Ebola: Current Understanding and Future Priorities

 

Professor David L. Heymann, M.D., Head and Senior Fellow, Chatham House Centre on Global Health Security and Professor, Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine

18th February 2015

 

Through meticulous reconstruction of the events that led to the first outbreak of Ebola in Yambuku, DRC (then Zaire) in 1976; and from continued research during and between successive outbreaks after 1976 until the present outbreaks in West Africa, a clear understanding of the epidemiology of Ebola has been gained.  From this understanding, and from successful containment of all pervious outbreaks while they remained in rural areas, three containment strategies have been shown to be effective:  rapid diagnosis and isolation of patients where infection control is able to prevent further spread; tracing of contacts of patients with temperature monitoring and rapid diagnosis of those who develop fever; and helping communities understand the means to stop transmission including the provision of safe and respectful means of patient and dead body transport and burial.  In some outbreaks attempts were made to treat patients using convalescent bloods from survivors, but there were no active research and development programmes for treatments and vaccines until there was a massive infusion of US funding in the early part of this century related to fears of bioterrorism.  There are now candidate vaccines, medicines and other treatments that have been shown to be effective in animal models, and the current sustained outbreak provides a means of testing them for efficacy in  humans.  Should they prove effective, they would then be of potential use in containing this and future Ebola outbreaks.