Health Editor’s Note: There have been movies/books that use the central theme of this scientific, potential, real horror show. A person can step onto a plane, not feeling particularly sick or even sick at all, not knowing that he or she is infected with some virulent disease, and be thousands of miles away within a few hours. While traveling the person has infected everyone he or she has come in contact with: the flight crew, other passengers on the plane, anyone who comes in contact with at the arrival destination. Potentially each person in contact with that person can then spread the disease after a few hours of the virus or bacteria incubating in the new body.
When a “sick/disease or virus carrying person” is able to easily move from home through travel or just going about daily activities, others can be exposed and the extent of the spread of the disease can get rapidly out of hand. An upgrade to being able to handle potential outbreaks in areas that have been previously isolated is important for the well-being of a region.
In areas that have here-to-fore not been easily traveled through or to, improvements in infrastructure that allow for treatment of the population is needed. Populations must have access to healthcare as numbers of people burgeon. Also, populations that have moved from rural areas into cities will be exposed to more and more people, some of whom will be contagious with something as relatively simple as the common cold or as potentially fatal as the Ebola virus. Too bad the TSA people cannot screen for viruses and bacteria. I know Africa seems a long way off and you may have no intention of every going there, but a lethal virus or bacteria that travels from Africa is as close as that person standing next to you in the elevator……Carol
NIAID (National Institute of Allergy and Infectious Diseases) Scientists, Colleagues say Rapid Central Africa Development Increases Outbreak Risk
Scientists Call for Proactive Investments in Health Care Infrastructure
NIAID scientists and their international colleagues say the Central Africa region is experiencing rapid urbanization, economic growth and infrastructure development that make the region more vulnerable to explosive infectious disease outbreaks. Their New England Journal of Medicine commentary notes that efforts to build the health care infrastructure in Central Africa are critically needed to mitigate or prevent a large outbreak of Ebola or other infectious disease in the region. The growth and development have altered ecosystems in which pathogens and their hosts reside, they note. This increases the opportunity for new infectious diseases to emerge and reduces the time it takes people to travel to and from urban areas, allowing outbreaks to spread quickly. Populations that have moved into urban areas will be exposed to more and more people, some of whom will be contagious with something as relatively simple as the common cold or as potentially fatal as the Ebola virus.
Citing the example of the 2013-2016 Ebola outbreak in West Africa, they note that Liberia, Sierra Leone and Guinea all have large, urban and mobile populations. Among other factors, this enabled the Ebola virus to quickly spread through these countries and overwhelm their limited health care infrastructures, resulting in more than 28,000 cases of Ebola virus disease and 11,000 fatalities.
Through their Central Africa field work over several years—primarily in the Republic of the Congo and the Democratic Republic of the Congo (DRC)—the researchers have observed what they describe as the world’s fastest rate of urbanization. By 2030, they write, half of the Central Africa population is expected to live in urban areas. They have seen the evolution of once-rutted jeep trails used to access remote villages now accessible by paved roads, typically related to the growth in logging, mining and hydroelectric industries. Road construction and similar disturbances in the jungle terrain alters ecosystems in which pathogens and their hosts reside, they note. This increases the opportunity for new infectious diseases to emerge and reduces the time it takes people to travel to and from urban areas, allowing outbreaks to spread quickly.
“Clearly, Central Africa is rapidly approaching a tipping point,” the authors state. “Africa’s economic development is a positive change that cannot and should not be stopped. At the same time, rapid economic and demographic transitions bring the challenges of emerging infectious disease outbreaks of increased frequency, size, and global impact.”
They believe that increases in population, income and educational attainment could spur demand for improved services, including health care. Moreover, directed investments in clinical research infrastructure could include training health care workers to identify, report and properly handle cases of unknown emerging infectious disease; diagnose patients; provide clinical care; and test new vaccines and therapeutics.
“Directed and sustained investment is urgently needed, before ongoing demographic and economic changes conspire to cause major outbreaks of both national and international consequence,” they write.
V Munster et al. Outbreaks in a Rapidly Changing Central Africa—Lessons from Ebola. New England Journal of Medicine DOI: 10.1056/NEJMp1807691 (2018).
Vincent Munster, Ph.D., chief of the virus ecology unit in NIAID’s Laboratory of Virology, is available to discuss this work.