Ebola and HIV in the 1970’s

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Selmi Nadhem and Hachicha D. Nejib describes Ebola as a communicative disease, meaning  it passes from contact with body fluids, blood, infected tissue from humans and animals and death or sick animals. Filovirus is the family/home classification for the Ebola virus grouping with viruses such as the Marburg virus.  In the Democratic Republic of Congo (DRC) formerly known as Zaire, in Yambuky, the first outbreak of Ebola occurred in 1976. It is from a river near the village of Yambuky that Ebola gets its name.  Out of the 318 cases, 280 people died accounting for an 88% case fatality. In that same year, in Nzara, Sudan experience 54% fatality rate from the same disease with 284 cases and 151 deaths. In 1977, 1 person contracted the disease in the Democratic of Congo and passed away. [Martiner, 2014]

 

Various methods of intervention used to control the spread of Ebola may  attribute to stomping an epidemic in the 1970’s. A WHO Bulletin explains that when the illness first broke out of haemorrhagic fever from a factory worker in Nzara, Sudan on June 27th, 1976 by October 29th of the same year the World Health Organization sent a team to the country.  Their immediate concern surrounded understanding the epidemiology of the illness. The team took blood from recovered patients for antibody study and samples from sections of the populations who were not exposed to the illness, simply to piece together the pattern of the illness.  They made sure there were sufficient supply of masks, caps, gloves and disposable gowns for the hospital staff. In addition, the team met with the local chiefs and sub chiefs who agreed and facilitated groups of surveillance.

Although the outbreak spontaneously died out in Nzara but for Maridia the Team needed a strategic plan. By November, the teams were searching house to house; any person found with the fever went to a special isolation ward to contain the spread of illness. It is important to mention here that the same surveillance practise grew to most of Western Equatorial Province, Sudan. On 20th of November of 1976, the country experienced its last known case of the illness for that year until 1979 (34 cases and 22 deaths.) The team (WHO) cautioned the people about the risk of eating the meat of fruit bats or monkeys/apes especially paying attention to thoroughly cook the meat. In addition, they encouraged the use of gloves when handling animal products and policies against reusing injections. Those were recommendations to cut the risk of transmission from wildlife to humans. And also quick and safe burial of the dead and monitoring the people who were in contact (close or direct) with Ebola patients. It is worth noting here that Alice Park explanation of similar yet different burial practises in the DRC and this helped edge out the spread of the virus via people to people contact.  WHO Team used similar methods as deployed in Sudan, in Zaire after the known infection occurred on August 26th, 1976. The outbreak circled the Bumba Zone of the Equatorial Region and within 70 miles of Yambuku most of the cases occurred. Apart of isolating patients, the Zaire team used Sodium hypochlorite to boil every utensil used on patients and burning and deeply burying of potentially everything deemed risky.

 

Another point to consider is that Ebola is a zoonotic illness. Usually the nature of some such illness is dipping after the first outbreak because they are not well-organized enough from spreading from person to person. Could it be that this quality along with other control techniques prohibited Ebola from turning into an epidemic in the 1970’s? It is worth pointing out here that  Ebola patient cannot spread the virus unless they are showing warning signs of the illness. Dr. Peter Piot who is credited for discovering the illness during the 1970’s points out that one needs very close contact with someone infected with Ebola to get the illness and that sitting next to that person on a bus is not necessary problematic. A further factor to consider is the strain of Ebola in the 1970’s as oppose to the problematic strains affecting West Africa now. The 1970’ strain was perhaps on a different path. Furthermore Dr. Piot cites that the remote area of the affected parts of Zaire and Sudan in the 1970’s made it easier to restrain Ebola (smaller and less mobile population).

 

This sort of holistic treatment did not occur for HIV until the virus covered many parts of the world. It is established that HIV came from SIV (simian immunodeficiency virus found in Chimpanzees) in Kinshasa (former Leopoldville until 1966) in the DRC around the 1920. The physical, economic and social conditions in Kinshasa groomed the virus for an epidemic.  Around that time there was a growing sex trade in the city and growing number of migrants. In addition, the transport network of railroads, rivers and roads made it easier for people to move in and out of the city.  By the end of the 1940’s, one million used Kinshasa’s railway (Gallagher, 2014). According to AVERTing HIV and AIDS, at that time in the North and East of DRC there were much lower reported cases of the virus  attributed to the lack of transportation links.

 

By 1980, HIV was already a growing epidemic when half of the reported cases were outside the DCR. By the 1960’s, experts trace the virus to Haiti, some present the view that Haitian professionals brought it over from the DCR, however Paul Farmer posits the view that tourists from USA brought the illness to the island. It was only when gay men from California and New York ailed with rare diseases such as a rare cancer Kaposi’s sarcoma and lung infection PCP that officially health professionals started investigating for a new illness.  It is important to highlight here that unlike Ebola which as an incubation period of 2-21 days, HIV’s incubation period is much longer, sometimes 10 years before AIDS symptoms start showing. Hence, one of the reasons the virus remembered undetected for so long, infecting many in silence. The time spending tracing the illness and learning about its epidemiology saw a global dismay manifesting. By attributing the virus to gay people, there was not only stigma but many others felt they were not susceptible to the virus. When the virus  name became AIDS in September 1982, it was then health officials realized that the virus spreading to heroin users and haemophiliacs. Later on they included pre-natal route of entry but AIDS is known chiefly as a sexually transmitted disease.  Another key implication for HIV epidemics is the lack of an immediate cure or treatment for many patients. When antiretroviral became available, it did cut the number of deaths from AIDs but many developing countries such as Haiti and Sub-Saharan Africa were dying from the disease as  oppose to living with the virus (Paul Farmer, 2006).

 

Works Cited

AVERT. Origin of HIV and AIDS. Last Reviewed 1 May 2015. 26 November 2015 <http://www.avert.org/professionals/history-hiv-aids/origin&gt;.

Beards, Graham. Social History of Viruses. Edited October 2015. November 25 2015 <https://en.wikipedia.org/wiki/Social_history_of_viruses&gt;.

Brown, Rob. The Virus Detectives Who Discovered Ebola in 1976. 18 July 2014. 25 November 2015 <http://www.bbc.com/news/magazine-28262541&gt;.

Commission, Report of an International. “Ebola Haemorrhagic Fever in Zaire, 1976.” Bulletin of the World Health Organization Volume 56 Issue 2 1978: 271-293.

Farmer, Paul. AIDS and Accusation: Haiti and the Geography of Blame, Updated. USA: Univerity of California Press, 2006.

Gallagher, James. Aids: Origin of pandemic ‘was 1920’s Kinshasa’. 3 October 2014. 26 November 2015 <http://www.bbc.com/news/health-29442642&gt;.

Martinier. Chronology of Ebola Virus Disease Outbreaks, 1976-2014. 10 June 2014. 25 November 2015 <http://healthintelligence.drupalgardens.com/content/chronology-ebola-virus-disease-outbreaks-1976-2014&gt;.

Oxford, The University of. HIV Pandemic’s Origns Located. 3 October 2014. 26 November 2015 <http://www.ox.ac.uk/news/2014-10-03-hiv-pandemics-origins-located&gt;.

Parker, Alice. 5 Reasons Ebola WasContained on the Congo. 16 October 2014. 25 Month 2015 <http://time.com/3511101/ebola-congo-contained-spread/&gt;.

Paul M. Sharp, Beatrice H. Hahn. “Origins of HIV and the AIDS Pandemic.” September 2011. Cold Springs Harbor Perspectives in Medicine. 26 November 2015 <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3234451/&gt;.

Selmi Nadhem, Hachicha D Nejib. “The Ebola Contagion and Forecasting Virus: Evidence From Four African Countries.” Health Economics Review (2015): Volume 5.

Smith, Laura. Ebola Virus: Can Nations Stop Deadliest Ever Outbrak From Spreading? 3 July 2014. 25 November 2015 <http://edition.cnn.com/2014/07/03/health/ebola-outbreak-west-africa/index.html&gt;.

Team, Report of a WHO International Study. “Ebola Haemorrhagic Fever in Sudan, 1976.” Bulletion of the World Health Organization 27 June 1976: Volume 56, Issue 247-270.

WHO. WHO/ Ebola Virus Disease. Last Upated August 2015. 25 November 2015 <http://www.who.int/mediacentre/factsheets/fs103/en/&gt;.

Wikipedia. History of HIV/AIDS. Last Modified 17 November 2015. 26 November 2015 <https://en.wikipedia.org/wiki/History_of_HIV/AIDS&gt;.

 

 

 

 

 

 

 

 

 

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