Viral threats

Dengue and Ebola

People often associate Africa with viral haemorrhagic fevers, like the diseases caused by the Filoviridae (Ebola and Marburg) and Flaviviridae (yellow fever and dengue) viruses. However, travel and introduction of the vector to different countries makes these diseases no longer strictly endemic to Africa. We are all familiar with the Dengue fever- it caused chaos in Pakistan back in 2011, when more than 2200 cases and around 300 casualties were reported. Currently, the United States of America faces a similar potential threat, ever since the Ebola virus, the causal organism of the deadly Ebola virus disease, found its way into the country back in August of this year.

The Ebola Virus Disease is an acute, severe illness which is often fatal if untreated. The virus is transmitted to people from wild animals. Dengue, on the other hand, is currently the most common mosquito-borne viral disease of humans. Transmitted by the main vector, the Aedes aegypti mosquito, dengue is caused by four distinct viruses. Both Ebola and Dengue viruses have a basic structure that consists of a core of ribonucleic acid (RNA) as the genetic material, surrounded by fatty material. They are dependent on an animal or insect host for survival, and spread to humans from the infected host or from person-to-person.

Pakistan is a third world country with limited resources, technology and awareness. Poor hygiene, vast open fields, overflowing gutters, leaking sewerage pipes and congested slums all result in bodies of water ideal for the laying of eggs by the Aedes mosquitoes. The scenario is aggravated by the torrential downpours of the monsoon season, which aids further mating and reproduction of these vector mosquitos. In addition, people who get internally displaced due to armed conflicts in the country become the prime targets of the Aedes mosquito, as they are unable to find shelter. All these factors lead to the dengue epidemic in 2011.

It is considered that during the epidemic, the officials used either outdated insecticides, or ones to which the mosquitoes had become resistant. Consequently, the involved insects continued to thrive and spread the virus. Adequate degree of awareness on preventive measures among the general population was required. Also, people who were aware of the virus, could not afford to purchase mosquito repellent sprays and nets to protect themselves from insect bites.

America, on the other hand, has advanced research and technology and adequate facilities. And yet, it also faces a threat of a viral fever outbreak. The news that a Dallas nurse who helped care for Thomas Eric Duncan, a Liberian man who recently died from Ebola, became infected with the virus instilled worry in many Americans. Health officials are using contact tracing to identify and monitor everyone who might have been exposed to the patient during the time he was contagious. Anyone who has symptoms is isolated and tested for Ebola. If the test is positive, that person is kept in isolation and treated, and his or her contacts are then traced. Federal officials announced that passengers from West Africa arriving at five American airports will be screened for fever. An experimental drug called ZMapp might help infected patients, but the drug is unproven and is no longer available. The World Health Organization suggests that blood from Ebola survivors might be used to treat others, but there is once again, no proof that such a treatment alone would work. All physicians can do to ensure the health of the patient is try to nurse him or her through the illness, using fluids and medicines to maintain blood pressure, and treat other infections that often strike the weakened body.

Concern amongst locals culminated when a case of Ebola sprung up in New York last Thursday. However, Gov Andrew Cuomo assured the people that New York State and City are well-prepared for the threat of Ebola.

“The more facts you know, the less frightening this situation is,” Cuomo added.

America’s approach to controlling Ebola is more efficient than Pakistan’s approach to controlling Dengue in 2011. That is the difference between a first world and third world country after all; America is trying to prevent the disease from spreading and causing chaos, whereas Pakistan started focusing on eradicating dengue after the outbreak started and significant damage had already been done. Essentially speaking, they believe in prevention, whereas we believe in cure.