Insights into Ebola and Other Emerging and Re-emerging Infectious Disease Risks

Open Access: Full open access to this and thousands of other papers at During the 20th and early 21st centuries, the discipline of environmental health has contributed to tremendous improvements in air, water, and food quality; occupational health; waste management practices; and disease vector control. As a result of these and other improvements, prevention and treatment of infectious disease (eg, those caused by biological agents) and non-infectious disease (eg, those caused by chemical or physical agents) has improved significantly around the world. However, substantial challenges remain, particularly in developing countries with limited health resources relative to more developed countries. Examples include recent (summer, fall, 2014) concerns for the Ebola virus and non-polio enterovi-rus D68 (EV-D68). There are also previous and ongoing concerns for diseases such as sudden acute respiratory syndrome (SARS); H1N1 influenza; other swine and avian influenza (swine, bird flu); and a variety of other viral, bacterial, and protozoal diseases. Are the risks of transmission of infectious diseases such as Ebola actually increasing, or is the public just more aware of the problem because of the efficiency of the global media in identifying infectious disease outbreaks? As an example, Ebola hemorrhagic fever has been in the news during summer and fall 2014 because of the outbreaks and related infections of health-care providers in Africa. Ebola transmission is accomplished via direct or indirect exposure to blood or other bodily fluids, and is therefore relatively easily controlled by the use of personal protective equipment such as gloves, masks, safety glasses, and Tyvek™ suits (Centers for Disease Control and Prevention [CDC]). 1 Therefore, the risks of an Ebola pandemic would appear to be low. However, there are concerns that Ebola could become an epidemic and/or endemic disease in Africa. A September, 2014 CDC Morbidity and Mortality Weekly Report Supplement predicted that there could be as many as 1.4 million cases in Liberia and Sierra Leone by January, 2015 2 It should be noted, however, that the authors outlined significant limitations to this prediction. There has also been public concern expressed about bringing infected health-care workers to the US because of the perceived potential for an outbreak of Ebola. Identification and treatment of specific Ebola symptoms and use of an experimental monoclonal antibody treatment (ZMapp™, developed by Mapp Biopharmaceutical Inc.) to manage the disease process appear promising. There is also an Ebola vaccine that began US National Institutes of Health (NIH) human testing …