CONAKRY, Guinea– A mystery plane, Ukrainian upheaval and an Olympic trial (of the criminal sort) headlined a mid-March media craze that had the globe glued to news outlets for late-breaking developments. On March 22, a health headline joined the fray, adding to the chaos and collective sense of doom.
The cause? Ebola, a fierce, incurable hemorrhagic fever. Central and West African nations familiar with mechanisms of Ebola fevers fear their sky-high mortality rates (in some cases, up to 90%). Thanks to the 1995 blockbuster Outbreak, westerners too, react to Ebola outbreaks with unease.
1976: Ebola Emerges
The first reported cases of Ebola were reported in 1976, when two simultaneous outbreaks struck villages in Sudan and the Democratic Republic of Congo (the latter is home to the Ebola river, the virus’ namesake). The villages’ tropical location and fruit bat (Ebola’s natural host) population defined them as risk areas for transmission.
To this day, all Ebola-related infections and mortalities have occurred in or originated from African strains (one varietal from the Philippines has yet to infect humans).
Animal hosts, namely primates and fruit bats, transmit the virus to humans in secretions, blood or other fluids that contaminate the environment. Any close contact with these byproducts or handling of infected animals poses a major infection risk.
Transmission, Signs and Symptoms
Once infected, a person can transmit Ebola to another through bodily fluids, including blood and seminal fluid. Infection risks to health-care workers underscore the importance of infection control procedures (principally, quarantine of infected persons for the entire duration of illness).
Ebola is most recognized for its unique and gruesome symptoms, distinguished by the internal and external bleeding that occurs in some patients (fever, vomiting, rash and impaired kidney and liver function are more typical).
Patients who lose the battle with Ebola generally expire due to severe dehydration and shock – rarely does blood loss play a factor. There is neither a cure for this hemorrhagic fever nor a therapy to treat it; rapid diagnosis is complicated by a lack of sufficient diagnostics and the speed of illness onset.
A whopping 50-90% of patients will not recover from Ebola-induced illnesses.
Guinea Ebola outbreak
On March 21, a laboratory in Lyon, France confirmed that Guineans experiencing a highly contagious fever-like illness were, in fact, living the Ebola nightmare.
Symptoms were first observed nearly six weeks prior, but the indistinguishable nature of the illness required further testing that was significantly delayed in transit between the small Western African nation and European labs.
By March 25, the World Health Organization (WHO) tallied the Guinea Ebola outbreak at 86 total cases (13 confirmed) with 60 deaths, for a cumulative mortality rate of nearly 70%. The Guinean Ministry of Health (GMOH) reports that the three affected districts are heavily forested areas on the border of Sierra Leone and Liberia.
A World on Edge
The infection has spread through the communities of Macenta, Guéckédou, and Kissidougou but not yet to Guinea’s capital, Conakry. Neighbors Sierra Leone and Liberia are on high alert; despite murmurs of suspected cases, the Centers for Disease Control and Prevention (CDC) has not yet confirmed Ebola outside of the country of origin.
The Western world, too, is on edge. A Canadian man recently returned from Liberia was hospitalized with acute fever-like symptoms, but ultimately tested negative for Ebola on the March 25.
Gregory Hartl, public relations guru for WHO, broke the news on Twitter via the Canadian government and North America breathed a sigh of relief.
How are Health Organizations Helping?
The GMOH and WHO are coordinating emergency response activities on a district, national and international level to plug up any potential transmission routes. UNICEF has also taken action, providing 50,000 pieces of soap, 1,000 bottles of rehydration solution and 5,000 packages of rehydration salts.
Dr. Mohamed Ag Ayoya, the Guinean representative for UNICEF, reports that Guinea’s poor medical infrastructure requires international assistance to keep an outbreak from spiraling out of control. “UNICEF has prepositioned supplies and stepped up … to inform and sensitize medical staff and the population,” Ayoya said.
Ensuring a proper Ebola education is as critical to the success of outbreak control as the provision of available medical equipment.
Misinformation Proves a Public Health Complication
Curbing misinformation has also been a battle for Hartl, whose antiviral activities are a double entendre at their core. His twitter account, @HaertlG, is riddled with admonitions of inaccurate articles and warnings against social media speculation.
The National Institutes of Health recognizes the transformative role of social media in disease surveillance and pandemic response activities in a 2012 article that identified Twitter as a “promising … health research tool.” The “microblogging” platform allows the CDC and WHO to track symptom clusters in real-time and could be a new source for big data on disease.Concerns abound, however.
#Outbreak: the Role of Social Media
Stephen Eubank, a professor at Virginia Polytechnic Institute and State University, admits that while social media allows for “democratic” communication, “anyone with access to a computer and an Internet connection can transmit information worldwide.” Validating the accuracy of these communications is a major hurdle for organizations hoping to harness health-related posts.
Eubank’s colleague, John Hopkins professor Josh Epstein, says that fear-induced responses to reports of outbreaks could hamper transmission prevention. Some people opt for isolation to protect against disease, while others engage in “fear-induced flight” which has “dangerous implications for the outbreak’s long-range spread.”
Ultimately, social media mavens must take responsibility for both the information they generate and the information they consume. Because unverifiable reports of infection may induce unnecessary panic on social media outlets, it is critical that bloggers, writers and tweeters exercise due diligence in vetting outbreak-related stories.
That effort frees up WHO officials like Hartl to expend precious resources of time and energy where truly needed – on the front lines of infection control.