Philandtropical

The family, filoviridae, of which the virus in question belongs, allows us to conjure up an image of the perpetrator; after all, the Latin filum alludes to its’ filamentous structure. A hidden threadlike set of molecules indeed. All filoviruses that have caused disease in humans have been endemic to sub-Saharan Africa only and it is here, in West Africa to be more specific, where the story of the biggest Ebola virus outbreak on record continues to unfold.

The virus was discovered less than 40 years ago in Zaire, by a team of Belgian scientists including The London School of Hygiene and Tropical Medicine’s current Director Professor Peter Piot, and was named after the nearby ‘Ebola’ river from where the scientists were investigating. The initial outbreaks were small in nature but the clinical features were devastating enough to spread fear across affected communities to wherever their stories reached.

To learn that a few strands of RNA transmitted by human contact, or possibly through the saliva or excreta of Rousettus aegyotiacus; or even the whole mammal on your dinner plate, can cause a visibly harrowing haemorrhagic fever with the capacity to kill within the space of twenty-one days, is enough to make the calmest of physicians exhibit cutis anserina. This is goose-bumps for the non medically adept layperson (myself included).

On September 9th, the World Health Organisation tallied 4,293 cases and 2,296 deaths across five West African countries which obliterates the previous record of 425 cases in Uganda during the 2000 – 2001 outbreak. Liberia is one of the worst affected countries, with the capital Monrovia so under-resourced to controlling the transmissions they are having to turn away up to 30 infected patients per day, according to Medecins sans Frontiers. The health systems in the affected countries are, quite clearly, struggling. Whilst the intermittent stories of recovery trickle through to offer the compulsory hope in any situation where it feels it does not belong, it is the realistic urgency from clinicians and scientists that has to be acted on to counter the frightening statistics on offer.

Esoteric as the virus may be, currently localised to an area of the world many of us will never venture, there holds a great degree of encouragement through seeing medical science funding bodies, such as the Wellcome Trust and Bill & Melinda Gates foundation, release emergency funds to help contain the Ebola epidemic. The experimental treatment ZMapp which was used to treat British Ebola patient and humanitarian nurse Will Pooley, alongside vector based vaccines, are considered promising prospects.

It is possible to download the full Manson’s Tropical Medicine chapter on Viral Haemorrhagic Fevers here, free, courtesy of The Wellcome Trust.