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Editorial

“Good News” From Africa?

February 2020
1044-7946
Wounds 2020;32(2):A8.

Dear Readers

As you may know, the Ebola virus has been found in certain animals, and occasionally people, since the 1970s in Africa. In 2014, the World Health Organization finally had to admit there was a major human outbreak of the Ebola virus in West Africa, but since then we have heard only sporadic reports from West Africa about the epidemic.1,2 After causing more than 28 000 cases and over 11 000 deaths, the disease was “officially” declared “under control” in Liberia, Guinea, and Sierra Leone, as well as other countries in West Africa in 2016. As a result, we have had little information about the disease since, such as the status of the Americans who contracted the disease and survived.

There was concern about the long-term effects of the Ebola virus on the survivors. This has been confirmed with up to 77% of surviving patients having some continued complications, mostly musculoskeletal, ocular, and neurological complications.3 One of the more “famous” survivors, Dr. Kent Brantly, a family medicine physician who contracted the disease in 2014 while treating patients in Liberia, seems to be recovering well. I had the opportunity to meet and visit with him in November 2016. He was doing well but still recovering at that time. Dr. Brantly continues to regain his health, and as of December 2019, returned to Zambia, Africa, to continue his medical work. Dr. Brantly is an amazing inspiration to us all.

But what about the disease? Perhaps it is under control in the aforementioned countries, but there has been another outbreak of the disease in the Democratic Republic of Congo (DRC) as of May 8, 2018. Since the news outlets have not covered it, the outbreak must not be a big deal, right? Wrong. As of January 16, 2020, there have been a total of 3409 cases of the Ebola virus with 2236 deaths; they are still checking the diagnosis on 516 cases.4 Detection and treatment has been hindered by the violence in that part of the DRC, which is preventing health care workers from working in the area. Médecins Sans Frontières (MSF) has pulled out of several areas because of threats to their hospitals and staff. In addition to a lack of health care workers, the disease is being spread by people infected with the Ebola virus in its early stages who are fleeing to other areas to escape the violence. Not only does this spread the disease, it prevents many patients from receiving early treatment. Because of the lack of control of the disease, the current outbreak is now the second largest Ebola outbreak in the world.4 

One of the advances in the prevention and treatment of the Ebola virus since our last update has been the development and use of a vaccine for the prevention of the disease. The vaccine was found to be very effective in preventing the disease. More than 236 000 people have been vaccinated in the past year. The programs have been vaccinating an average of 3000 people per month since the vaccine became available, but due to the violence, only 324 people were vaccinated in the month of November.4 

As can be seen, the devastating disease caused by the Ebola virus is still a major problem worldwide. Fortunately, the development of a safe and effective vaccine will help reduce the devastation caused by the disease. Unfortunately, religious beliefs, social violence, and governmental failures still allow the disease to spread and kill those in under-resourced countries. Hopefully, public health goals will be realized, and care will be available to those in need. The most important thing to remember is that even in this day of instant and constant news coverage, just because you are not hearing about a problem does not mean it no longer exists or has been resolved.

References

1. Treadwell T. All nations deserve compassion. Wounds. 2014;26(8):A9. 2. Treadwell T. Out of sight, out of mind. Wounds. 2015;27(3):A6,A7. 3. Etard JF, Sow MS, Leroy S, et al ; Postebogui Study Group. Multidisciplinary assessment of post-Ebola sequelae in Guinea (Postebogui): an observational cohort study [published online January 14, 2017]. Lancet Infect Dis. 2017;17(5):545–552. 4. Soucheray S. Three new Ebola cases confirmed as MSF warns of instability. CIDRAP News. January 16, 2020. http://www.cidrap.umn.edu/news-perspective/2020/01/three-new-ebola-cases-confirmed-msf-warns-instability

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