There’s no question Ebola is one of the most terrifying diseases out there. It causes a painful death, typically kills more than 50 percent of those infected and essentially has no cure.
But if you compare how contagious the Ebola virus is to, say SARS or the measles, Ebola just doesn’t stack up. In fact, the virus is harder to catch than the common cold.
That’s because there has been no evidence that Ebola spreads between people through the air. Health experts repeatedly emphasize that human-to-human transmission requires direct contact with infected bodily fluids, including blood, vomit and feces.
And to infect, those fluids have to reach a break in the skin or the mucous membranes found around your eyes, mouth and nose.
But that hasn’t stopped two-thirds of Americans from thinking that the virus spreads “easily,” a poll from Harvard School of Public Health found in August. Almost 40 percent of the 1,025 people surveyed said they worry about an Ebola epidemic in the U.S. More than a quarter were concerned about catching the virus themselves.
Many questions still linger. Is Ebola really not airborne? Can it spread through contaminated water? What about through a drop of blood left behind on a table?
Photo: A burial team in Barkedu, Liberia, buries their protective clothing alongside the body of an Ebola victim. It’s possible to catch the virus from clothing soiled by infected blood or other bodily fluids. (Tommy Trenchard for NPR)
Here are three words you don’t often see in close proximity: Good. Death. Ebola.
Yet there they stand, united in the headline for an essay in The New England Journal of Medicine this month: "A Good Death: Ebola and Sacrifice."
The essay was written by Dr. Josh Mugele, assistant professor of clinical emergency medicine at Indiana University’s School of Medicine, and Chad Priest, an assistant dean at the Indiana University School of Nursing. They pay tribute to a Liberian colleague, Dr. Samuel Brisbane, director of the emergency department at Monrovia’s John F. Kennedy Memorial Medical Center.
They’d worked closely with Sam Brisbane on a disaster-medicine program. He was a memorable character, they write: “at once caring and profane … his laugh was best described as a giggle, and he swore frequently.”
And he was terrified by Ebola. “Dr. Brisbane was a wreck,” they recall. When they asked how they could protect themselves, he told the authors: “Leave Monrovia.”
his summer, Dr. Brisbane treated a patient with “suspected Ebola.” A few days later, the 74-year-old doctor came down with symptoms of the virus. He died on July 26.
"With apologies to his wife and family, who saw him dire horribly and unjustly," Mugele and Priest conclude, "we believe our friend died a good death – as did all the nurses and doctors who have sacrificed themselves caring for patients with this awful disease."
We spoke with Mugele and Priest about the idea of a “good death.”
You believe Dr. Brisbane died a good death because of his self-sacrifice?
Mugele: Dr. Brisbane was an older gentleman, he had a coffee plantation, he had a wife and children. He didn’t have to treat these patients. He didn’t have to be a doctor at that stage of his life. And he kept doing it even though he knew [Ebola] was very contagious and he had a high likelihood of getting it. Dying was a selfless act on his part.
Illustration by Maria Fabrizio for NPR
ADDIS ABABA, Ethiopia — Zebiba, 28, sits in her purple headscarf in the small clinic room, the cramping already beginning. She took the tablets early this morning. She is three months pregnant.
By 2 p.m., her abortion should be complete. She will return to her two children, now at school. She is divorcing their father, who has taken a second wife.
Thus far, she has refused pain medications. Her relief at the ease of this termination is palpable. “She was nervous coming here,” says the nurse.
A generation ago, botched abortions were the single biggest contributor to Ethiopia’s sky-high maternal mortality rate. Doctors in the largest public hospital in Addis Ababa, where Zebiba lives, still remember the time when three-quarters of the beds in the maternal ward were reserved purely for complications from such procedures.
Then, in 2005, the country liberalized its abortion law.
Today, it’s hard to find a health provider who’s seen more than one abortion-related death in the past five years. Although access to safe procedures and high quality care could still be expanded, doctors say that, increasingly, those who need an abortion can get one safely.
Read the full piece here: How Ethiopia solved its abortion problem
Photos by Heather Horn/GlobalPost
By Andrew Pollack
An experimental vaccine against dengue fever being developed by Sanofi proved about 60 percent effective in its second large clinical trial. The results could clear the way for the introduction of the world’s first inoculation against the disease, which is mosquito-borne and becoming an increasing threat.
Sanofi, a French drug company, said on Wednesday that use of the vaccine cut the risk of getting dengue by 60.8 percent in the trial, which involved 20,875 children ages 9 to 16 from several countries in Latin America and the Caribbean.
Those who received the vaccine also had an 80.3 percent lower risk of being hospitalized for dengue compared with children who received injections of a placebo.
The results are roughly similar to those from the first large clinical trial, in which the vaccine reduced the incidence of dengue fever by 56.5 percent. That trial involved about 10,000 children in Southeast Asia.
“For the first time ever, after 20 years of research and industrial commitment, dengue is set to become a vaccine-preventable disease,” Olivier Charmeil, chief executive of Sanofi Pasteur, the vaccine division of Sanofi, said in a statement.
It’s only a matter of time, some researchers are warning, before isolated cases of Ebola start turning up in developed nations, as well as hitherto-unaffected African countries.
The current Ebola outbreak in West Africa has killed more people than all previous outbreaks combined, the World Health Organization said Wednesday. The official count ;includes about 3,600 cases and 1,800 deaths across four countries.
Meanwhile, the authors of a new analysis say many countries — including the U.S. — should gear up to recognize, isolate and treat imported cases of Ebola.
The probability of seeing at least one imported case of Ebola in the U.S. is as high as 18 percent by late September, researchers reported Tuesday in the journal PLOS Currents: Outbreaks. That’s compared with less than 5 percent right now.
These predictions are based on the flow of airline passengers from West Africa and the difficulty of preventing an infected passenger from boarding a flight.
As with any such analysis, there’s some uncertainty. The range of a probable U.S. importation of Ebola by Sept. 22 runs from 1 percent to 18 percent. But with time — and a continuing intense outbreak in West Africa — importation is almost inevitable, the researchers told NPR.
"What is happening in West Africa is going to get here. We can’t escape that at this point," says physicist Alessandro Vespignani, the senior author on the study, who analyzes the spread of infectious diseases at Northeastern University.
Image: Air traffic connections from West Africa to the rest of the world: While Guinea, Liberia and Sierra Leone don’t have many flights outside the region, Nigeria is well-connected to Europe and the U.S. (PLOS Currents: Outbreaks)
Antiretroviral therapy has saved the lives of over seven million people living with HIV. Yet vulnerable populations still fall through the cracks. Groups like LGBT people, sex workers, and people who inject drugs have limited access to HIV prevention and treatment services. These gaps threaten the gains that have been made in the global fight against AIDS. View the Pulitzer Center’s latest interactive map.
A newly released video shows health workers in Liberia attempting to capture a suspected Ebola patient, who had allegedly escaped from a treatment center on Sept. 1.
Clad in a red shirt, the man was wearing a badge indicating that he was being treated for Ebola at the ELWA hospital in the Paynesville neighborhood of Monrovia, the capital city. The Ebola wards at ELWA have been so overcrowded that at times they’ve had to turn away people suspected of being infected with the deadly virus.