Ebola Virus and TB

With the best-seller, Hot Zone and the current movie Outbreak as background, the real outbreak of the Ebola virus is in Kikwit, a city of 600,000 in Zaire. Already dozens have perished from what physicians describe as tissue failure, organ failure, and suffocation with blood flowing from ears, eyes, mouth and other orifices.

This lethal virus is spread through contact with blood and through contaminated syringes used on many patients. Dr. Ruth Berkelman of the Centers for Disease Control said that previous Ebola outbreaks in 1976 and 1979 in Africa were controlled by precautions such as not using dirty needles.

Fast-mutating killer viruses that can spread through breathing have long been the stuff of science fiction novels. More recently, they are the subject of non-fiction books like “The Corning Plague” by Laurie Garrett. Add that to the massive writings about the AIDS epidemic and the 3 million people who die in the world every year from Tuberculosis (TB) and some serious questions are demand­ing answers.

What are the suspected causes or conditions for these diseases? Why do they start or thrive in impoverished

regions of the world where public health programs are weak or non-existent? Nightline reporter, John Donvan, said the other evening that “Politics may matter as much as biology, especially in a place like Zaire,” where, he added, the medical system is devastated by a collapsing economy, corrupt regimes and other disastrous conditions for ordi­nary people, ideal conditions for extraordinary viruses.

More knowledge is needed, for instance, about whether the disruption of the tropical forests are releasing new organisms that are infectious. But there is also far more knowledge than there is both the will and funding to put to work to curb early on these infections.

Consider TB. The World Health Organization (WHO) has demonstrated that early detection of TB-infected per­sons followed by taking a course of proven medicines for six months can be effective 95% of the time. The delivery and treatment cost is within a range of $13 to $200 per person. The success stories that WHO has documented are in Tanzania and in a province of China.

The world spends four billion dollars a day on military armaments. The world spends not one percent of that amount on external assistance for treating TB — a disease that will destroy thirty million lives in the next decade — many of them children in the developing world.

With modern, fast transportation, viruses can spread more rapidly. All the world’s people can become virally connected.

Viruses may arise and spread from poverty and disrupted societies but once unleashed they do not observe national boundaries, class, race or gender distinctions. They will take down a billionaire or an urchin. Their means of spread could be more and more through the air, not just through personal contacts.

Does Congress show much sensitivity to these needs of preventive medicine — from research to public health measures on the ground. Well, the Republican plan for a balanced budget does not increase the meager funding for the U.S. Centers for Disease Control. This budget lets the Pentagon’s massive budget grow over the next seven years, even though the Sino-Soviet military threat to the U.S. was declared over by President George Bush.

What will it take for Congress and the White House to pay serious attention to the risks of viral epidemics? One physician acerbically

replied: Viral epidemics.

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