Teaching tools for Ebola & public health diseases

Ebola_toy
Credit:Wendie Norris

Band Aid is a tried and tested method of public engagement, bringing Ebola to public attention and giving us all something we can do to help rather than just scaring us. What is also needed here and in West Africa, is education.

For a novel method of education, I bring you Giant Microbes, which are sold as teaching tools. They are soft plush “cuddly” toys, anthropomorphised versions of microscopic images of microbes, and provide information on the microbe and the disease it causes in the attached label. Apparently they are currently sold out!

I own their version of Ebola virus (shown opposite is the actual toy sitting on my desk): its based on the shape of the virus seen in an electron microsopic image. My colleague owns a tuberculosis (TB) virus toy. Bought at a public health conference, the label for my Ebola toy is dated 2004 and describes the symptoms, the 50-90% mortality but also tells me that outbreaks are limited to a few hundred cases. The toy produced now, in 2014, will have a very different set of statistics to present.

The West African outbreak today stands at 14383 cases, with 5165 deaths in 6 countries.

Of those 6 African countries, Nigeria and Senegal have had their Ebola Virus Disease (EVD) outbreaks declared as officially over. [A national EVD outbreak is considered to be over when 42 days (double the 21-day incubation period of the Ebola virus) has elapsed since the last patient in isolation became laboratory negative for EVD].

Last week, my colleague had house-guests.  On seeing the TB “cuddly toy” at home, they asked where was the Ebola one (?) and she was gratified to say “its at work”!  Clearly information on Ebola has successfully entered UK public consciousness.

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Ebola: a “filthy little virus” says Bob Geldorf

Sierra_Leone_National_Ebola_Emergency_Operations_Center _CDC
Sierra Leone National Ebola Emergency Operations Center
Credit: Jennifer Brooks, CDC.


Following
the launch of Band Aid 30, "the Ebola song”, on X-factor [Sunday 16 November 2014], Bob Geldorf did the media rounds on the Monday morning including BBC 5live, to further drive home the message. People are dying from Ebola in West Africa because they are poor, living in countries without the health service infrastructure to stop it in its tracks, and “we are all just a plane ride away from it”.AS of that Monday, you can buy and download the song here via Amazon, Itunes and Google Play, or purchase the CD.

WE at CABI, devoted last month’s focus of the Global Health Knowledge Base e-newsletter to Ebola research.

With the charitable effort of Band Aid 30 ringing in our ears, I thought it timely to highlight another such effort, from researchers, specifically from the Wellcome Trust.

Wellcome Trust: Emergency Ebola initiative
 The Wellcome Trust (WT), the world's second largest private funder  of medical research after Bill & Melinda Gates Foundation,  are funding a multi-million pound emergency research package [Emergency Ebola Initiative] to investigate new approaches to treat, prevent and contain Ebola viral disease, during the current epidemic in West Africa. WT will also support research into the ethical challenges of testing experimental medicines during epidemics, and has a £40 million long-term investment in African science.

One of their anti-Ebola vaccines is being fast-tracked.

Further Reading

A new rapid sequencing method created for Lassa, was applied to Ebola virus, sequencing nearly 100 Ebola patient blood samples In Sierra Leone, within 10 days. The method is also cost-effective, and may help West African nations rapidly and effectively track outbreaks with limited resources. This article is one of the records on CABI's Global Health database.

 

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Foot-and-Mouth Disease (FMD) Targeted for Eradication

By Miroslav Djuric, DVM

Following the successful eradication of Rinderpest (Cattle plague, see blog), veterinarians, farmers and donors across the World are turning their focus to combat Foot-and-Mouth Disease (FMD) on a global scale. The FAO and the World Organisation for Animal Health (OIE) have developed a detailed strategy for FMD control under the umbrella of their Global Framework for the Progressive Control of Transboundary Animal Diseases (GF-TADs). However, it is clear that only a massive commitment of national and international resources can make FMD eradication possible, as surveillance and monitoring over a long period is required.

Cattlenov12

FMD is a highly infectious disease caused by a picornavirus, which affects cloven-hoofed animals, in particular cattle, sheep, goats, pigs and deer. Other animals including camelids and elephants can also be affected. The disease is notifiable, which means that the local veterinary services must be notified immediately if FMD is suspected.Although FMD does not pose a direct threat to human health, and is rarely fatal in animals, it can cause reduced milk yield, weight loss and lower fertility.

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Veterinarians Target Next Virus for Eradication

 
Following the recent eradication of rinderpest virus in cattle (see blog), the veterinary profession is contemplating which viral disease of animals should be targeted for eradication next. This is not an easy task considering the vast number of viral diseases that plague livestock animals and have devastating effects on animal health, public health and people’s livelihoods.

Sheep

According to the authors of a scientific editorial (1) and a review article (2) that appeared in the recent issue of Veterinary Record published on 1st July 2011, the next livestock virus targeted for eradication could be peste des petits ruminants (PPR) virus.

Dr Michael Baron and colleagues from the Institute for Animal Health (IAH), Pirbright, UK said in their review that the Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (OIE) should focus on PPR virus as the next livestock virus for eradication.

PPR virus affects sheep and goats and is closely related to the recently eradicated rinderpest virus. Cattle can also be infected with PPR virus but they do not show obvious signs of disease. PPR is circulating on the edges of the European Union, on the southern shores of the Mediterranean. Outbreaks were reported in Morocco and Tunisia in 2008 and there is evidence for its presence in Algerian sheep this year. It has also been present in Turkey for many years. PPR is the fastest growing and one of the most economically important diseases of sheep and goats, the animals that play a very important role in sustainable agriculture and development in Africa and Asia. Mortality in infected animals ranges from 10 to 90%, depending on age, breed and secondary infectious agents. Animals that survive become anorexic, their milk yield is reduced, and they are susceptible to secondary infections and abortions.

Baron and colleagues are already working on the development of a “smart” vaccine for PPR, one that leaves an antibody signature different from that created by infection with the virulent virus, so that vaccinated animals can be distinguished from animals that have been infected by virulent virus, and vice versa. They are also working on a "dip stick" test for PPR virus, similar to the one that IAH developed for the rinderpest eradication programme.

There are good reasons to believe that the eradication of PPR is an achievable goal, because the PPR virus shares a number of properties with rinderpest virus that contributed to the successful campaign to eradicate the latter, i.e. there is a safe and reliable vaccine; simple and effective diagnostic tests are available; the virus has a short infectious period, with no carrier/persistent state; transmission occurs only by close contact; and there is an economic incentive to eradicate it.

However, before a massive commitment of national and international resources for a successful eradication campaign, which would require surveillance and monitoring over a long period, a thorough evaluation of the likelihood of success of an eradication campaign, as well as its costs and benefits, is of utmost importance. Potential for eradication of other diseases such as foot and mouth disease (FMD) or rabies virus, for example, also needs to be evaluated.

CAB Direct database offers an excellent source of scientific information and is a very useful tool for evaluating potential for eradication of any viral disease of animals. It comprehensively covers world’s scientific literature from over 150 countries and in over 50 languages on all the viral diseases of animals, including PPR, FMD and rabies. CAB Direct database contains over 17000 records on rabies, over 13000 records on foot-and mouth disease and over 800 records on peste des petits ruminants.

References:

1. Anderson J., Baron MD., Cameron A., Kock R., Jones B., Pfeiffer D., Mariner J., McKeever D., Oura, CAL., Roeder P., Rossiter P. and Taylor W. (2011): Rinderpest eradicated – what next? Veterinary Record, 169: 10-11, doi: 10.1136/vr.d4011.

2. Baron MD., Parida S. and Oura CAL. (2011). Peste des petits ruminants: a suitable case for eradication? Veterinary Record, 169: 16-21 doi: 10.1136/vr.d3947.

A new deadly virus

As the world’s attention has been focussed on the global financial crisis,
little notice has been taken of the emergence of  a new deadly disease in
southern Africa. In September a woman tourist guide living near Lusaka, Zambia
was evacuated to South Africa in a critical state. Her symptoms included fever
myalgia, vomiting, diarrhoea, followed by rash, liver dysfunction and
convulsions. Within a few weeks she died of acute respiratory distress syndrome.
A paramedic who had cared for the patient during the evacuation developed
similar symptoms and died, as did an intensive care nurse who treated the
patient. A fourth person also fell ill.

The culprit of this deadly disease appears to be an Arenavirus (Family
Arenaviridae),.  These are enveloped viruses with a bi-segmented negative
strand RNA genome. The African and Old World arenaviruses (like Lassa fever virus)
differ from the New World viruses such as Junin virus in their use of primary
receptors.  The prototype Arenavirus is Lymphocytic Choriomeningitis virus
(LCMV) which can cause meningitis. Rodents such as mice and hamsters can harbour
the virus and pass it on to humans. It is a potential problem particularly for pregnant women
who should avoid handling pet (or laboratory) rodents. Other Arenaviruses cause
haemorrhagic fever, such as Lassa fever virus, Guanarito virus, and Machupo virus.
Lassa fever virus causes thousands of cases of disease each year throughout West
Africa, with estimates of around 500 deaths a year. As with LCMV, these other
viruses are also found in rodents, which act as reservoir hosts, and humans can
contract the disease by contact with faeces, urine, blood or saliva of infected
rodents.

The Arenavirus isolated from the recent South African cases of disease have
yet to be identified, but could be a new virus. In a brief news item in the New
Scientists there is a quote from Bob Swanepoel of the South African National
Institute for Communicable Disease saying "how little we know about the
viruses circulating in Africa". A look on the CAB Abstracts and Global
Health Databases show that there is more than 800 records on this viruses. Of
these over 200 are on Lassa fever virus. A brief look through these records
helps to create a picture of the effect that these viruses are having, what the
current state of knowledge is, and where the work is being done.

By looking through the records on CAB it appears that this outbreak in Africa
is not the only recent case of Arenaviruses emerging and causing fatalities. Earlier this year another new Arenavirus was reported in a cluster of fatal
cases associated with transplant complications in the USA. The virus in this
cluster was found to resemble the LCMV virus*. Most of the new viral diseases,
such as SARS, Nipah, and Hendra virus infection, that crop up in humans have
crossed the species barrier and come from other animals. This would reinforce
the importance of  information across the medical and the veterinary areas
in understanding and controlling these diseases. 

*Arenavirus in a cluster of fatal transplant-associated diseases. Palacios, G. (et. al), New
England Journal of Medicine, 2008, Vol. 358, No. 10, pp. 991-998.