Ebola Archives - Maryn McKenna

Get Your Shots, Wash Your Hands, Thanks, and Goodbye

March 27, 2015 By Maryn Leave a Comment

IceNine (CC), on Flickr

A little less than 5 years ago, editor Betsy Mason of WIRED Science called to ask whether I’d be interested in joining a new thing. WIRED was thinking about starting a science blog platform; she wondered whether I’d want to be one of the bloggers.

I did very much want: WIRED is both a great magazine, with inspiring storytelling and innovative design, and a brand with international reach. I was a bit perplexed why they would want me — scary diseases didn’t seem like a core interest for WIRED readers — but Betsy (now one of the authors of WIRED’s Map Lab blog) was confident the audience was there.

She was right. Superbug debuted Sept. 14, 2010 with a report on the “Indian superbug,” the antibiotic resistance factor NDM that was then just starting to move across the world. My second post explored “livestock MRSA,” the bacterium that originates in antibiotic overuse in agriculture, and the third looked at the shivery subject of a rare and deadly parasite transmitted by organ transplants. Those three posts pretty much defined Superbug’s turf: public health, global health, and food policy, with a sprinkle of dread. Readers responded with fascination and good will, then and to the more than 300 posts afterward.

Of which, as you’ve probably guessed, this is the last. Superbug has had a fantastic run, but there was only one other place I wanted to work, and I’m headed there. Next week, I’ll be joining National Geographic’s Phenomena under a new blog name.

(Worth saying: This move is coincident with Wired.com’s redesign, but is not at all related. Phenomena happened to have a rare opening.)

[Read more…]

"We Are Not Ready": Ebola Analysis from Front-Line Workers (And Bill Gates)

March 23, 2015 By Maryn Leave a Comment

A volunteer gets sprayed a bleach mixture while training for a mission to support the German Red Cross in Liberia, Oct. 23, 2014. Markus Schreiber/AP

Bill Gates speaks at TED 2015 in Vancouver. (Image courtesy TED on Flickr (CC).)

We’ve just passed a difficult and little-noticed anniversary: Last week, the Ebola epidemic in West Africa achieved its first birthday. Though the viral outbreak has been contained, it is still not under control: According to the World Health Organization, cases continue in Sierra Leone and are rising again in Guinea. Liberia was about to record an entire incubation period without a new case — a signal that the chain of person-to-person transmission might have been broken — but on Friday, it announced that it had found a single new case. How that woman became infected is unclear; it is possible that she represents, not a new outbreak, but a brief interruption in an otherwise promising trend.

It has been decades since there was an epidemic of this persistence and magnitude. No other Ebola outbreak matches it; nor does the 2003 epidemic of SARS. You would have to go back to the early days of HIV in the 1980s, or to the flu pandemics in 1968, 1957 or even 1918, to find an outbreak that sickened so many people, challenged international response capacity so much, and instilled such fear in other countries.

The anniversary has triggered reflections. Some criticize the response to Ebola for being inadequate and slow. Others — such as two talks at last week’s TED conference, one by Bill Gates — extract lessons that should inform responses to future epidemics.

Because there will be future epidemics. That’s for sure.

[Read more…]

Ebola Could Cause Thousands More Deaths — By Ushering In Measles

March 15, 2015 By Maryn Leave a Comment

Women gather in the Guinean village of Meliandou, believed to be Ebola’s ground zero. Jerome Delay/AP

Awareness of Ebola is picking up again in the United States: An American volunteer who was working in Sierra Leone has contracted Ebola and been medevac’d to the National Institutes of Health Clinical Center for Ebola treatment, and 10 more volunteers have been brought back to NIH, Omaha and Atlanta, to be examined at three of the four institutions in the US that have safe units to house them.

It’s a reminder that Ebola still persists in West Africa: In the last period the World Health Organization reported on (the 7 days ending March 8), there were 116 new cases. One bit of good news: None of them were in Liberia, for the second week in a row. But Guinea and Sierra Leone, where this volunteer was infected, continue to struggle.

And in a research paper published as that volunteer was being flown back, there’s a reminder that the Ebola outbreak is creating layers of health risks for those countries. In Science , researchers from NIH and four universities warn that Ebola’s interruption of other health services, such as childhood immunizations, threatens to create secondary epidemics of preventable diseases that would dwarf Ebola’s impact. In particular, they warn that there could be 100,000 additional measles cases, and up to 16,000 additional deaths, if health services are not restored.

[Read more…]

Ebola's Not Over For Health Care's Volunteers

March 4, 2015 By Maryn Leave a Comment

EU Humanitarian Aid and Civil Protection (CC) on Flickr

You might have missed it, because we’re barely talking about it in the United States, but the African Ebola epidemic has still not died down: the World Health Organization identified 99 new cases in its most recent status report. And as long as the disease persists, the possibility exists that it could spread back out of that confined area to other countries. Which makes it a good time to consider several new reports of what happened to US health care workers involved in responding to Ebola, and how that experience still affects their lives.

Short version: Of two who contracted Ebola and survived, one remains ill and fears she was manipulated, and the other, though well, feels he was misrepresented and stigmatized. Both worry their experience will dissuade others from volunteering in turn. And a major new government report backs them up.

[Read more…]

Still Fighting Ebola: A View from Liberia's Front Line

February 16, 2015 By Maryn Leave a Comment

Nine-year-old Nowa Paye is taken to an ambulance after showing signs of the Ebola infection in the village of Freeman Reserve, about 30 miles north of Monrovia, Liberia. Jerome Delay/AP

We’ve pretty much signed off on Ebola in the United States — last week, President Obama withdrew the US troops sent to fight the disease — but in Africa, the news on the epidemic has seemed pretty good. The overall number of known cases stands at 22,894, with 9,177 deaths, far below the dire predictions made last fall that the epidemic could sicken millions.

Progress at beating the disease is stalling, though. According to the World Health Organization, the number of new cases has gone back up for two weeks in a row. Sierra Leone, now the outbreak’s epicenter, still has what the WHO calls “widespread transmission,” and on Saturday its government quarantined part of the capital. Guinea has had a spike in cases, and in several areas, mobs have attacked clinics.

The news is best from Liberia, where there were just three new cases last week compared to 65 in Guinea and 76 in Sierra Leone. Liberia was hard-hit, with 8,881 confirmed cases and 3,826 deaths — 300 cases per week at some points. But it also seems to have done the most to curb the disease’s spread: Today, schools that had been closed since last fall are supposed to open again.

Last week, though, I had the opportunity to speak to a front-line Ebola fighter in Liberia, and what he told me underlined how precarious that country’s progress is.

[Read more…]

The Long Tail of Ebola: Depressing African Economic Progress

January 12, 2015 By Maryn Leave a Comment

EpSos.de (CC), Flickr

It has almost completely vanished from the news in the United States, but Ebola persists in three countries in Africa: Liberia, Guinea, and Sierra Leone. The World Health Organization’s update today puts the case toll at 21,171 in those three countries, with 8,371 deaths. (Eight thousand deaths. Think about that, for a minute.)

But the uncomfortable reality is that the impact of Ebola reaches far beyond those individual cases. In reports issued today and in December — which I missed at the time, so am bumping it back up for reading now — the World Bank predicts that the disease will cripple the economies of these countries into the future.

[Read more…]

2015 Resolution: Accept that Diseases Hop Borders, Don't Dismiss Them, and Don't Panic

January 3, 2015 By Maryn Leave a Comment

Cogdog (CC), Flickr

Happy New Year, constant readers. There’s no question that the big public health story of 2014 was Ebola. The African epidemic has now racked up more than 20,000 cases, according to the World Health Organization, which has put together a useful map and timeline of developments since March. If you’d like to look back on the year, the best sum-up by far is the New York Times’ long and beautifully told “How Ebola Roared Back,” and for a sense of what we learned this year — and what we still don’t know — consider reading Helen Branswell’s account, published at the Winnipeg Free Press.

The international health community still must focus on Ebola; the disease is by no means contained. But my New Year’s wish, for those of us outside that community, is that we begin 2015 by accepting that wherever diseases occur, they are going to travel. We had repeated demonstrations of this with Ebola; and as a global community, we didn’t react well. (If you feel like revisiting the cringe-making details, the Today in Ebolanoia Tumblr is still up.)

The disease that really makes this case, though, is the antibiotic resistance factor NDM. Since its original discovery in one person in Sweden in 2008, this snippet of DNA — which makes common infections essentially untreatable — has been carried by patients to at least 40 countries, and spread within those countries to create local hospital outbreaks.

That’s a lot of border-crossing.

[Read more…]

Ebola Here and There: Knowing When It Is And Isn't Over

November 13, 2014 By Maryn Leave a Comment

The European Commission’s DG ECHO team (CC), on Flickr

It may have skipped your notice, but the United States is now Ebola-free. Dr. Craig Spencer was released from treatment in New York City Tuesday; that day also marked the end of the watch period for Kaci Hickox, the nurse force-quarantined in New Jersey and then allowed to go home to a remote town on the Maine border. The two nurses who treated deceased patient Thomas Duncan, Amber Vinson and Nina Pham, were both released from treatment two weeks ago. The health care workers who were sickened in Africa and came home for treatment have all gone home.

There are some things to note in these events. The first is that the Ebolanoia over the possibility of the disease spreading in the United States is now clearly shown to have been an over-reaction. No one got sick because Spencer went around New York City in the days before he developed symptoms. No one got sick, either, from contact with Kaci Hickox — and, an important point, she never developed symptoms herself. Her quarantine was self-evidently unnecessary. The only people to have contracted Ebola in the United States are the two nurses who were in close face-to-face contact with Duncan when he was floridly ill, and while the hospital that treated him, and the Centers for Disease Control and Prevention, were working out the best protective protocols.

So we really could calm down now. (Have you noticed how the chatter has died down? Especially since the election?) But we also shouldn’t forget that Ebola continues in West Africa, and could return to the US at any time.

Here’s an example of the continuing challenges: the West African country of Mali.

[Read more…]

African Scientist: African Corruption Made Ebola Worse

November 4, 2014 By Maryn Leave a Comment

Daliborlev (CC), Flickr

Since last week, there has been some good news on the Ebola front: a suggestion that the epidemic in Liberia is beginning to slow down, with fewer new cases reported. At the same time, there is a new outbreak in Sierra Leone, in a part of the country that thought it had beaten the disease and then self-quarantined to keep it at bay. So it is probably too soon to hope that the entire international outbreak is on its way to being extinguished.

At the same time, two major international medical meetings happening this week have allowed researchers to discuss the newest reports from the field — but not with equal success. The annual meeting of the American Society of Tropical Medicine and Hygiene, the largest medical society devoted to diseases such as Ebola, lost a significant number of attendees when the conference’s host state, Louisiana, threatened to forcibly quarantine anyone traveling from a country experiencing Ebola, whether or not that person had been exposed. Meanwhile, Vienna, Austria had no such qualms, and so the International Meeting on Emerging Diseases and Surveillance proceeded without any difficulties, allowing physicians and epidemiologists fresh from the Ebola zone to share reports.

It’s from that second meeting that this week’s news comes. Oyewale Tomori, president of the Nigerian Academy of Science and a leader of the World Health Organization’s Ebola response in 1995, used the IMED podium to deliver a stinging critique of the behavior of African governments during the current crisis, charging that internal corruption has crippled the continent’s ability to fight its own disease battles.

[Read more…]

The Grim Future if Ebola Goes Global

October 27, 2014 By Maryn Leave a Comment

Healthcare workers load a man suspected of suffering from the Ebola virus onto an ambulance in Kenema, Sierra Leone, on Sept. 25, 2014. Tanya Bindra/AP

If you listened hard over the weekend to the chatter around the political theater of detaining a nurse returning from the Ebola zone in a tent with no heat or running water, you might have heard a larger concern expressed. It was this: What happens if this kind of punitive detention — which went far beyond what medical authorities recommend — deters aid workers from going to West Africa to help?

As a reminder, the African Ebola epidemic is still roaring in three countries; two others have contained the disease, but it has now leaked to a sixth, Mali. The case count is 10,141, with 4,922 deaths. Last month, the Centers for Disease Control and Prevention estimated that if the epidemic continued on its current course, cases would hit 1.4 million by next January. Last week, Yale researchers said in the journal Lancet Infectious Diseases that even current promises of international aid will not contain the epidemic — so the volunteering of medical personnel such as that nurse becomes even more important.

But what if, because of this weekend’s events, volunteers are discouraged from going to West Africa, for fear of how they will be received on return? Or what if they do go, and their efforts are still not enough?

I wanted to be sure I wasn’t over-imagining what might happen next with Ebola, if it is not contained at its source now. For a fact-check, I turned to Jody Lanard and Peter Sandman, two risk-communication experts who have been involved in most of the big epidemic threats of the past decades. (I met them, I think, in the first run-up of concern over H5N1 avian flu in 2003.)

I hoped they would tell me not to be too worried about Ebola becoming a permanent threat in West Africa. Instead, they told me to be very worried indeed.

[Read more…]