Emerging Infectious Diseases in the Time of Ebola
- Since its discovery in Saudi Arabia in mid-2012, Middle East respiratory syndrome (MERS) has continued to be reported following exposure to infected camels and human contact in the healthcare setting, almost exclusively in Middle Eastern countries. There have, however, been subsequent reports of virus transmission outside the Arabian Peninsula in the 3 years since (Iran, Tunisia, UK, France, Italy, and USA).1 Globally, since September 2012, the World Health Organization (WHO) has been notified of 1368 laboratory-confirmed cases of MERS coronavirus (MERS-CoV) infection, including at least 490 related deaths.
- The international community has responded to the Ebola outbreak in West Africa with an approach that could be described as ‘top down’. Small groups of elite scientists, health policy makers, pharmaceutical company executives, and the staff of the World Health Organization (WHO), governmental agencies, and non-governmental institutions have decided how to implement interventions for outbreak control and containment and develop new Ebola vaccines and treatments. These ‘top down’ interventions have built Ebola treatment units and organized the delivery of supplies, communications, and surveillance that have been essential for outbreak control.
- French Polynesia (FP) is a French overseas territory of about 270,000 inhabitants in the Southeast Pacific, and one of the 22 Pacific Islands Countries and Territories (PICTs). Arthropod-borne virus (arbovirus) infections are major public health concern in the PICTs, with dengue virus (DENV), a Flavivirus of the Flaviviridae family, as the most common circulating and widespread arbovirus.1 In FP, DENV outbreaks have been recorded since the 40s.1–4 DENV used to be the only arbovirus isolated until October 2013 when FP experienced the largest outbreak of Zika virus (ZIKV) ever reported,5,6 followed by an outbreak of chikungunya virus (CHIKV) that started in October 2014.
- The rate of HIV is exploding in the men who have sex with men (MSM) population in the Philippines. There is a paucity of information with respect to sexual behaviour, condom use, psychological health, and the prevalence of other STIs in the MSM subpopulation. At present there are no existing private or public clinical services in the country that focus on health services of MSM. We discuss the current epidemic situation and the steps needed to further define the rapidly evolving epidemic among MSM.
- The weekly epidemiological record of the World Health Organisation 15th May 20151 states that ‘the cases of Middle East Respiratory Syndrome (MERS) recently exported to other countries have not resulted in sustained onward transmission to persons in close contact with these cases on aircraft or in the respective countries outside the Middle East.’ This situation has changed rapidly and remarkably. Five days after the publication of this report, the first case of a MERS-coronavirus (MERS-CoV) infection in Seoul, South Korea was reported on 20 May 20152.
- In a provocative article published in this issue, Fedson and Rordam argue that statins and angiotensin II receptor blockers (ARBs) could be used as therapeutic agents in Ebola virus disease (EVD). The authors assert that the loss of vascular integrity represents a critical step in the pathophysiology of EVD, leading to hypovolemia and multi-organ failure. Since every blood vessel in the body is lined by endothelial cells and since, according to the authors, statins and ARBs work to maintain or enhance endothelial barrier integrity, these drugs might keep the patient alive long enough for the immune system to clear the virus.