Ebola emergency

The deadly ebola virus has already claimed over 1,000 lives and infected about 2,000 people in the West African countries of Guinea, Sierra Leone, Liberia and Nigeria. The outbreak is a reminder of SARS in 2002-03, which claimed nearly 800 lives, and H1N1 (also called swine flu) which killed a colossal 18,000, but across 170 countries. While these three viruses have emanated from infected animals, ebola has mercifully not mutated to become an airborne disease. Ebola spreads through body fluids, which means that general circumspection can go a long way in containing its spread. The World Health Organisation (WHO) has been confident enough to say that restrictions on air travel are not warranted. However, ebola is especially lethal for two reasons: first, the body fluids of an infected person carry a much higher load of virus than, say, HIV, and therefore people in close contact such as care givers and health workers are very vulnerable; and second, there is no known cure. Fatality rates in ebola are higher than SARS (which, incidentally, resurfaced in some countries in May) and swine flu. India must be alert to even the remotest chance of the ebola virus entering the country.

The government should set up screening facilities at major airports for passengers coming from the affected countries. Medical teams should be alert to symptoms such as fever, skin rash, chest pain and gastrointestinal trouble and quarantine such individuals. The ebola virus is not known to be contagious when it is dormant in an individual, a period that could go up to three weeks. Therefore, the chances of an active carrier escaping medical surveillance are not too high. The Health Ministry should disseminate information on ebola symptoms requiring hospitalisation and the precautions to be taken by care givers. Hospitals should be prepared with testing kits and protective gear. Prevention is the best cure, as it could take six months to a year for an effective drug to be available in the requisite quantities. However, any medical emergency opens up the possibility of compulsory licensing, and we could learn a lesson or two from the supply crunch when SARS and H1N1 broke out.

Finally, every epidemic is a pointer to socio-economic breakdown. Malaria and leptospirosis are major killers in West Africa, which shows that sanitation and medical infrastructure are in a shambles. Rapid and chaotic urbanisation amidst acute poverty (these countries are at the bottom of the Human Development index) has played a big part in the spread of disease in the region. India’s not too different; some of its cities could have an epidemic lurking around the corner. Prime Minister Narendra Modi’s call for an attack on poverty and sanitation in his Independence Day address could not have been better timed. He could as well have said that it’s a medical imperative.

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