OUTBREAKS of infectious diseases are not confined to Ebola or West Africa, but when it comes to dying from any disease, geography matters.

Dr Sheik Humarr Khan from Sierra Leone was probably the world’s most renowned Ebola doctor. He and some of his colleagues had collected samples from 78 Ebola victims and characterised changes in the virus as well as what could possibly be done to stop it. Some of this data was used to drive the production by GlaxoSmithKline of ZMapp, the experimental drug being used in the management of some persons with Ebola viral disease. Still, Dr Khan died from Ebola viral disease in Sierra Leone without a chance, because some technocrats in the developed world decided the drug was untested and should not be administered to him. Why then was this untested drug used on the Americans, Dr Brantly and Nurse Writebol? Ironically, they survived.

Regardless of the overwhelming challenges in our health system, we cannot panic, we must fix it. Infectious diseases at biosafety level four, the greatest danger level, are emerging rapidly, almost every 12-18 months, and countries are passing laws to protect their borders by preventing anyone suspected of being infected from entering.

We can expect pathogens that cause human disease to be detected in the future at an alarming rate due to increased species jumps, where pathogens move from species like monkeys and rats to humans, causing diseases. These diseases can cause significant morbidity and mortality and must be worked with at higher containment levels and this is why under section 361 of the USA Public Health Service, the US Secretary of Health and Human services is authorised to take measures to prevent the entry and spread of infectious diseases from foreign countries into the USA.

It means if there is an outbreak and non-containment of any of these biosafety level four pathogens in Jamaica, we may be cut off from the rest of the world and all of Jamaica, uptown and downtown, will be affected. Our health infrastructure is inadequate, but no country is perfect, even the technologically and medically advanced USA with the world’s best Emerging Infectious Diseases Laboratory and the Centers for Disease Control (CDC) erred when the first Ebola Zaire patient sought treatment in Dallas, Texas.

He was turned away even though he had a fever and was recently in Africa. Spain, too, had its misstep when the first nurse became a victim after treating two infected priests. The recommendations from the CDC were to:

1. Find/identify the patient;

2. Isolate the patient;

3. Find everyone the original patient had contact with;

4. Keep the patient isolated until no longer a threat;

5. Quarantine contacts if necessary.

The world is currently facing an increased viral pandemic where species of infectious diseases are moving from animals to animals and humans. In 1994, there was an outbreak of Ebola Reston in Virginia, USA.

In 1967, there was an outbreak of Marburg in Germany and Yugoslavia, seven out of 30 infected people died. Marburg virus belongs to the same family as the Ebola and is an equally deadly RNA virus. There is currently an outbreak of Enterovirus D68 in 30 states in the USA, which has put many children in intensive care.

There is also the Middle East Respiratory Syndrome (MERS). Using Ebola disease spread patterns and airline traffic data, scientists predict a 75 per cent chance the virus could reach France by October 24, a 50 per cent chance for Britain and a 15 per cent chance for Spain and the Netherlands.

Those numbers are based on air traffic remaining at full capacity. Assuming an 80 per cent reduction in travel as many airlines are reducing flights to Africa, France’s risk is 25 per cent, and Britain’s is 15 per cent. Although people should be very careful about hygiene, it is a myth that Ebola is unstoppable. There have been 33 previous outbreaks of various Ebola viruses on record, all of which have been contained and stopped with fewer deaths than this one.

The problem is that people initially gave the outbreak in West Africa scant attention. The panic started when it dawned on the world that it did not matters where the outbreak occurred, based on global travel, one was hours away from possible infection.

It is also a myth that Ebola is not ‘druggable’. The hopeful news is that Ebola is not inherently super-complex; therefore, some of its receptors can be down-regulated by drugs. We have a number of promising drugs such as ZMapp and the NewLink Genetics Vaccine, which have already shown activities against the virus.

Japan has Avigan and Cuba and Thailand are jointly developing a cocktail of antibodies. Countries like Jamaica need to lobby the World Health Organisation and the Pan American Health Organisation for a more concerted effort to get these medicines into advanced testing, and to make them available in the field.

Experimental drugs are available to Americans who have been infected with the virus but is not generally available to anyone else because of the cost. There are also several effective treatments for Ebola that can help support individuals through the worst phases of the disease and increase their chance of survival.

These treatments include early and careful resuscitation with intravenous fluids, blood products such as packed red blood cells, platelets and concentrations of clotting factors to prevent haemorrhage. We may have bungled the chikungunya crisis; we must do better at planning for Ebola. We have the knowledge and capabilities to prevent Ebola from taking root in Jamaica if it gets here.

Thomas Duncan, the imported Ebola case from Liberia, died, many feel because he was given the Ebola drug too late only after outcries from black communities. Many feel no pity because they reasoned that he should not have been on American soil. Jamaica has responded to poliomyelitis, cholera and malaria in the past. For now, it is Ebola, but tomorrow it may be biological terrorism. Microbes continue to change into virulent diseases, Jamaica’s greatest challenge must be to down-regulate these pathogens before they become a threat to the country.

Dr Rachael Irving is a senior research fellow at the Department of Basic Medical Sciences, Faculty of Medical Sciences, UWI, Mona.