By Dr. Anthony Policastro

Much has been made of the current Ebola outbreak in Africa. There have been 16 recorded Ebola outbreaks in the Congo prior to the current one. All were handled. This time, the World Health Organization (WHO) has issued a special warning.

One might wonder why this one is any different. This one is taking on the makings of a perfect storm. There are many subplots. When added together, they present a worrisome future outlook.

The Ebola virus is carried by the fruit bat. Humans get it from contact with them. The most common strain of the virus is known as the Zaire strain. Because it is common, antiviral agents have been found to treat it. In addition, there is now a vaccine for it.

The current epidemic is caused by the Bundibugyo strain. It is not clear that any of the antiviral medications used for other strains will work. There is no vaccine for it. That would take six to nine months to develop. So this strain is less treatable.

A second factor is that the rapid field test for the virus detects the Zaire strain. It does not test for the new strain. For that reason, it was not identified until three weeks after the epidemic started. That was when laboratory sequencing of the virus finally occurred.

That delay allowed the virus to spread much further than in other outbreaks. For example, it had already spread to Uganda before it was identified. Uganda and nearby Rwanda now have border closures for that reason. However, that approach has been tried in the past without much success.

Once the actual virus was identified, there were an inadequate number of test kits available for that particular strain. That delayed diagnosis. For that reason, we still are not sure of the exact number of cases or number of deaths.

All Ebola viruses have a high mortality rate. The current strain has a 30 to 50 percent mortality among contained cases. Unfortunately, deaths have been high in the health care workers caring for these patients.

Secretions from infected individuals can cause human-to-human infection. That may be from blood, saliva or sweat. The religion in the area has a burial process that helps spread it to people doing the burial. They are angry with health care workers for not allowing them to follow their religious practices.

To complicate matters more, there is a great amount of tribal warfare in the affected areas. This hinders the ability to get into those areas and do testing.

The bottom line is that this current epidemic is spreading further and faster than any of the previous 16 outbreaks. It is clearly following a different course. Until we know more, WHO will continue to monitor the situation closely.

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