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Ebola: the Song of Summer 2014

21.8.2014

While I have no desire to trivialize the subject of a disease with such devastating consequences as Ebola, it is hard to ignore the fact that the current outbreak of this deadly infection has become the media hit of the summer, just as mad cow disease and swine flu did before. Every so often—almost always during the summer silly season—the media elevates some emerging disease to breaking news status with front page headlines and prime time minutes. "More children die in Africa every day from malaria than have died from Ebola since the start of the current outbreak" Clearly, the current Ebola outbreak is unusual, both in terms of its duration (over five months now) and geographical spread (it has caused deaths in four different countries).

Over the last four decades, since the virus first appeared in 1976, there have been 24 “official” outbreaks of Ebola, in the course of which almost 2,400 people have been infected, two-thirds of whom have died. The number of people infected during the current outbreak almost equals the cumulative total of all previous cases and the situation is still far from under control, although in the last few hours the World Health Organisation has started talking about hopeful signs. While it is understandable that the spread of a very lethal infectious disease with no known cure will always give rise to uncertainty, it is important not to let this disquiet set off social alarm bells, particularly in places where local transmission is highly unlikely and mechanisms that can prevent the disease are already in place.

We expect our experts to be knowledgeable about international protocols, foresee problems, exercise great caution, and above all to be consistent. Consequently, the decision to treat a patient from Sierra Leone with Ebola in the Carlos III hospital in Madrid is surprising since there is a centre of reference for tropical diseases in Barcelona that is specifically equipped and prepared for the management of such patients.  Communication between experts and other health professionals as well as with the media must be effective, transparent and responsive in order to forestall unnecessary alarm about possible cases and the stigmatisation of patients based on their country of origin.

Moreover, we should not let the trees obscure our view of the forest; that is, we cannot allow rare and extraordinary conditions make us lose sight of more ordinary diseases. More children die in Africa every day from malaria than have died from Ebola since the start of the current outbreak. The initial symptoms of Ebola are indistinguishable from those of many other diseases. Should we therefore quarantine every patient coming from West Africa who presents fever and general malaise? The response to that question would appear to be obvious. The news that the patient isolated in the Hospital de Basurto in Bilbao suspected of having Ebola has been diagnosed with malaria should serve to refocus our attention on the more well-known theme of this longstanding disease.

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