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Crawford Dorothy H. - Ebola: Profile of a Killer Virus

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Crawford Dorothy H. Ebola: Profile of a Killer Virus
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Ebola Profile of a Killer Virus - image 1
Ebola
Ebola Profile of a Killer Virus - image 2

Ebola slogan on a wall in Freetown, Sierra Leone, 2015.

Ebola Profile of a Killer Virus - image 3

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)

Acknowledgements

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.

Contents
Photo by Dorothy Crawford
Shutterstock
CDC/Frederick A. Murphy
Courtesy Neal Lineback/Geography in the News LLC
Ali S. Khan, F. Kweteminga Tshioko, David L. Heymann, Bernard Le Guenno, Pierre Nabeth, Barbara Kerstins, Yon Fleerackers, Peter H. Kilmarx, Guenael R. Rodier, Okumi Nkuku, Pierre E. Rollin, Anthony Sanchez, Sherif R. Zaki, Robert Swanepoel, Oyewale Tomori, Stuart T. Nichol, C. J. Peters, J. J. Muyembe-Tamfum, Thomas G. Ksiazek, for the Commission de Lutte contre les Epidmies Kikwit, The Reemergence of Ebola Hemorrhagic Fever, Democratic Republic of the Congo, 1995, Journal of Infectious Diseases, 1999, 179, pp. S76S86, by permission of Oxford University Press
CDC
Ebola death toll maps for March 2014, May 2014, June 2014, and September 2014, taken from Ebola: Mapping the outbreak, http://www.bbc.co.uk/news/world-africa-28755033, based on data from the WHO and HDX. WHO data is licensed under CC IGO 3.0, and the presence of WHO data does not represent an endorsement of any kind
Shutterstock
ton koene/Alamy Stock Photo
Infographic: Ricci Coughlan/DFID. From First British Ebola treatment facility opens in Sierra Leone https://www.gov.uk/government/news/first-british-ebola-treatment-facility-opens-in-sierra-leone
Reprinted from http://www.bbc.co.uk/news/world-africa-28755033, with permission, based on data taken from WHO Ebola situation reports, Data summary, All data and statistics and Ebola maps http://www.who.int/csr/disease/ebola/en/
Based on data from Transmission Chains in the Outbreak of Ebola Virus Disease in Guinea, from Blaize et al, Emergence of Zaire Ebola Virus Disease in Guinea, The New England Journal of Medicine 37:15 October 9 2014
AD3Chimpanzee adenovirus 3
Acquired immune deficiency syndrome
CDCCentres for Disease Control
DNADeoxyribonucleic acid
DRCDemocratic Republic of Congo
EMElectron microscope
FluInfluenza
GAVIGlobal Alliance Vaccine Initiative
GDPGross domestic product
HIVHuman immunodeficiency virus
MRMagnetic resonance imaging
MSFMdcins Sans Frontires (Doctors without Borders)
MVAModified vaccinia Ankara virus
NGONon-governmental organization
PCRPolymerase chain reaction
PHEPublic Health England
PLZLever Plantations in Zaire
RNARibonucleic acid
SARSSevere acute respiratory syndrome
TBTuberculosis
UNICEFUnited Nations International Childrens Emergency Fund
VSVVesicular stomatitis virus
WHOWorld 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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