The man who discovered Ebola on why this epidemic spiraled out of control

[Pathfinder]

The man who discovered Ebola on why this epidemic spiraled out of control

Updated by Julia Belluz on September 29, 2014, 8:50 a.m. ET

Piot is now one of the world's foremost infectious diseases experts, and a former under-secretary general of the United Nations. He's been watching the world's largest-ever epidemic unfold from his post in London, and we spoke with him about his thoughts on the outbreak and how the global community can prevent future tragedies of this scale. This transcript has been edited for length and clarity.

JB: Before this year, could you have imagined an Ebola outbreak of this size?

PP: I never thought it would get this big. I always thought it was an accident of history where someone becomes infected ? from a bat probably ? and then an outbreak is contained. Ebola came and went. I really never thought this could happen. But it shows again: when the right, or bad conditions are all combined with each other, then these things will happen again.
...
JB: What is the biggest public-health threat on the horizon?

PP: The biggest threat remains a flu pandemic. There I think we're better prepared with early alerts and the good news is that China is quite open now. The first cases of flu often come from China. In more recent years ? still fortunately small outbreaks ? there was open and prompt reporting [to the international community about flu cases]. I think there we have made real progress. But I think it'll come back to the fact that there has to be some central leadership.

http://www.vox.com/2014/9/29/6851701...piraled-out-of

 

[Pathfinder]

Re: The man who discovered Ebola on why this epidemic spiraled out of control

'In 1976 I discovered Ebola, now I fear an unimaginable tragedy'

Rafaela von Bredow and Veronika Hackenbroch

The Observer, Saturday 4 October 2014 17.00 EDT
...
After Yambuku, you spent the next 30 years of your professional life devoted to combating Aids. But now Ebola has caught up to you again. American scientists fear that hundreds of thousands of people could ultimately become infected. Was such an epidemic to be expected?

No, not at all. On the contrary, I always thought that Ebola, in comparison to Aids or malaria, didn't present much of a problem because the outbreaks were always brief and local. Around June it became clear to me that there was something fundamentally different about this outbreak. At about the same time, the aid organisation Médecins Sans Frontières sounded the alarm. We Flemish tend to be rather unemotional, but it was at that point that I began to get really worried.
...
For the first time in its history, the virus also reached metropolises such as Monrovia and Freetown. Is that the worst thing that can happen?

In large cities – particularly in chaotic slums – it is virtually impossible to find those who had contact with patients, no matter how great the effort. ...

Have we completely lost control of the epidemic?

I have always been an optimist and I think that we now have no other choice than to try everything, really everything. It's good that the United States and some other countries are finally beginning to help. But Germany or even Belgium, for example, must do a lot more. And it should be clear to all of us: This isn't just an epidemic any more. This is a humanitarian catastrophe. We don't just need care personnel, but also logistics experts, trucks, jeeps and foodstuffs. Such an epidemic can destabilise entire regions. I can only hope that we will be able to get it under control. I really never thought that it could get this bad.
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The virus is continually changing its genetic makeup. The more people who become infected, the greater the chance becomes that it will mutate ...

... which might speed its spread. Yes, that really is the apocalyptic scenario. Humans are actually just an accidental host for the virus, and not a good one. From the perspective of a virus, it isn't desirable for its host, within which the pathogen hopes to multiply, to die so quickly. It would be much better for the virus to allow us to stay alive longer.

Could the virus suddenly change itself such that it could be spread through the air?

Like measles, you mean? Luckily that is extremely unlikely. But a mutation that would allow Ebola patients to live a couple of weeks longer is certainly possible and would be advantageous for the virus. But that would allow Ebola patients to infect many, many more people than is currently the case.

But that is just speculation, isn't it?

Certainly. But it is just one of many possible ways the virus could change to spread itself more easily. And it is clear that the virus is mutating.
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Der Spiegel

Full text:
http://www.theguardian.com/world/2014/oct/04/ebola-zaire-peter-piot-outbreak