Universities around the world have been
swept up in activities responding to the outbreak of Ebola in West
Africa. Many are monitoring international students coming from the
region, others have cancelled student and academic visits, and some are
involved in cutting-edge Ebola research and vaccine trials.
Last week saw the announcement of
experimental therapies and vaccines developed by world-leading
universities and major pharmaceutical companies, supported by research
councils and funding from foundations and governments.
The Ebola situation
The outbreak of Ebola viral disease in
West Africa was first reported in March this year in Guinea. It spread
in four countries – Guinea, Liberia, Sierra Leone and Nigeria – with a
first case reported in Senegal last week and a different virus appearing
in the Democratic Republic of Congo, laboratory-confirmed on 26 August.
Senegal reported its first case late last week, involving a 21-year-old student from Guinea.
Last Friday the number of Ebola cases had
reportedly risen to 3,069 with 1,552 deaths, and the outbreak continued
to accelerate with more than 40 per cent of cases having occurred
within the past three weeks – although most were concentrated in a few
localities.
The death rate from the disease is 52 per
cent but ranges from 42 per cent in Sierra Leone to 66 per cent in
Guinea. People infected with the Ebola virus are thought to be
contagious only when they are sick, and after death, and the virus is
transmitted only through contact with bodily fluids.
WHO analysis has shown that 62 per cent
of reported cases are still concentrated in the epicentre of the
outbreak in Guinea, Liberia and Sierra Leone and cases continue to rise.
Major cities are a problem because of population density and
repercussions for travel and trade.
The epidemic is anticipated to claim more
lives than all previous Ebola outbreaks combined. WHO declared it a
global health emergency and predicted that it could eventually infect
20,000 people.
West African students abroad
In the case of Nigeria, all cases of
Ebola have been linked to one imported case and there has not been wider
transmission – a factor of some relief to universities in destination
countries since there are tens of thousands of Nigerian students abroad.
The UNESCO Institute for Statistics’
“Global Flow of Tertiary-Level Students” reports nearly 50,000 Nigerians
studying abroad, with 17,550 in the United Kingdom, 6,113 in
neighbouring Ghana, 4,795 in Malaysia, 2,575 in South Africa and 2,031
in Canada, and approaching 1,000 Nigerian students each in Finland,
Saudi Arabia, the United Arab Emirate and Russia.
Newer figures show that in 2013, there
were more than 7,300 Nigerian students in the United States, according
to the Open Doors report of the Institute of International Education, as
well as 79 from Guinea, 172 from Liberia and 123 from Sierra Leone.
UNESCO puts the total number of
international students from Guinea at just over 6,000, with the majority
– nearly 4,000 – in France and just over 500 in Morocco followed by
Saudi Arabia, Canada, Spain and Malaysia.
There are more than 800 students from
Sierra Leone abroad – mostly in Saudi Arabia, the United Kingdom and
America – and just under 700 Liberian students overseas, primarily in
Ghana and the United States, according to UNESCO.
With several international airlines
cancelling flights in and out of affected West African countries, it is
possible that international students will find it increasingly difficult
to reach their destination countries for study – or return home.
Universities act
In response to local concerns about
international students from West Africa spreading Ebola on campuses,
universities in popular West African student destination countries have
been disseminating information about how the disease is spread and what
health authorities and universities are doing in response to Ebola.
Most universities receiving West African
students appear to be monitoring their health in a quite hands-off way –
asking students to take their temperature regularly – as well as
following health guidelines and keeping abreast of outbreak
developments.
The spread of Ebola on campuses is being considered a low threat.
Newspapers in the US, Canada and the UK
were reporting students – armed with information universities and the
media were giving them – to be generally relaxed about West African
students on campus.
But many universities have suspended
study abroad programmes in West Africa, are discouraging students from
travelling in countries where the outbreak has occurred and are also
monitoring students who may have travelled in West Africa recently.
In Britain, the government produced an Ebola advice and risk assessment for tertiary institutions last Friday.
It describes the risk of Ebola arriving
in the United Kingdom as “very low”. Affected countries have introduced
exit screening at airports to ensure that people who are ill do not
board flights, in line with WHO guidance and as part of efforts to
reduce the risk of international spread of disease.
“However, as the time between contact
with an infected person and symptoms first appearing can range from two
to 21 days, it is possible that students returning from affected
countries could develop symptoms up to three weeks after arrival,” said
the UK guidance.
Public Health England produced an
algorithm – a short series of questions leading to actions – to inform
the assessment of unwell students.
In the United States, there were reports
that West African students might need to undergo health checks on
arriving in the country.
The US Centers for Disease Control and
Prevention did not issue recommendations for colleges and universities,
but some states provided information on symptoms and many universities
instituted health screening and developed plans to deal with Ebola cases
if they occurred.
In Ghana, with its thousands of
international students from across West Africa, universities are
submitting Ebola-preparedness plans to the Ministry of Education, as are
university hospitals.
Affected medics and scientists
The WHO and partners are in West Africa
establishing Ebola treatment centres and building capacity for
laboratory testing, contact tracing, social mobilisation and safe
burials. They are being assisted by numerous West African and
international doctors and researchers.
WHO said that as of August 25, at least 240 health workers had been infected in the outbreak and more than 120 had died.
One was a Senegalese epidemiologist who
worked with WHO in Sierra Leone, and arrived last Wednesday in Germany
for treatment. The epidemiologist was a surveillance officer, not
involved in the direct treatment of patients, WHO spokeswoman in West
Africa, Christy Feig, told the Canadian Broadcasting Corporation News.
Feig said WHO was checking to make sure
there was not an infection risk in the living and working environment
that had not been uncovered.
“The international surge of health
workers is extremely important and if something happens, if health
workers get infected and it scares off other international health
workers from coming, we will be in dire straits,” she told CBC News.
Last week the US Centers for Disease
Control and Prevention said two staff members had been removed from
Kailahun in Sierra Leone after one had low-risk contact with a person
infected by the Ebola virus.
Also it was announced that a third medic,
Dr. Sahr Rogers, had died in Sierra Leone. He had been working in a
hospital in Kenema in the east, in a country that has only two doctors
per 100,000 people. By comparison, reported CBC, Canada had 2.5 doctors
per 1,000 people.
Canada said it was to bring home three
scientists from Sierra Leone, who had been working to identify people
infected with Ebola, as a precautionary measure.
Several Westerners infected with Ebola
who were sent home for treatment – including two Americans and a British
nurse – have survived, with research assisting in the development of
effective treatments, which are now being disseminated to health workers
in West Africa.
The science
As the Ebola outbreak unfolded,
universities and drug companies raced ahead with studying the disease,
and developing experimental therapies and vaccines.
Last Friday, Bloomberg reported that
France’s state health institute Inserm was talking to the Guinea
authorities about first clinical trials of experimental Ebola therapies.
Jean-Francois Delfraissy, director of
Inserm’s Institute of Microbiology and Infectious Diseases, said there
were two trials being considered, each involving some 15 patients to
test compounds from Fujifilm Holdings Corp and Tekmira Pharmaceuticals
Corp.
The Boston Business Journal reported that
researchers from the Broad Institute and Harvard University had
published research on 99 Ebola virus genomes, identifying mutations
relevant for diagnostics and treatment, online in the journal Science.
The research “details the sequencing of
99 Ebola virus strains collected from 78 patients diagnosed with the
disease in Sierra Leone during the first 24 days of the initial
outbreak”, said the publication.
The Broad Institute team’s testing of
samples of the disease shipped from Africa, found more than 300 genetic
changes, which they said made the 2014 virus distinct from previous
Ebola outbreaks.
The Boston Business Journal reported
co-author of the research Pardis Sabeti, a senior associate member at
the Broad Institute and an associate professor at Harvard University, as
saying there were significant implications for diagnosis and vaccines.
“Based on what the virus is that we’re
looking at, based on the analysis we’ve done, the virus has a number of
mutations that have happened over a short period of time.” Understanding
the virus was critical for the efficacy of diagnostics.
There are vaccine trials under way in the United States for another strain of Ebola.
Last Thursday The Telegraph revealed that
an experimental Ebola vaccine was to be tested on British volunteers
“in fast-tracked emergency clinical trials to begin in September”.
“The vaccine will use a single Ebola
protein and will not infect the subjects with live Ebola virus.”
Meanwhile, 10,000 doses would be produced so that the vaccine could be
widely used if the trials were successful.
“The vaccine being developed by
GlaxoSmithKline and the US National Institutes of Health is being
fast-tracked with a £2.8 million [US$4.6 million] grant from the
Wellcome Trust, the Medical Research Council and the UK Department for
International Development.”
Initially, according to The Telegraph, 60
volunteers would be injected with the vaccine at the Jenner Institute
at Oxford University “and if they show a good immune response with few
side effects then a further 40 volunteers will be given the vaccine in
Gambia”, followed by a similar test in Mali, both under Medical Research
Council – MRC – units there.
Professor Umberto D’Alessandro, director
of the MRC Unit in Gambia, said the proposed trial would not “benefit
immediately those currently at risk but we hope that in a not too
distant future we may be able to protect people against Ebola”.
