Though India's health minister Dr Harsh Vardhan has insisted that the country faces no threat from Ebola, both the United Nations and the United States government have expressed alarm at the spread of the disease. As a result, doctors in India have become concerned that the subcontinent could also witness cases of the disease, whose fatality rate has reached nearly 70% during the recent outbreak.
In addition to the nearly 9,000 Ebola cases recorded worldwide since the start of the outbreak, the World Health Organisation warned that there could be up to 10,000 new cases per week by December. WHO assistant director-general Bruce Aylward said that virus is on the move and that all major cities in the world are under threat.
“The World Health Organisation has already declared it a global epidemic and it has spread over Australia, the US, in Europe other than West Africa,” said Dr Jugal Kishore, an expert on community medicine at the Maulana Azad Medical College in New Delhi. 'We would be naive to believe that just because the government thinks that they are prepared with precautions, India is safe from this virus. The virus is still at an early stage, where every day something new is being discovered about it."
Dr Kishore recently authored a review of India’s effort to tackle the disease that was published in the Indian Journal of Youth and Adolescent Health.
Rethinking transmission
Ebola, first identified in 1976 in present-day Democratic Republic of Congo, has never before spread with such rapidity. The spike in cases has caused some to reexamine transmission, which is known to occur when an uninfected individual has direct contact with the blood or bodily fluids (sweat, urine) of an infected person.
Dr. Gary Kobinger, chief of special pathogens at the National Microbiology Laboratory in Winnipeg, Canada, speculated on the role of droplets in the rapid spread of the disease. “What we suspect is happening is large droplets ‒ they can stay in the air, but not long, they don't go far," he said. “But they can be absorbed in the airway and this is how the infection starts, and this is what we think, because we saw a lot of evidence in the lungs of the non-human primates that the virus got in that way,” said Kobinger to the BBC.
It is important to note that the spread of droplet-borne diseases varies sharply from the spread of airborne diseases, which are far more transmittable than the latter.
Droplet route
However, other experts believe that even if disease is being transmitted via droplets, it will still only be infectious if a patient suffering from Ebola vomits or bleeds within three feet or less of other people, said Dr Baijayantimala Mishra of the department of microbiology at the All India Institute of Medical Sciences in Bhubaneshwar.
Roughly 45,000 Indian citizens are living in Ebola-affected countries in West Africa. “Nigeria alone has over 40,000 Indians staying there and a lot of them keep travelling between India and Nigeria for business purposes,” said Dr Mishra.
If the virus has mutated, he said, then the disease cannot be prevented from spreading by just medical examinations and moving suspected cases to quarantine facilities. "A simple sneeze can make sure that the virus travels in droplets and it can remain airborne for a long time before it is inhaled by another host body," he said.
Heightened surveillance
Surveillance has also been heightened at airports, where thorough medical examinations are being conducted on passengers from high-risk countries. According to an official at the Indira Gandhi International Airport in Delhi, 485 travellers out of a total 1,200 suspected people have been quarantined at a local facility.
India’s health ministry says it has taken a number of preventive steps to ensure that the disease does not spread in country. The National Institute of Virology in Pune and the National Centre for Disease Control in Delhi have been directed to increase their capacity to run tests to diagnose suspected cases of Ebola.
However, authorities have to do a lot more if it they intend to stop this disease from spreading, according to Dr Kishore. “The population of this country is over a billion. Just two laboratories cannot do adequate amount of testing required,” he said. “Ideally, there should be at least one laboratory designated in every state for testing the virus in suspected cases.”
In addition to the nearly 9,000 Ebola cases recorded worldwide since the start of the outbreak, the World Health Organisation warned that there could be up to 10,000 new cases per week by December. WHO assistant director-general Bruce Aylward said that virus is on the move and that all major cities in the world are under threat.
“The World Health Organisation has already declared it a global epidemic and it has spread over Australia, the US, in Europe other than West Africa,” said Dr Jugal Kishore, an expert on community medicine at the Maulana Azad Medical College in New Delhi. 'We would be naive to believe that just because the government thinks that they are prepared with precautions, India is safe from this virus. The virus is still at an early stage, where every day something new is being discovered about it."
Dr Kishore recently authored a review of India’s effort to tackle the disease that was published in the Indian Journal of Youth and Adolescent Health.
Rethinking transmission
Ebola, first identified in 1976 in present-day Democratic Republic of Congo, has never before spread with such rapidity. The spike in cases has caused some to reexamine transmission, which is known to occur when an uninfected individual has direct contact with the blood or bodily fluids (sweat, urine) of an infected person.
Dr. Gary Kobinger, chief of special pathogens at the National Microbiology Laboratory in Winnipeg, Canada, speculated on the role of droplets in the rapid spread of the disease. “What we suspect is happening is large droplets ‒ they can stay in the air, but not long, they don't go far," he said. “But they can be absorbed in the airway and this is how the infection starts, and this is what we think, because we saw a lot of evidence in the lungs of the non-human primates that the virus got in that way,” said Kobinger to the BBC.
It is important to note that the spread of droplet-borne diseases varies sharply from the spread of airborne diseases, which are far more transmittable than the latter.
Droplet route
However, other experts believe that even if disease is being transmitted via droplets, it will still only be infectious if a patient suffering from Ebola vomits or bleeds within three feet or less of other people, said Dr Baijayantimala Mishra of the department of microbiology at the All India Institute of Medical Sciences in Bhubaneshwar.
Roughly 45,000 Indian citizens are living in Ebola-affected countries in West Africa. “Nigeria alone has over 40,000 Indians staying there and a lot of them keep travelling between India and Nigeria for business purposes,” said Dr Mishra.
If the virus has mutated, he said, then the disease cannot be prevented from spreading by just medical examinations and moving suspected cases to quarantine facilities. "A simple sneeze can make sure that the virus travels in droplets and it can remain airborne for a long time before it is inhaled by another host body," he said.
Heightened surveillance
Surveillance has also been heightened at airports, where thorough medical examinations are being conducted on passengers from high-risk countries. According to an official at the Indira Gandhi International Airport in Delhi, 485 travellers out of a total 1,200 suspected people have been quarantined at a local facility.
India’s health ministry says it has taken a number of preventive steps to ensure that the disease does not spread in country. The National Institute of Virology in Pune and the National Centre for Disease Control in Delhi have been directed to increase their capacity to run tests to diagnose suspected cases of Ebola.
However, authorities have to do a lot more if it they intend to stop this disease from spreading, according to Dr Kishore. “The population of this country is over a billion. Just two laboratories cannot do adequate amount of testing required,” he said. “Ideally, there should be at least one laboratory designated in every state for testing the virus in suspected cases.”
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