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RCSI
MATTERS
41
ON THE FRONTLINE
EBOLA
NEW ZIKA
THREAT:
UNANSWERED
QUESTIONS
here is a ot to earn
abo t the i a vir s
the atest disease
to hit the head ines
internationa y
accordin to Pro essor
am c on ey
We know that Zika can
be spread by day-biting
tropical mosquitoes of
Aedes genus, by sex and
by blood transfusion. e
virus has been linked to
babies in Brazil and in
French Polynesia who have
been born with small heads
and brains; a neurological
disease called Guillain
Barré and possibly other
neurological disorders.
e mosquito vector,
Aedes albopictus, are
widely found including
in Spain, Greece, Italy in
the summer, most of the
southern US and most of
tropical Asia, so, in theory,
Zika could spread widely in
summer 2016.
ere is no treatment, no
vaccine at present and
there is also the danger it
could start to spread in
new species of mosquito,
and extend its geographical
range; Zika may potentially
become a major global
health emergency.
Pro essor am
c on ey ead o
e artment nternationa
ea th ro ica
edicine
rovides
an overview o the bo a
o tbrea the cha en es
it resented and the
strate ies ado ted to dea
with it
Ebola virus disease emerged in
Sierra Leone in 2014 as a dramatic,
unprecedented and terrifying
illness. I know the country well
from volunteering there during the
1990s war. While 24 known previous
outbreaks of Ebola in Africa have
stayed mostly in a few villages, this
one burned uncontrollably like a
wild re, from rural Guinea Conakry
where it began, to all of Liberia and
Sierra Leone, and parts of Nigeria,
Mali, Senegal, US, Spain and UK.
Why was this outbreak di erent? No
one in that area was expecting Ebola,
so it had already spread widely
before action was taken. No one in
Sierra Leone had the experience and
tools to accurately diagnose Ebola
in early 2014. West Africa is very
poor. Accurate diagnostic tests are
unavailable, so many people died
with fever unexpectedly and it was
labelled `malaria', without speci c
tests. Traditionally, a `good' burial
would include relatives and friends
touching and washing the body of
the deceased. e power, wealth and
capacity of the governments to make
a good plan and do a job was limited.
Several countries controlled Ebola
well, speci cally Nigeria and the
developed countries.
ere was one generation of spread
to healthcare sta in Spain and the
US; therea er, enhanced isolation
of patients, training and re-training
of sta , and provision of personal
protective equipment led to a halt.
In a peculiar irony, we have bene ted
from the Ebola outbreak by learning
better infection control, and learning
to get into the habit of rigorous
systematic adherence to good
practices.
AN OUTBREAK WITH A DIFFERENCE
A good day at the Kerry Town Ebola Treatment Centre.
RCSI MattersSRH.indd 41
03/03/2016 11:57