"A girl was never ruined by books," my mother used to say. I've spent most of my life trying to prove that wrong.

Thursday, October 9, 2014

Ebola and Other Plagues: A Book to Put Them in Context

Laurie Garrett's book The Coming Plague: Newly Emerging Diseases in a World Out of Balance is nearly 20 years old but it offers very interesting background information about the first round of Ebola in Africa, plus important discussion of how diseases develop and spread.   Garrett is now  senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer, as well as being an engaging writer.

I had read this book several years ago when doing research on some medical matter at a time when AIDS was still little understood by the public.  The chapters on Ebola and Marburg diseases were fascinating.  While much has changed  since, the account gives some idea of how diseases emerged out of nowhere and then receded after less than a year.

What is puzzling is that the diseases seemed to burn themselves out.  This does not seem to be happening here, possibly because the outbreaks began in more densely populated, better connected parts of Africa than during the 25 previous episodes of the disease.  (For an interesting comment see: Ebola: The Tolling Bell.)  When people incubating the virus can travel, the risk of them contaminating others is great.  In earlier epidemics, Ebola appears to have been confined to relatively isolated villages and once everyone in contracted the disease and either died or survived and became immune, the outbreak was over.

The video attached is from Outbreak, a blockbuster disaster flick, that ends without the world ending, despite forecasts of universal doom.  Better to read Garrett's book or her trenchant piece Foreign Policy published Oct. 6, 2014.  She writes:  "First, a rapid point-of-care diagnostic that can find Ebola virus in a single droplet of blood must be developed. A point-of-care test avoids the need to ship samples to a laboratory and then wait for days to learn the results....I suggest the use of self-administered implements commonly used by diabetics to make a finger prick and squeeze out a droplet of blood. That droplet would go into a tiny plastic well -- an object about an inch in size that is internally coated with either DNA or antibodies that recognize specific genes or proteins found exclusively in the Ebola virus. If those viral markers are present, the device would glow with bioluminescence or change color -- the result would be observable with the naked eye...

"Finger-prick tests for Ebola are in development now at Senova, a company in Weimar, Germany; at a small Colorado company called Corgenix; and at California-based Theranos...One of these screening tests should soon meet the criteria of speed, accuracy, and ease of use necessary to prevent travelers' spread of Ebola; facilitate contact tracing; and, in the midst of the epidemic, tell who has the virus and who does not."







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