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Should You Be Afraid Of Ebola?

With the recent localized outbreak of Ebola in West Africa, much information and disinformation has made its way to the Internet and mainstreamed media outlets. Given the foggy haze of reality, I thought it would be helpful to publish a summary of important facts – as the science currently supports – about Ebola: how it is transmitted, treated, and even prevented.

Background

According to the WHO, Ebola is a hemorrhagic fever that, if left untreated, is often fatal (WHO, 2014). Infectious diseases have what are referred to as “incubation periods” that can be defined as the time-lapse between exposure to the infectious agent and first demonstrable symptom of disease. The symptomology of Ebola infection shares attributes with many other infectious diseases, such as fever, fatigue, sore throat, etc. This display of symptoms, similar to other diseases, can make an initial definitive diagnosis difficult. WHO (2014) indicates that suspected Ebola infections are diagnosed as a confirmed case typically using the following methods (taken direct from WHO, 2014):

  • Antibody-capture enzyme-linked immunosorbent assay (ELISA)
  • Antigen-capture detection tests
  • Serum neutralization test
  • Reverse transcriptase polymerase chain reaction (RT-PCR) assay
  • Electron microscopy
  • Virus isolation by cell culture

Transmission

WHO (2014) indicates that the prevailing thought for transmission is in the blood and meat of contaminated fruit bats or other infected animals in the affected region. Human-to-human transmissions are primarily attributed to an uninfected person coming into direct contact with the blood, secretions, organs, or other bodily fluids of an infected person.ebola-1024x591

To further put things into perspective, the recent image to the right published by authors Murray and Weber (2014), summarizes the reproduction rate (or, number of people likely to be infected after contact with an infected person). It illustrates the likelihood of transmission compared to other common infectious diseases.

As you can see, there is far more risk for contracting polio and whooping cough as compared to Ebola. The underlying fear of transmission may be in the fact that it is a devastating and often untreatable illness. In any case, if proper precautions are taken, as described below, the likelihood of infection is far lower than many other serious infectious diseases (i.e., polio).

Treatments

While there are many experimental products on the horizon, including vaccines and serums, as well as the existing drugs in the “statin” class, there are a few that are being used for the direct treatment of Ebola-infected patients. Below is a summary table of the available treatment options found in literature as of October 9, 2014.

ConsortiumNumber of MembersPremier Financial Services MembersLeader(s)Start DateFocus/Goal
R3CEV84DTCC, American Express, Bank of America Merrill Lynch, Wells Fargo, Citigroup, TD Bank, BBVA, Bank of New York Mellon, Northern Trust, HSBC, BarclaysR3, CEV2014General-purpose platform and technology to design and deliver advanced distributed ledger technologies to the financial services market.
Digital Asset Holdings15Deutsche Borse, J.P. Morgan, DTCC, ABN AMRO, Goldman Sachs, Santander, Citi, IBMDAH2014Capital markets – post-trade settlement. Building distributed, encrypted straight through processing tools to improve efficiency, security, compliance, and settlement speed.
Hyperledger Project 142J.P. Morgan, Barclays, Deutsche Bank, Wells Fargo, UBS, BBVA, Bank of New York MellonLinux Foundation, IBM, Cisco, Intel, SWIFT, DAH2015General purpose blockchain. Open source collaborative effort based on IBM’s Fabric codebase, which was created to advance cross-industry blockchain technologies. It is a global collaboration that includes leaders in finance, banking, the internet of things (IoT), supply chain, manufacturing, and technology. The Linux Foundation hosts Hyperledger as a Collaborative Project under the foundation.
Ethereum116J.P. Morgan, Santander, BNY Mellon, BBVA, Bank of New York MellonMicrosoft, Intel 2017Considering a more distributed approach to self-management rather than the more traditional leadership structure adopted by competing blockchain consortia like R3CEV and Hyperledger. Offers smart contract features that contain a virtual machine, executing peer-to-peer contracts using a cryptocurrency known as Ether.
Ripple75UBS, Standard Chartered, Santander, CIBC, Sumitomo Mitsui Banking Corporation (SMBC), MUFG, MizuhoGoogle, IDG Capital Partners 2012Payments. A real-time gross settlement system (RTGS), currency exchange and remittance network by the company of the same name. The Ripple Transaction Protocol (RTXP) or Ripple protocol is built upon a distributed open-source Internet protocol, consensus ledger and native currency called XRP (ripples).
Kinakuta35Ethereum FoundationMicrosoft,
ConsenSys
2016Working group dedicated to improving smart contracts security.

Prevention

Given the typical modes of transmission, the prevention methods fall into three broad categories per the WHO (2014):

  1. Reducing wildlife-to-human transmission
  2. Reducing human-to-human transmission
  3. Containing outbreaks

References

Chimerix. (2014). Frequently Asked Questions on the Potential use of Brincidofovir in the Ebola Outbreak. Retrieved from http://www.chimerix.com/c/discovery-clinical-trials/brincidofovir-ebola.php on October, 9, 2014

Koons, C., Chen, C., and Langreth, R. (2014). Ebola Drug by Tekmira May Be Used on Infected Patients. Bloomberg News

FDA. (2014). Guidance for Industry Product Development Under the Animal Rule. Retrieved from http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM399217.pdf on October 9, 2014.

Murray, M. and Weber, M. (2014). How contagious is Ebola? Retrieved from http://blog.thomsonreuters.com/index.php/how-contagious-is-ebola-graphic-of-the-day/ on October 9, 2014

Qiu, X., Wong, G., Audet, J., et al. (2014). Reversion of advanced Ebola virus disease in nonhuman primates with ZMapp. Nature 514 pp. 47-53.

WHO. (2014). Ebola Virus Disease. Retrieved from http://www.who.int/mediacentre/factsheets/fs103/en/ on October 9, 2014.

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Rodney Lemery

Dr. Rodney Lemery specializes in the implementation, support, and development of software used in the collection, management, and analysis of clinical data. His accomplishments as director of safety and pharmacovigilance at Perficient include the management of numerous clinical application implementation projects. In addition to his expertise in clinical and safety applications, Rodney is able to navigate between the technical and clinical worlds with ease due to his complementary educational background in epidemiology. He also holds a part-time professorship in the School of Health Sciences at Walden University, which solidifies his ability to lead global safety implementations at Perficient. Rodney has been with Perficient, via the acquisition of BioPharm Systems, since 2000. Prior to joining the company, he worked at Pfizer.

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