infectious disease

Biopiracy and Vaccines

"Bromo Mountain In East Java, Indonesia" by suwatpo at freedigitalphotos.net
“Bromo Mountain In East Java, Indonesia” by suwatpo at freedigitalphotos.net

Mariah Tso, an undergraduate student, just posted a great summary of my article, “Biopiracy and Vaccines: Indonesia and the WHO Pandemic Influenza Plan” on the blog “Climate Vulture.” This blog is also a great resource for information on climate change. You can view the original article here. I also have a second article on influenza, which examines conspiracy theories and the 2009 pandemic, which is publicly available.

Shawn Smallman, Portland State University

New Map of MERS

European Centre for Disease and Infection Control map of MERS, November 2014
European Centre for Disease and Infection Control map of MERS, November 2014

I’ve discussed MERS before in this blog, but this virus has faded from public attention as Ebola has become a major health crisis in West Africa. This recent map by the European Centre for Disease and Infection Control, however, makes clear why MERS remains a global health challenge.

Shawn Smallman, Portland State University

Columbia Prediction of Infectious Diseases

Map of outbreaks of the Ebola virus in Africa by strain and confirmed contractions. Created by: Zach Orecchio, University of South Florida Geography Dep.
Map of outbreaks of the Ebola virus in Africa by strain and confirmed contractions.
Created by: Zach Orecchio, University of South Florida Geography Dep, Obtained from Wikipedia, Creative Commons.

One of the major questions that international agencies and governments have been wrestling with is the likely future of the Ebola epidemic in Africa. Perhaps the best website for these predictions is the Columbia Prediction of Infectious Diseases site. Unfortunately, despite the heroic efforts currently being made in West Africa, the curve towards mid-November shows a steady increase. Of course, there are success stories as well, as Nigeria has recently been declared Ebola-free. But this site indicates the scale of the challenge that world currently faces. The website is also useful for tracking yearly influenza epidemics.

At this date, a great deal rides on the outcome of Ebola vaccine trials. The Canadian government yesterday sent 800 vials of experimental vaccine to the WHO, for this organization to distribute as it sees best. The world is also increasing the supplies and manpower provided to West Africa. It is now clear that everyone underestimated the dangers of this outbreak, because Ebola had been controlled before. What has been different has been that this outbreak is taking place in an urban setting.

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Shawn Smallman, Portland State University

International Pandemics: An infographic

I was recently asked to share this great infographic, so I am posting it here. Many thanks to the folks at “Nursing School Hub.”

Shawn Smallman, Portland State University

What do we know about Ebola?

"Airline Route On World Map" by digitalart at freedigitalphotos.com
“Airline Route On World Map” by digitalart at freedigitalphotos.com

One of the questions now being raised is whether public health decisions are being based on sound science. At the center of this debate is the question of testing travelers from affected countries for fever, which some infectious disease researchers -and people in the countries themselves- argue is unlikely to be successful. But there is also the larger question of how much we know about the transmission of the virus. For a good discussion of these issues, see David William’s article in the “LA Times.” Williams interviewed C.J. Peters, a senior and respected figure in the field of infectious disease, who points out what we still don’t know about this virus.

Shawn Smallman

Ebola in the United States

"Anti Virus" by hyena reality at freedigitalphotos.net
“Anti Virus” by hyena reality at freedigitalphotos.net

With the arrival of Ebola in Texas, the media coverage of Ebola has increased dramatically. Reuters has a good video talking about the current situation with Ebola (click here). As the video discusses, people are starting to ask questions about mass transit and other technologies that bring people into contact. Could you transmit Ebola through the key pads for debit cards? Elevator buttons and handrails in public buildings. Cash? Is the United States so different that it could not have a significant Ebola outbreak? On the one hand, Ebola has been controlled in Nigeria through an effective health response. On the other hand, there are many things about Ebola that researchers are still learning, such as the implications of recent Canadian scholarship suggesting that Ebola can be spread by an airborne route in the lab. Ian MacKay (a key source for information on the outbreak) has a good blog post on the different meanings that “air-borne transmission” may have for a medical researcher as opposed to the lay person. The bottom line is that it may be possible in the lab, but is unlikely to be a major transmission route in the real world. But people have many questions, and there needs to be clearer information available. …

Ebola and “exponential growth”

WHO: Map of Ebola Cases in Guinea, Liberia and Sierra Leone as of 6 September 2014
WHO: Map of Ebola Cases in Guinea, Liberia and Sierra Leone as of 6 September 2014

The Ebola outbreak in West Africa has not received the resources it merits, in part because other Ebola outbreaks proved relatively easy to contain. Those epidemics, however, tended to take place in a rural context, and Africa has changed profoundly since the 1970s. The urbanization and transportation networks that are remaking the region have also meant that it is far easier for diseases to spread. The current outbreak is expanding exponentially. The latest map on the Ebola outbreak by the World Health Organization makes clear the scale of the challenge that the global community now faces. When you look at this map, keep in mind that these are confirmed cases. So this map is an underestimate. According to some calculations, there may be 100,000 cases in Africa by December. Without rapid and massive international aid, this outbreak will not be controlled. On Twitter? I recommend following Laurie Garrett (Pulitzer prize winner for her writing on public health), who has a great commentary on the outbreak, which includes key documents such as this map. If you are interested in global health, you might also be interested in my book on the AIDS Pandemic in Latin America.

Shawn Smallman, Portland State University

Ebola update

"3d Rendered Virus" by chrisroll
“3d Rendered Virus” by chrisroll

There is a great deal of news today about Ebola, which has now spread to Senegal, the fifth country in West Africa to be affected by the outbreak. The nation has tried to protect itself by banning flights from affected countries, but this is unlikely to be effective given that most people cross the border by ground transport. In Liberia the government has lifted the quarantine on the slum community of West Point, after widespread media reports that the quarantine was being flouted by people who bribed police to leave. At this time, quarantines do not seem to be effective in dense urban environments in developing countries; they are difficult to enforce, and the social costs are high. …

Ebola and Culture

"Wallpaper World" by Salvatore Vuono at freedigitalphotos.net
“Wallpaper World” by Salvatore Vuono at freedigitalphotos.net

A crowd of men recently overran an Ebola clinic in Liberia, after which 17 patients disappeared. One of the factors driving this event may have been a sense of denial that Ebola exists. Such concerns led to an improbable new pop culture hit in West Africa: a song titled “Ebola in Town.” In recent article on NPR (titled “`Shadow and `D-12′ Sing an infectious song about Ebola”) John Poole describes the emergence of this unlikely piece. At first, there would seem to be few things more inappropriate than a pop song about a fatal disease. But the song emerged from local concerns that people did not believe in Ebola, or understand how to fight the spread of the disease. For this reason, the song informs people about the appearance of Ebola, its spread through physical contact, the importance of social distancing and the dangers of bush meat. All with a catchy beat. Click here to read Poole’s article and hear the song. And bravo to NPR in general for their great coverage of the outbreak. Want to read more about the epidemic? One great source is Ian Mackay’s blog, Virology Down Under.

Shawn Smallman, Portland State University

 

Ebola and Denial in Liberia

"Virus" by ddpavumba at freedigitalphotos.net
“Virus” by ddpavumba at freedigitalphotos.net

Today a clinic in Liberia that cares for Ebola patients was overrun. The looters even stole a bloodied mattress, while patients left the facility. Everyone receiving care at the center had tested positive for Ebola, and seventeen of them had disappeared after this tumult. According to Elise Zoker and Caroline Chen’s piece in the Sydney Morning Herald, one of the attackers said that they did not believe in “this Ebola outbreak.” To many readers, it may seem inconceivable that people would choose to take people infected with a deadly and communicable disease back to their families or neighborhoods. It’s perhaps equally unthinkable that people would walk unprotected through a facility drenched in a virus so deadly that it should be contained in a biohazard level four facility, and then take an item soaked in the blood of an Ebola patient. But such strange behavior is not new; denial has always been a part of major disease outbreaks. When I read this news, it reminded me of the early history of HIV. …

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