About That Upcoming African “Feelgood” Exercise

I’m sure everyone’s heard by now that the US is sending troops to “help fight the West Africa Ebola outbreak” (or words to that effect). I’m equally sure many have mixed feelings about doing this.

I think that’s a manifestly bad idea. And, contrary to this tool’s ridiculous verbal diarrhea, the reason I think the operation is ill-advised IS NOT because it would help (as he put it) “brown or black people”.

IMO, it’s an undertaking that can do little to help. But it could well result in bringing a previously-unknown pestilence to this hemisphere – like the Europeans did when they brought smallpox to the Americas, or when syphilis was introduced to Europe by those returning from the Americas. Ask Native Americans and Europeans/Asians how those introductions of previously-unknown, untreatable, and incurable diseases went.

The remainder of this article will discuss the reasons I feel this “we gotta do something to make ourselves feel good” adventure is a serious mistake. Feel free to disagree.

But you might want to read what follows, anyway.

1. We simply don’t know that much about Ebola and other Filoviridae.

Ebola belongs to a type of viruses called filoviruses. They’re so named because they’re filament-shaped. These viruses collectively form the viral family Filoviridae.

Even today, we don’t know much about them. The first filovirus genus to be discovered – Marburg – was discovered in 1967. Ebola was isolated next, in 1976. The third genus, Cuevavirus (with a single known species), was isolated in 2010. At present, these seem to be the only three genera of Filovirudae to have been discovered.

Of these three Filovirudae genera, there are at present eight species for which data is available. Of those eight, six (both known Marburg species and four of the five known Ebola species) are known to cause fatal illnesses in humans. One Ebola species appears to infect humans without causing serious illness. The ability of Cuevavirus species to infect humans is currently unknown.

In short: we just don’t know very much about Ebola and its close relatives. Fifty years ago, we didn’t even know the entire Family existed. Hell, the likely natural reservoir of filoviruses – bats – was only recently identified in 2009, or over 40 years after the first filovirus was isolated. And scientists aren’t yet absolutely positive that bats are the natural reservoir.

2. Ebola is both deadly and incurable.

There is no known cure for Ebola and other filovirus diseases. An infected person either gets well or dies. Other than provide supportive care, medical science can’t do a damn thing for them.

Let me restate that: there is no cure for Ebola. You get it, you are screwed. You’ve got a damn good chance of dying – and it’s a very horrible kind of death. (I’ll spare everybody the details here; descriptions of the disease’s progression are readily available on the Internet. Look them up if you have a fascination with the grotesque.)

Yes, there is an experimental serum – Zmapp – that has shown some promise. It was used to treat two American healthcare workers who contracted the disease while treating Ebola patients during the recent outbreak.

Both survived, albeit only after a long and serious illness. Unfortunately, that serum is experimental – so that means it’s produced in a lab environment. It currently takes at least one week to produce the raw materials (grown in tobacco leaves) needed for a single dose of the serum; more time is required to produce the serum afterwards.

There are literally thousands of unfortunate individuals in the current outbreak who are currently infected. You do the math.

The recent Ebola outbreak in West Africa is a variant of the Ebola Zaire species. If there is any one filovirus species that qualifies as “worst of them all”, Ebola Zaire is it. It has the highest demonstrated fatality rate – up to 90% in some outbreaks. In the present outbreak, it seems to be running about 50% lethal – meaning around half of those who get it, die. Horribly. In a period of about 2-3 weeks.

Oh, and those who do recover remain carriers of the virus for weeks after they recover (it’s been isolated in the semen of recovered male patients more than 80 days after clinical recovery, and sexual transmission has been documented as late as 7 weeks after clinical recovery). Many have severe health problems afterwards as well. So it’s not exactly “all good” afterwards for those who do recover, either.

“Sobering” doesn’t begin to describe the prospects.

3. There is no vaccine.

Unlike other serious diseases we’ve dealt with in the recent past that were both communicable and highly lethal, there also is no vaccine for Ebola that provides someone exposed to the virus with immunity to the disease. Instead, one must depend solely on avoiding exposure to avoid becoming a casualty.

This means protective gear. And unlike AIDS and other diseases people have heard about, we’re not talking the standard “gloves and masks” protection being anywhere near sufficient.

Recommended protection measures and protocols are discussed here; details regarding the equipment required can be found here. And while exposure to of bodily fluids of an infected person is thought to be the primary means of infection, aerosol infection has not been definitively ruled out (more about this later). So, yeah – most if not all of those measures are required.

That’s what’s required for someone working with anyone who’s infected with Ebola.

Wonder what working in that gear is like?  From the description above (and accounts I’ve read), I get the impression that wearing that kind of protective gear is maybe 2 steps away from working in full MOPP-4. I could be wrong.

You tell me people won’t start cutting corners when they get tired. Or making mistakes brought on by fatigue and discomfort.

4. We don’t know definitively that Ebola is not transmissible via airborne droplets – like the common cold or flu.

It is currently believed that Ebola is primarily transmitted by direct contact with contaminated bodily fluids from an infected person. (Per the WHO, sweat is among the bodily fluids believed to be a means of transmitting the virus.) Contact with objects contaminated with the virus is a secondary means of transmission, as is sexual activity.

However, the jury is still out on whether or not airborne droplet transmission is a means of transmission. And based on one known past incident, there is substantial evidence that some forms of the Ebola virus indeed are transmitted in that manner.

Ebola outbreaks in the US have actually occurred twice in the past. The first was the famous “monkey house” outbreak that occurred in Reston, VA, in 1989. The second was the less-well-known Ebola outbreak – again at a primate isolation facility – that occurred in Alice, TX, in 1990. In both cases, the primates in question (macaque monkeys) were received from the same primate facility in the Philippines.

In both cases, the USA dodged a bullet. Both cases were outbreaks of Ebola Reston – the sole known species of Ebola that can infect but does not produce serious illness in humans. (In contrast, Marburg was discovered when an infected primate managed to pass along a lethal filovirus to humans; that occurred in Marburg, Germany – hence the name.)  However, in both cases medical testing of humans working with the infected primates confirmed that some humans had been inffected as well. So if this had been a fatal Ebola strain, we’d have very likely been in deep trouble.

Why? Because in both cases there is strong evidence that aerosol transmission of the virus was a primary means of transmission, at least among the primate population. Here’s a quote from the linked article above relating to the Reston outbreak (emphasis added):

The investigators documented a high likelihood of aerosol transmission outside a controlled laboratory setting, because the virus appeared to pass between rooms to infect susceptible monkeys.

Aerosol droplets spread by the facility’s ventilation system are believed to have been the mechanism.

Further, even today not all virologists are convinced that Ebola doesn’t spread via aerosol means.

This is the basis for today’s debate over whether Ebola can be transmitted through the lungs, a discussion that has never been fully resolved, Dr. Murphy said.

The “Dr. Murphy” here is Dr. Frederick Murphy – a virologist from the University of Texas. IMO we probably should listen to him. He helped discover Marburg, participated in the investigation of the 1st known Ebola outbreak as well as that of the 1989 outbreak of Ebola Reston in Reston, VA. He was the 1st person to image the Ebola virus with an electron scanning microscope. I’d guess his opinion concerning filoviruses like Ebola is probably more likely to be correct than that of most others on this planet.

5. The troops going won’t be adequately trained for the mission.

During the 1989 Ebola Reston outbreak, DoD responders were from USAMRIID – DoD’s premier biological research facility. Even then, there were difficulties. And those were the most experienced people we had (remember, this was during the wind-down of the Cold War; and biowarfare was still a real concern.)

To my knowledge, we’re not packing up USAMRIID and sending them on this mission. We’re sending normal DoD units – regular troops.

I don’t think they’re the right people to send.

6. Recent reports indicate cultural factors and superstitions must change before containment will be effective.

I don’t think I need to discuss this much. Teams in West Africa trying to educate the population concerning the disease have been attacked and slaughtered by the population they’re trying to help. Ditto those who were sent to recover infected dead for safe burial.

Why? The indigenous population largely either denies the existence of the disease, or blames the public health care personnel trying to help for spreading it. Until superstition, denial, and cultural practices that spread the disease change (e.g., communal food plates from which everyone eats with their hands, washing bodies for burial, poor public sanitation) IMO what we’re doing is effectively the same as peeing into the ocean in an attempt to raise sea level. It just ain’t gonna have much effect.

I fear that this disease will only run its course, and the outbreak only eventually stop through burnout. And at this point, I fear the best we can do is try to keep it on one continent.

Cold, and harsh? Yes. The truth often is.

Summary.

Still, the POTUS seems hell-bent on acting. So, we’re going to send troops

1. to a region of little strategic importance to the US,
2. on a non-military mission, for which
3. they’re not really properly trained.

It’s a region experiencing an outbreak of a disease that is

1. easily transmissible (if it isn’t, explain the protective gear required),
2. may or may not spread by aerial droplet transmission like the common cold,
3. doesn’t manifest for up to 21 days after infection, for which
4. no practical effective treatment exists, plus
5. no vaccine exists,and
6. infection fatal for about 50% of those contracting it within 2 or 3 weeks, with
7. a truly painful and horrible death, and for which
8. long-term (up to 90 days) quarantine will be required for those who catch the disease and recover due to the fact that they still harbor the virus, as well as
9. a 30-day post-mission quarantine for returning troops will be necessary to protect public health.

Further, the troops won’t really be able to do much that changes the outcome of the outbreak. We’re really doing it for no other reason than to make ourselves “feel good” by “doing something to help” – even if it really doesn’t.

But if returning troops do manage to bring that crap back to the USA, literally millions could die if a widespread outbreak occurs. And you just KNOW that the returning troops will be quarantined for 30 days to ensure no one is infected but in the latent/incubation period when the mission ends – right? (Yes, that last question was both sarcastic and rhetorical.)

I truly feel for the poor souls in West Africa facing this plague.  I don’t see how our involvement can really help.  But our involvement could indeed bring that crap back to this continent.  All we need for that to happen is one missed incubating infection.

And since we have bats here also, it’s not beyond the realm of possibility that it could become endemic here too.

To me, it seems the risk is too great, and what we can do is in practice small if not negligible.  It just doesn’t seem like a good idea.  But we’re apparently going to do it anyway.

“I got a really bad feeling about this.”

 

(Sorry this article is such a downer on an otherwise nice Sunday.  But it needs to be said.)

 

Category: "Teh Stoopid", "Your Tax Dollars At Work", Military issues