Ebola - How HITA e.V. can help effectively even without a vaccine

Almost exactly 4 years ago (early 2014), the Ebola virus broke out in West Africa. It was the deadliest Ebola epidemic since the virus was discovered in 1976: more than 28,000 people became infected with the Ebola virus and more than 11,000 of them died. The number of unreported cases is probably much higher; it can be assumed that many cases have not been recorded at all. For a long time, the Ebola virus was strongly present in the media in this country, as is also known from other diseases such as swine flu, bird flu, EHEC or, as a more recent example, the Zika virus. Our fear of diseases and their consequences also explains our curiosity towards them. The Ebola virus was particularly frightening and in Germany, too, many people were afraid of the disease raging in Africa. The reason: There was neither a vaccine nor suitable drugs to treat the virus adequately. However, the Ebola virus did not spread in Europe, of course, and infected almost exclusively people from West African countries (mainly Liberia, Sierra Leone and Senegal). In these states, poverty prevails and there is no adequate medical infrastructure. These are, of course, factors favorable to an epidemic and even exacerbate it.

At the beginning of 2016, the epidemic was declared over and the affected West African states have been considered Ebola-free again since then. At the end of the same year, it was announced that a potentially viable vaccine had been found. However, this will most likely only be able to help with a specific strain of the Ebola virus. Nevertheless, this vaccine, which may receive market approval this year (2018) and can thus go into production, will give humanity a weapon against the deadly disease, and in the future it will hopefully be possible to save many people from the Ebola virus.

However, this funding comes four years too late for the more than 10,000 Ebola deaths. This reveals a fundamental problem with viral epidemics: There is often no direct treatment option for the viral disease; the protective vaccinations (passive and active) usually come too late and are not available when they are urgently needed. Why is that? How to change this? This requires a small digression into the medical context:

Infectious diseases, i.e. contagious diseases, can be caused either by bacteria, viruses or fungi. Fungal diseases, however, are left out of this context. Bacteria are small organisms that fulfill all the necessary conditions for the definition of a biological living being: they have their own metabolism and can reproduce, to name just two characteristics. If a bacterial infection occurs in humans, i.e. if bacteria enter our body and our immune system cannot fight the harmful bacteria (bacteria are not harmful per se) on its own, these infections can be fatal. Fortunately, since 1941 at the latest, we have had drugs that can act against these biotic (ancient Greek bios "life") processes: antibiotics. Antibiotics help against bacteria, which are small living microorganisms, by attacking their reproduction or metabolism. While there are different antibiotic groups for different bacterial diseases and not every antibiotic is appropriate for every bacterial infection, even if the bacterium has not been accurately diagnosed, broad-spectrum antibiotics can be used to effectively treat the infection. We owe a significantly increased life expectancy and improved quality of life to antibiotics compared to people from a time when antibiotics did not exist and an infected wound could lead to death.

So far, this applies to bacteria or bacterial infections. Viruses, on the other hand, are much smaller than bacteria and do not count as living organisms, since they do not fulfill the necessary characteristics of biological life: they have neither their own reproduction nor their own metabolism (in fact, it is disputed within biology whether viruses cannot be counted as living organisms after all, since they have genetic information). Antibiotics, which can only act against biotic/lethal pathogens, thus do not help with viral diseases.

Although viruses do not have their own reproduction, they reproduce. They do this by infecting a host cell (for example, a human host cell) and reproducing through it. If a person suffers from a viral disease and an attempt is made to prevent the virus from reproducing, it would be necessary to attack the body's own cells. There are antivirals (i.e., drugs against viruses), but these are mostly pathogen-specific - there are no broad-spectrum virustatics. Provided that a vaccine is available, it is possible to help people against viral diseases, even if the person is already infected. However, if there is no remedy for a specific virus, one can only treat the symptoms and thus give the body's own immune system the opportunity to fight the virus itself. This is also how the Ebola virus is currently being treated. Viral diseases have the advantage for humans that viruses, which were once successfully fought by our immune system, are fought much faster and more effectively in the future, that our immune system has a kind of memory for viruses. This is the reason why we do not get many childhood diseases a second time in adulthood.

For vaccine development, however, this means that a separate vaccine must be developed for each virus. A pathogen-specific virustatic agent must therefore always be researched anew. Even once a potential vaccine has been found, various tests must be performed on animals and then on humans before it can receive marketing approval and be produced. Even if massive amounts of money are spent on research and all the researchers in the world are working on a vaccine, it will always take several years before it is actually available. Of course, viruses can also mutate and thus undermine protective vaccinations.

So if a vaccine for a virus is needed at short notice, in many cases it is simply not available. A vaccine may now be available for the Ebola virus four years after the Ebola epidemic. But what about the Zika virus or other viruses that could lead to an epidemic in the future! The problem of having vaccines often only after a time delay will probably accompany mankind for the next decades. So what is to be done? How can you still help effectively? How can HITA e.V. help effectively?

The best way to fight an infectious disease is to prevent it from spreading. If no vaccine is available, the means of prevention remains. While a vaccine for the Ebola virus is not known, the modes of transmission are, and so is how to prevent transmission of the virus. In this context, it should be noted: The Ebola virus is not transmitted through the air. The protective suits and special isolation wards in hospitals are much more of a precautionary measure, as airborne transmission of bodily fluids from an Ebola-infected person could occur. Normally, however, transmission can only occur through direct contact with an infected person, especially with bodily fluids. For a short period of time, transmission is also possible through objects (for example, the clothes of an infected person), provided they have come into contact with infected body fluid. As long as you don't have any open wounds on your hands (not even small skin cracks), you can even get rid of the virus by washing your hands. The simplest hygiene measures can be sufficient to effectively protect against the virus.

The problem actually lies in another place: this knowledge about infectious diseases and the transmission of the Ebola virus is in most cases unknown to those affected. As already written at the beginning, poor people in particular are affected by the disease. In addition, there is the culture of the people in West Africa: People eat mainly with their fingers, often without washing their hands beforehand. This happens out of ignorance about hygiene and infectious diseases. In addition, dead relatives are washed by families, so transmission has often occurred in this way as well if the dead person was infected with the Ebola virus. The governments of the affected states have of course reacted to this and tried to inform the population with posters all over the country and urge them to take hygiene measures. But even these posters have not been able to help many people.

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