Don’t forget vital lessons
The home of the deadliest Ebola outbreak in history has finally been declared free from transmission of the virus. Guinea, in West Africa, was cleared by the World Health Organization on Tuesday, 42 days after the last person there who was still infected with Ebola had tested negative.
It was appropriately hailed as an important milestone in the defeat of an epidemic that killed more than 11,300 people — five times more than all other documented Ebola outbreaks combined. More than 28,600 were sickened and the Ebola virus spread for the first time to North America, where it triggered fear in millions of people.
Now, two years after claiming its first known victim, a 2-year-old who died in a small village in east Guinea in late December 2013, the virus has been beaten into submission. That leaves Liberia as the last country still watching the calendar and counting down days from its last known transmission.
But this is no cause for complacency. On the contrary, the epidemic’s up-and-down history illustrates the importance of maintaining an aggressive response to Ebola.
WHO experts and their partners internationally and in West Africa are pledging to stay vigilant, including in Guinea. This is essential because the Ebola virus is remarkably persistent. Even after being cleared from a survivor’s bloodstream, it can linger in the semen of some males for as long as a year.
WHO has announced that Guinea is now entering a 90-day period of “heightened surveillance” to ensure any new “flares” of the virus are quickly identified before spreading to other people.
“The coming months will be absolutely critical,” said Dr. Bruce Aylward, a key member of WHO’s Ebola response team. The organization’s outbreak response crews will remain in Guinea, Liberia and Sierra Leone through 2016, he said, “to prevent, detect and respond to any new cases.”
That commitment marks a welcome shift from WHO’s unsatisfactory response in the early stages of this epidemic, signalling that much has been learned from past failures. In addition to vigilant monitoring, lessons include:
Resources must be mobilized as soon as a case is detected. WHO initially failed to grasp the immense danger posed by the outbreak. It declared a “public health emergency of international concern” eight months after the first known Ebola fatality, and after almost 1,000 people had died. That lethargy allowed the epidemic to spread to critical levels.
Teamwork is essential. Ebola was finally defeated through the combined efforts of more than 200 government agencies, aid organizations, hospitals and academic institutions from around the world. They were able to supply hard-hit areas with badly needed doctors, nurses, infection control experts, logisticians, lab workers, public health professionals, emergency specialists and “social mobilization” authorities.
Bold scientific innovation is vital. WHO backed deployment of experimental drugs in a desperate effort to stem Ebola’s deadly tide, and it appeared to work. In particular, a new vaccine pioneered in Canada was described as a “game changer” in the battle against the outbreak. Dubbed VSV-EBOV, the new compound was developed by scientists at the Public Health Agency of Canada’s national Microbiology Laboratory in Winnipeg.
Smarter work is needed at the grassroots level. An important strategy in ultimately defeating the virus was simply having volunteers go house-to-house in an affected area to explain the risks posed by Ebola. Finding ways to safely dispose of infected bodies was key. And researchers had a great deal of success using a “ring vaccination” approach, going out in the field to immunize everyone they could find who had been in recent contact with a known Ebola patient.
Humanity will never be free of the menace posed by stubborn pathogens such as Ebola, but it can do better to limit their deadly toll. Lessons learned over the past two years must not be forgotten. With any luck, these insights could spare the world from having to endure another disaster caused by this horrific virus.