Crawford Dorothy H. - Ebola: Profile of a Killer Virus
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Ebola slogan on a wall in Freetown, Sierra Leone, 2015.
Great Clarendon Street, Oxford, ox 2 6 dp , United Kingdom
Oxford University Press is a department of the University of Oxford. It furthers the Universitys objective of excellence in research, scholarship, and education by publishing worldwide. Oxford is a registered trade mark of Oxford University Press in the UK and in certain other countries
Dorothy H. Crawford 2016
The moral rights of the author have been asserted
First Edition published in 2016
Impression: 1
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Oxford University Press, or as expressly permitted by law, by licence or under terms agreed with the appropriate reprographics rights organization. Enquiries concerning reproduction outside the scope of the above should be sent to the Rights Department, Oxford University Press, at the address above
You must not circulate this work in any other form and you must impose this same condition on any acquirer
Published in the United States of America by Oxford University Press 198 Madison Avenue, New York, NY 10016, United States of America
British Library Cataloguing in Publication Data
Data available
Library of Congress Control Number: 2016943467
ISBN 9780198759997
ebook ISBN 9780191078323
Printed in Great Britain by Clays Ltd, St Ives plc
Links to third party websites are provided by Oxford in good faith and for information only. Oxford disclaims any responsibility for the materials contained in any third party website referenced in this work
This book is dedicated to Dr Jean Alero Thomas (19452015)
I would like to thank all those experts who helped and advised on the writing of this book: Tim Brooks, Public Health England, Jeremy Farrar, Wellcome Trust, Ian Goodfellow, University of Cambridge, Brian Greenwood, London School of Hygiene and Tropical Medicine, David Heymann, Public Health England and Centre on Global Health Security, Paul Johnson, Public Health England, Peter Piot, London School of Hygiene and Tropical Medicine, and Katrina Roper, World Health Organization.
I am also indebted to the following for reading and commenting on the manuscript: William Alexander, Martin Allday, Jeanne Bell, Richard Boyd, Jude Fantes, Tanzina Haque, Ingolfur Johannessen, Barbara Judge, Jim Piper, Iain Ritchie, Paul Saba, Bobby Stansfield, Tara Womersley, and to Latha Menon at Oxford University Press for her constant support.
I am particularly grateful to Frances Fowler, who facilitated my meetings with Ebola experts, and Tim Brooks, who allowed me to shadow him for a short time while he went about his busy schedule in Sierra Leone in April 2015.
AD3 | Chimpanzee adenovirus 3 |
Acquired immune deficiency syndrome | |
CDC | Centres for Disease Control |
DNA | Deoxyribonucleic acid |
DRC | Democratic Republic of Congo |
EM | Electron microscope |
Flu | Influenza |
GAVI | Global Alliance Vaccine Initiative |
GDP | Gross domestic product |
HIV | Human immunodeficiency virus |
MR | Magnetic resonance imaging |
MSF | Mdcins Sans Frontires (Doctors without Borders) |
MVA | Modified vaccinia Ankara virus |
NGO | Non-governmental organization |
PCR | Polymerase chain reaction |
PHE | Public Health England |
PLZ | Lever Plantations in Zaire |
RNA | Ribonucleic acid |
SARS | Severe acute respiratory syndrome |
TB | Tuberculosis |
UNICEF | United Nations International Childrens Emergency Fund |
VSV | Vesicular stomatitis virus |
WHO | World Health Organization |
When I arrived in Freetown, Sierra Leone, in April 2015 the atmosphere was electric. There was clear optimism in the air; the Ebola epidemic that had been raging for more than a year was coming under control, markets were functioning again, and schools had reopened. But no one could miss the fact that the country was in the grip of a deadly epidemic. At the airport we were politely told to wash our hands in chlorine solution even before entering the building. Once inside we completed long health questionnaires and were submitted to health checks. Gowned and masked figures wearing plastic gloves and aprons took our temperatures using a Thermoflasha handgun-shaped, electronic, infrared, contactless thermometeralarmingly aimed straight at the forehead.
This ritual of hand washing and temperature taking was repeated numerous times during my stay. Vats of chlorine solution sat outside every building, be it a hospital, office block, supermarket, or hotel. No one was allowed to enter without washing their hands and having their temperature taken. The same ritual occurred at frequent intervals along the highways; my temperature remained stubbornly at 36.2C throughout.
All over the country Ebola had a palpable presence. Everyone was committed to abolishing the deadly virus. Freetown was ringed by police check points to ensure no Ebola victim could evade quarantine. Streets were lined with Ebola posters with catchy reminders:
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