"There is hope!"
January 2, 2015 12:30 PM Subscribe
As the West African Ebola epidemic stretches into its 10th month: researchers have identified the likely cause of the initial outbreak: a young boy playing with bats in a village in Guinea. The NY Times considers how the opportunity to contain the epidemic was missed and the effects of Ebola on West African economies. Vanity Fair takes a look at the failure to contain the disease within Guinea, Frontline goes to "Ground Zero" in Guinea, and searches for a missing Ebola patient. Meanwhile, West Africans welcomed Christmas (previously) and the New Year. Africa Stop Ebola!
Heartbreaking for Etienne Ouamouno and all those like him. To lose his infant daughter and pregnant wife in such a horribly way. I can't imagine.
posted by sbutler at 1:00 PM on January 2, 2015
posted by sbutler at 1:00 PM on January 2, 2015
a young boy playing with bats in a village in Guinea
Poor little guy. He was 2 years old, barely more than a baby.
.
posted by leotrotsky at 1:00 PM on January 2, 2015 [4 favorites]
Poor little guy. He was 2 years old, barely more than a baby.
.
posted by leotrotsky at 1:00 PM on January 2, 2015 [4 favorites]
reading the above article on the west african economies, it struck me that fear of ebola might, if nothing else, also slow the spread of AIDS. ABC.
posted by OHenryPacey at 1:22 PM on January 2, 2015
posted by OHenryPacey at 1:22 PM on January 2, 2015
Wikipedia: Patient Zero
Radiolab: Patient Zero
Radiolab: Patient Zero
The greatest mysteries have a shadowy figure at the center—someone who sets things in motion and holds the key to how the story unfolds. In epidemiology, this central character is known as Patient Zero—the case at the heart of an outbreak. This hour, Radiolab hunts for Patient Zeroes from all over the map.posted by standardasparagus at 1:31 PM on January 2, 2015 [1 favorite]
a really interesting article about the controversy over IV hydration alternatives
This is the article.
posted by Dip Flash at 2:38 PM on January 2, 2015 [2 favorites]
This is the article.
posted by Dip Flash at 2:38 PM on January 2, 2015 [2 favorites]
The shame of it is that Sierra Leone was growing at an impressive clip — before Ebola hit.The role of strong public institutions in preserving a strong economy - like having a working healthcare system - often gets taken for granted when things are just working and the economy is "growing at an impressive clip". Taken for granted until something like this.
posted by clawsoon at 2:41 PM on January 2, 2015
Fruit bat hunting and butchering are common activities in southern Guinea, therefore facilitating direct human contact. [from the first link]
Unfortunately this means that a new outbreak could begin at any time, even in the middle of the current one. Ultimately, only deployment of an effective vaccine will stop ebola.
posted by beagle at 3:16 PM on January 2, 2015
Unfortunately this means that a new outbreak could begin at any time, even in the middle of the current one. Ultimately, only deployment of an effective vaccine will stop ebola.
posted by beagle at 3:16 PM on January 2, 2015
only deployment of an effective vaccine will stop ebola
Please review your epidemiology, quality urban sanitation and well understood public health practices are completely effective. Ivory Coast nestled between several outbreaks is not having the magnitude of epidemic issues as countries with poor public health practices.
posted by sammyo at 3:33 PM on January 2, 2015
Please review your epidemiology, quality urban sanitation and well understood public health practices are completely effective. Ivory Coast nestled between several outbreaks is not having the magnitude of epidemic issues as countries with poor public health practices.
posted by sammyo at 3:33 PM on January 2, 2015
Actually, Cote d'Ivoire just hasn't had any cases yet, probably because they effectively closed borders with Guinea and Liberia. I seriously doubt the lack of Ebola in Cote d'Ivoire is due to their stellar public health systems; while it's true that Cote d'Ivoire is in significantly better shape economically speaking than Sierra Leone and Liberia, the post-election violence in 2010 did a pretty good job gutting a lot of their infrastructure. It could very easily have gone the other way.
posted by ChuraChura at 4:22 PM on January 2, 2015 [2 favorites]
posted by ChuraChura at 4:22 PM on January 2, 2015 [2 favorites]
a new outbreak could begin at any time,
Perhaps, but while there must be a reservoir of the virus in this population, it doesn't seem especially common or this would have happened earlier.
ChuraChura, I think you have a valid point, but this WHO paper from 2000 [pdf] ranked Cote d'Ivoire 137th, above Kenya and China, while Guinea is at 161st, Liberia 186th, and Sierra Leone dead last at 191st. This may well be the test that distinguishes "barely functioning" from "utterly hopeless".
My personal take is that the epidemic zone is not directly adjacent to Cote d'Ivoire and spans a fluid-border region touching all three of the affected states. It's not clear they could have kept it out if they'd tried; it was effectively already there.
posted by dhartung at 5:13 PM on January 2, 2015 [1 favorite]
Perhaps, but while there must be a reservoir of the virus in this population, it doesn't seem especially common or this would have happened earlier.
ChuraChura, I think you have a valid point, but this WHO paper from 2000 [pdf] ranked Cote d'Ivoire 137th, above Kenya and China, while Guinea is at 161st, Liberia 186th, and Sierra Leone dead last at 191st. This may well be the test that distinguishes "barely functioning" from "utterly hopeless".
My personal take is that the epidemic zone is not directly adjacent to Cote d'Ivoire and spans a fluid-border region touching all three of the affected states. It's not clear they could have kept it out if they'd tried; it was effectively already there.
posted by dhartung at 5:13 PM on January 2, 2015 [1 favorite]
That survey data is before a 2002-2008 civil war and then the subsequent 2010-2012 "post-election violence." I do think that Cote d'Ivoire's infrastructure at this point is more comparable to Liberia than China, especially in the northwest of the country closest to Guinea. Although there is some past experience with Ebola in CIV - the last case of Ebola to leave the African continent was a Swiss woman who was infected by a dead chimpanzee in western CIV, so it's not something the government has never considered before.
Regardless, though, your point about the location of initial infection is an important one. I believe it's the case that the area this epidemic erupted from is at least partially populated by an ethnic group that spans those porous borders. People hop on autobuses and taxis to see their families over the border in Gueckedou or Kailahun or Vanjaima (and bring their sister's 2-year-old, who just has a little bloody nose). It's hard to keep that sort of thing from happening. But I have friends who haven't been able to get across the border in Southwestern Cote d'Ivoire to see family in southeastern Liberia - a porous, difficult to control border if ever there was one (I accidentally swam to Liberia once) - because of public education campaigns, the closed borders, and, probably, a lot of fear.
posted by ChuraChura at 7:11 PM on January 2, 2015 [2 favorites]
Regardless, though, your point about the location of initial infection is an important one. I believe it's the case that the area this epidemic erupted from is at least partially populated by an ethnic group that spans those porous borders. People hop on autobuses and taxis to see their families over the border in Gueckedou or Kailahun or Vanjaima (and bring their sister's 2-year-old, who just has a little bloody nose). It's hard to keep that sort of thing from happening. But I have friends who haven't been able to get across the border in Southwestern Cote d'Ivoire to see family in southeastern Liberia - a porous, difficult to control border if ever there was one (I accidentally swam to Liberia once) - because of public education campaigns, the closed borders, and, probably, a lot of fear.
posted by ChuraChura at 7:11 PM on January 2, 2015 [2 favorites]
I believe it's the case that the area this epidemic erupted from is at least partially populated by an ethnic group that spans those porous borders. People hop on autobuses and taxis to see their families over the border in Gueckedou or Kailahun or Vanjaima (and bring their sister's 2-year-old, who just has a little bloody nose).
I have traveled in that border area (including, if I am reading maps correctly, very close to what is thought to be the beginning point of the current epidemic). At that time "porous" doesn't even begin to describe how open it was -- there was on-and-off active fighting in Liberia and Sierra Leone then, plus some small rebel activity in Guinea, and yet the border crossing was two posts on the side of the road and a couple of lounging teenage soldiers. If for some reason the soldiers weren't letting people through that day, you could walk about fifty feet off to the side in the jungle and never be seen from the road. There have been huge refugee movements back and forth across the borders in three directions for decades on top of the usual family and commercial traffic, and as you note the borders were superimposed on existing ethnic groupings and have never had much central control.
Again, this was a while back, but that area (especially near Gueckedou) had a serious wild-west feel to it. Lots of guns around, lots of idle young men, and the only army/police I saw were traveling in force and people avoided them. Rebel groups from each country used the camps to resupply and rest during the downtime, and were openly tolerated. Very little infrastructure existed outside of what the international aid organizations were providing to refugees, which itself created a lot of resentment because those services weren't being provided to locals and the government officials were openly on the take. At the military checkpoints on the highway, drunk or stoned soldiers openly demanded money while being pretty casual about where their guns were pointed and as long as you had the cash you could pass, no matter who you were or what you were carrying.
I liked visiting and would love to go back, but without some amazing restructuring of all three countries' governments to be able to provide effective public services in those areas, I don't see how you could effectively control future disease outbreaks. At that time there were a lot of people, from corrupt officials to rebels to smugglers to illegal refugees, who had a vested interest in keeping things loose and unstructured; I saw a lot of barriers to even very basic health outreach and control.
posted by Dip Flash at 7:50 PM on January 2, 2015 [2 favorites]
I have traveled in that border area (including, if I am reading maps correctly, very close to what is thought to be the beginning point of the current epidemic). At that time "porous" doesn't even begin to describe how open it was -- there was on-and-off active fighting in Liberia and Sierra Leone then, plus some small rebel activity in Guinea, and yet the border crossing was two posts on the side of the road and a couple of lounging teenage soldiers. If for some reason the soldiers weren't letting people through that day, you could walk about fifty feet off to the side in the jungle and never be seen from the road. There have been huge refugee movements back and forth across the borders in three directions for decades on top of the usual family and commercial traffic, and as you note the borders were superimposed on existing ethnic groupings and have never had much central control.
Again, this was a while back, but that area (especially near Gueckedou) had a serious wild-west feel to it. Lots of guns around, lots of idle young men, and the only army/police I saw were traveling in force and people avoided them. Rebel groups from each country used the camps to resupply and rest during the downtime, and were openly tolerated. Very little infrastructure existed outside of what the international aid organizations were providing to refugees, which itself created a lot of resentment because those services weren't being provided to locals and the government officials were openly on the take. At the military checkpoints on the highway, drunk or stoned soldiers openly demanded money while being pretty casual about where their guns were pointed and as long as you had the cash you could pass, no matter who you were or what you were carrying.
I liked visiting and would love to go back, but without some amazing restructuring of all three countries' governments to be able to provide effective public services in those areas, I don't see how you could effectively control future disease outbreaks. At that time there were a lot of people, from corrupt officials to rebels to smugglers to illegal refugees, who had a vested interest in keeping things loose and unstructured; I saw a lot of barriers to even very basic health outreach and control.
posted by Dip Flash at 7:50 PM on January 2, 2015 [2 favorites]
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posted by Dip Flash at 12:34 PM on January 2, 2015