Vaccine may be only way to bring Ebola under control in West Africa – may have to vaccinate an entire country to save it

October 2014 – HEALTH – A dire warning from one of the aid groups on the ground in western Africa: UNICEF has now declared the Ebola epidemic an extreme crisis. And one of the outcomes of this crisis is the thousands of children who are now Ebola orphans. Jackson Proskow reports. As West Africa’s Ebola outbreak continues to rage, some experts are coming to the conclusion that it may take large amounts of vaccines and maybe even drugs – all still experimental and in short supply – to bring the outbreak under control. Embedded in that notion is the reality that the catastrophic epidemic may remain unchecked for months, given that these products haven’t yet been proven to be safe or effective in people, and won’t be available in significant amounts any time soon. Experimental Ebola drugs in particular will remain in scarce supply for a considerable time.“It is conceivable that this epidemic will not turn around even if we pour resources into it. It may just keep going and going and it might require a vaccine,” Dr. Anthony Fauci, director of the U.S. National Institute for Allergy and Infectious Diseases, told The Canadian Press in an interview.

“As the epidemic gets more and more formidable and in some cases out of control it is quite conceivable, if not likely, that we may need to deploy the vaccine to the entire country to be able to shut the epidemic down. That is clearly a possibility.” Earlier in the outbreak many experts insisted experimental vaccines could not be tested and produced in large enough amounts in time to have an impact on the outcome. They stressed – publicly, some still do – that the “tried and true” measures used to contain Ebola outbreaks in the past would eventually control this one. Those measures are aimed at breaking the chains of transmission. The sick are housed in isolation units, where the only people they have contact with are garbed head-to-toe in protective apparel. Those who don’t survive are buried in thick body bags, without the cultural rituals that often spread the disease. Contacts of the sick are monitored for 21 days and are whisked into isolation if they start to get ill. People with Ebola are believed to be contagious only when they have symptoms, which is when you need to ensure they don’t come into contact with others.

But this epidemic is so large it has long since outstripped the capacity of responders to care for all the sick, let alone trace their contacts. People are dying at home, infecting their families in the process. Some are dying abandoned on streets, or outside the gates of over-full treatment centers. On Sunday, Sierra Leone reported 121 deaths. That is more deaths in a single day than recorded in most Ebola outbreaks from start to finish. The World Health Organization says to date about 7,500 people are known to have been infected with the virus, and more than 3,400 have died. The head of the Wellcome Trust says it’s time to stop telling the public the traditional way of containing Ebola can quell this epidemic. Dr. Jeremy Farrar, who runs the global charitable foundation, says that message is now counterproductive, getting in the way of spurring the pharmaceutical industry to put on the type of full-court press that the situation demands. –Global News