere good

By Helen Branswell The Canadian Press

TORONTO – The unprecedented spread of the Ebola virus in West Africa may be pushing the world towards a viral disaster, a commentary published in Friday’s New York Times suggests.

The article reveals that experts are worried ongoing transmission of the virus through people runs the risk of giving rise to mutations that will allow Ebola to spread through the air, like some of the world’s most contagious viruses. The virus currently spreads via contact with contaminated bodily fluids.

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