“… if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days.”

“Just seven weeks after an Ebola outbreak was discovered in the Democratic Republic of Congo, it’s already looking like the end is in sight.
According to the DRC’s health ministry, as of June 28, all people who were potentially exposed to the Ebola virus have finished a 21-day incubation period. It can take that long for a person exposed to Ebola to show symptoms of the disease. All those people remaining healthy means the epidemic is under control.
Oly Ilunga Kalenga, the DRC’s health minister, said in a statement, “This is an important milestone in the Ebola response, as it marks the start of the countdown towards the end of the ninth Ebola outbreak in the Democratic Republic of Congo.”
It’s also a testament to what can happen when national and international health officials work together to swiftly stop the virus from harming and killing people. We know how to stop outbreaks of Ebola, and we just proved it again in the DRC.
What this means is that with some effort and coordination, the world can rapidly stamp out an Ebola outbreak. What this doesn’t mean is that the world is ready for the next pandemic…
Still, it’s too early to declare total victory over Ebola or any other pandemic threat for several reasons…
This combination of experience with a known virus, a vaccine, and a relatively convenient geography won’t be there in every outbreak. That’s why it’s too early” (A)

“The DRC’s previous experiences with Ebola has also proved useful. The MSF rapidly employed 470 trained experts in the field, mainly locals – who all knew how to deal with an outbreak. Extensive surveillance, rapid detection and diagnosis are key, as well as comprehensive tracing of contacts, prompt patient isolation, supportive clinical care and rigorous efforts to prevent and control infection. And then there is the question of safely engaging local and remote communities with appropriate and dignified burial of the victims.
The response “has been swift and rigorous”, says professor Peter Piot, director of the London School of Hygiene and Tropical Medicine and part of the team that first discovered the virus. “The DRC has a strong record of containing Ebola outbreaks, and I am not surprised the Congolese are once again doing a good job,” he adds.
Crucially, in the DRC there has been no deadly delay in administering intravenous fluids. The DRC Ministry of Health, MSF and other NGOs quickly set up several Ebola treatment centres. There is a 12-bed unit in Mbandaka and a 20-bed centre in Bikoro, which also has a survivors’ clinic for post-Ebola complications and mental health issues. Further afield in Kinkole, the suburbs of the capital Kinshasa, there is a ten-bed unit that was completed with training of health care workers covering personal protection measures, treatment procedures and transport of patients. There is also a unit in Itipo.” (B)

“Ebola is endemic to Congo’s rain forests. Because of its prevalence in the country, Congo’s health officials have had more practice than anyone else in containing the virus, and they are generally reputed to be the most skilled at it in the world.
But Ebola is not a virus that one simply contains and forgets about.
“As Ebola is a virus whose natural reservoir is located in the Equatorial Forest, we must prepare ourselves for the 10th Ebola outbreak,” said Ilunga.
“Moreover, with the greater mobility of the population, we can expect to have other outbreaks in urban zones in the future. We must learn the lessons from this response and strengthen our system in order to detect and respond even more efficiently to the next outbreak.”” (C)

“On average, in one corner of the world or another, a new infectious disease has emerged every year for the past 30 years: mers, Nipah, Hendra, and many more. Researchers estimate that birds and mammals harbor anywhere from 631,000 to 827,000 unknown viruses that could potentially leap into humans. Valiant efforts are under way to identify them all, and scan for them in places like poultry farms and bushmeat markets, where animals and people are most likely to encounter each other. Still, we likely won’t ever be able to predict which will spill over next; even long-known viruses like Zika, which was discovered in 1947, can suddenly develop into unforeseen epidemics.” (D)

“The first confirmed human case of Keystone virus has been diagnosed in a Florida teen, but it’s likely that infection with the mosquito-borne disease is common among state residents, researchers report.
The virus can cause a rash and mild fever. It’s named after the location in the Tampa Bay area where it was first identified in 1964. It has been found in animals along U.S. coastal regions from Texas to the Chesapeake Bay.
University of Florida researchers describe the case of a teenage boy who went to an urgent care clinic in North Central Florida with a rash and fever in August 2016, during the Zika virus epidemic in Florida and the Caribbean.
Tests on the patient were negative for Zika or related viruses, but did reveal Keystone virus infection, according to the study published June 9 in the journal Clinical Infectious Diseases.
“Although the virus has never previously been found in humans, the infection may actually be fairly common in North Florida,” said corresponding author Dr. J. Glenn Morris. He is director of the university’s Emerging Pathogens Institute.
“It’s one of these instances where if you don’t know to look for something, you don’t find it,” he added in a university news release.”” (E)

“A bird flu that started in China five years ago has slowly started to spread. Some experts worry it could be this year’s “Disease X.”
New fears are starting to grow as there’s a strain of bird flu that’s killed over one-third of those it infects. Some experts warn that it has the potential to be the next pandemic.
As of June 15, 1,625 people in China have become infected with this virus and 623 are now dead — a total of 38 percent…
However, one good piece of news is that the virus doesn’t infect humans very easily. Most bird flu infections are transmitted between birds and only spread to humans who have close contact with the animals…
Although this virus was found in China, experts worry that in today’s globalized world it can have ramifications across continents.
This year, experts have already detected cases of global spread: Two cases of the virus were seen in Canada and one case in Malaysia. The CDC also reported that two cases of H7N9 were found on farms in Tennessee last year, despite having weaker features for human transmission.” (F)

“Reports are now emerging that these efforts succeeded and officials are cautiously optimistic that the outbreak is over. Health workers used a “ring vaccination” strategy in which all contacts of known patients were vaccinated to stop the spread. Surprisingly, the acceptance of the vaccine was very high with almost everyone offered the vaccine agreeing to be vaccinated. Furthermore, the supply of Merck’s vaccine is far from exhausted. The company has a stockpile of 300,000 emergency use doses.
J&J is still pushing forward with their vaccine efforts as well. While Merck’s vaccine is ideal for “ring vaccination”, J&J’s approach uses a two-part vaccine which could enable it to be longer lasting. Thus, these vaccines could complement each other. J&J has already tested its vaccine on 5,000 volunteers in 11 different trials and has confirmed both its safety and its ability to generate an immune response.
Here are two of the world’s largest pharmaceutical companies working on an Ebola vaccine – a vaccine that offers NO potential for financial return. These same R&D efforts could easily be used to find vaccines that are needed in the western world, vaccines that certainly would prove to be financially rewarding…” (G)

“The next global epidemic is likely around the corner—and no amount of U.S. retrenchment from globalization will halt that outbreak at the U.S. border…
Klain identified several large gaps in U.S. preparedness for the next global outbreak.
• A leadership gap. “There is no one at the White House right now who is in charge of this problem,” Klain said.
• A funding gap. “We’re underfunding, underinvesting” in preparedness, he said.
• A facilities and training gap. Klain said that there was exhaustive training of first responders carried out right after the Ebola outbreak in 2014. But there are other diseases for which they are still unprepared. “Training needs to be renewed. People need to be drilled,” he said. “Our first responders need to be trained. We need better and more facilities.”
• A science gap. “We haven’t yet developed all the vaccines and the therapeutics we need,” Klain added.
• A policy gap. “The holes in American law that we need to fill about licensing people in medical emergencies to practice in other states or,” he said, “using the Stafford Act”—the federal law that governs relief and emergency assistance for state and local governments during a natural disaster—“to respond to emergencies.”
But the biggest gap, he said, is the global gap: “We can’t be safe here in America when there’s a risk of pandemics around the world,” Klain said. “The world’s just too small. Diseases spread too quickly. … There is no wall we can build that is high enough to keep viruses and the disease threat out of the United States. We have to engage in the world.”” (H)

“Ebola is one of a series of previously unknown diseases – others include Sars and Zika – that have recently appeared without warning and devastated communities, having jumped from animal populations to humans. HIV spread to humans from chimpanzees, for example.
And in future new killers will emerge as humans spread into previously inaccessible areas and come into contact with infected creatures, causing deadly new pandemics.
Now a group of scientists believe they have solution. They have launched a remarkable new project which aims to spot the next pandemic virus. The international initiative is known as the Global Virome Project (GVP) and it aims to pinpoint the causes of fatal new diseases before they start to make people ill.
Advocates of the project say they will achieve this remarkable task by genetically characterising viruses found in wild animals – particularly those that have been major sources of viruses deadly to humans. By pinpointing viruses at greatest risk of infecting humans,, counter-measures, such as vaccines can be prepared.” (I)

“The big picture: The total number of outbreaks every 10 years “has more than tripled since the 1980s,” Yong says. Bill Gates told Yong that if there was a severe flu pandemic, more than 33 million people could be killed across the world in 250 days.
“Boy, do we not have our act together.” — Bill Gates” (D)

(A) Good news: the Ebola outbreak in DRC is contained, by Julia Belluz, https://www.vox.com/2018/6/29/17518144/ebola-outbreak-drc-contained
(B) How science beat Ebola, by Alexander Kumar, http://www.wired.co.uk/article/ebola-vaccine-outbreak
(C) We Have Some Great News About The Ebola Outbreak in Congo, https://www.sciencealert.com/congo-ebola-outbreak-may-be-finally-contained
(D) The Next Plague Is Coming. Is America Ready?, by Ed Yong, https://www.theatlantic.com/magazine/archive/2018/07/when-the-next-plague-hits/561734/
(E) Florida teen first human case of another mosquito-borne virus, https://medicalxpress.com/news/2018-06-florida-teen-human-case-mosquito-borne.html
(F) This Strain of Bird Flu Kills One-Third of Patients, by Rajiv Bahl, https://www.healthline.com/health-news/this-strain-of-bird-flu-kills-one-third-of-patients#5
(G) Big Pharma Rises To The Ebola Challenge, by John LaMattina, https://www.forbes.com/
(H) How Will Trump Lead During the Next Global Pandemic?, Krishnadev Calamur, https://www.theatlantic.com/health/archive/2018/06/the-next-epidemic/563546/
(I) Scientists aim to stop the devastation of Zika-like pandemics, by Robin McKie, https://www.theguardian.com/science/2018/jun/24/global-pandemic-prevented-map-animal-virus-ebola-sars-zika

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