At least 30 experts were unable to attend the American Society of Tropical Medicine and Hygiene Conference in New Orleans these past few days, as the Louisiana State Health authorities banned any potential attendee who had been working in the Ebola-affected countries of Liberia, Sierra Leone or Guinea. This lead to some Ebola experts calling in to make presentations to audiences of several hundred, who sat raptly listening to the latest updates from representatives of Doctors Without Borders (MSF), WHO, Tulane, and the Kenema Government Hospital in Sierra Leone. One researcher who returned before the deadline, and is about to leave again for Sierra Leone in a few days, is Tulane's Dr. Lina Moses, who has been on the front lines of some of the most cutting edge research to date.
Dr. Moses confirmed that, "Sub-Saharan Africa is the most genetically diverse region in the world." The rates of susceptibility and not only whether or not someone becomes ill, but also whether or not they live or die, or even display symptoms, varies widely. The genetics of both this deadly strain of Ebola itself, and of the populations living in the affected areas, are at the forefront of the efforts by Dr. Moses as she works with Dr.Pardis Sabeti at Harvard to provide samples for genome sequencing. As they were already on site due to earlier research on Lassa fever, Dr. Sabeti's Lab was well-placed to collect samples as soon as the outbreak hit in order to focus on Ebola.
Dr. Sabeti's team is also hoping to help find ways to create therapeutics by providing novel diagnostics, create new therapies and vaccines based on this research. More generally, the work being done tells us a great deal about how both humans and the pathogens, which might kill us, influence one another. Dr. Sabeti was part of a group that recently published an article in Nature entitled, "Natural selection and infectious disease in human populations." From the abstract of the article comes the following:
The ancient biological "arms race" between microbial pathogens and humans has shaped genetic variation in modern populations, and this has important implications for the growing field of medical genomics. As humans migrated throughout the world, populations encountered distinct pathogens, and natural selection increased the prevalence of alleles that are advantageous in the new ecosystems in both host and pathogens. This ancient history now influences human infectious disease susceptibility and microbiome homeostasis, and contributes to common diseases that show geographical disparities, such as autoimmune and
So how did our human genetics morph into groups, which are more or less resistant to these pathogens? Was it prior outbreaks, such as the Bubonic Plague in Europe, which appears to have left some of the populations there with mutated alleles, which either prevent or slow down the spread of deadly viruses? It has become evident that those who are suffering from compromised immune systems are the most at risk from Ebola. This includes women who are pregnant. Add to that the breakdown of basic health care, which results in pregnant women almost universally dying from Ebola once they are infected, and almost all of these women suffer miscarriages in their third trimester. Even healthy pregnant women are now at risk of dying, as there are no doctors left in Sierra Leone to provide C-sections, much less deliver babies. Maternal death rates were already high in this country where many doctors have already died from Ebola, and it is difficult to even find health care workers who will take care of the sick and dying. Every medical procedure involving a great deal of blood isn't being carried out, no doctor wants to take the risk.
Already the presence of not only the aforementioned Lassa fever, but also Malaria, HIV and a host of other diseases, are found in a large majority of households in Sierra Leone. Now there are no next to no doctors in some areas, no health care workers, and those who fear they may be infected, or a family member may be infected with Ebola, are not showing up at the clinics and hospitals. They are simply going underground. This means that even if they are Ebola-free, they may be suffering from other life-threatening illnesses that are not being treated. Rumors are becoming more credible that black market "survivor's blood" is being sold as a cure for Ebola. What those both selling and possibly acquiring this blood seem to be unaware of, is that it takes a pool of different survivors' blood, and enough antibodies, not just one individual survivor's, to even begin the process of creating what should ideally happen in a lab (which is also testing for other pathogens, viruses and co-factors) to create what is known as convalescent serum, which may not even work.
What we are not hearing in the mainstream press is precisely what we need to know most. What some publications are focused on are the economics of a successful vaccine, which becomes absurd when discussing the poorest countries in the world. Ebola is not the place to imagine an IPO based on fast-track human testing being provided by this outbreak. What many people do not realize, as few of us take the time to seek out scientific publications, (which, even if we could understand the terminology, are not written for non-scientists) is that genetically at least, we are all interconnected. If some of us are more or less susceptible to pathogens, then those human beings can be the answers to helping others survive. Sierra Leone, Liberia and Guinea are not distant lands in which bad things happen to unfortunate people, but rather part of our combined genetic family. What we all need to understand, and in the case of this largest ever Ebola outbreak, deeply take to heart, is the Native American saying, "I Am Another Yourself."
(Dr. Dan Bausch of Tulane University and Head of the Virology and Emerging Infections . Department of the U.S. Naval Medical Research, also stated that as a result of yesterday's elections in the U.S., we need to be vigilant regarding funding for the CDC, NIH and other organizations in order to stay on top of the Ebola outbreak, as well as to make sure other research focused on increasing instances of Dengue, the biggest killer, Malaria, Lassa fever and other tropical diseases does not suffer.)