Talking About Ebola

Dr. Amesh Adalja

An Interview with Dr. Amesh Adalja.

By Peter Bjel.

A physician by training, Dr. Amesh Adalja is editor of the journal Biosecurity and Bioterrorism, and writes and lectures frequently on infectious diseases, critical care, and emergency medicine issues, along with pandemic preparedness, bioterrorism, and emerging infections. He is a Senior Associate at the University of Pittsburgh Medical Center’s Center for Health Security and also a professor at the University’s Department of Critical Care Medicine and instructor at its Department of Medicine’s Division of Infectious Diseases. Dr. Adalja is also a Fellow of the American College of Physicians.

The Global Intelligence: How exactly does Ebola ‘do its damage’ to an infected patient? What is the most common form of treatment for the disease?
Dr. Adalja: The Ebola virus causes damage to an infected individual by causing a multi-organ infection that leads to the collapse of many organ systems. The most common treatment is supportive care—intravenous fluids and fever control.

TGI: Why are some patients able to recover from the disease while others can not?
Dr. Adalja: It’s unclear why some recover. It is likely a combination of how fast they receive supportive care and their own genetic constitution.

TGI: This is not the first time that there has been an Ebola outbreak in Africa. Why has this current outbreak been so widespread and deadly, and what makes it different from past outbreaks?
Dr. Adalja: This outbreak is so much larger than prior outbreaks for many reasons. First, West Africa has never had an Ebola outbreak in the past and the population there has no experience with this disease. Also, the epicenter of the outbreak is centered on a 3-country border region, making coordination, contact tracing, and other public health activities more difficult. Lastly—and probably most important—the 3 countries affected have a long history of civil war and dictatorships in which the healthcare infrastructure was eroded and the population lost confidence in their governments. Such loss of confidence makes public health messaging difficult as people do not heed warnings, run from the Red Cross, and hide illnesses and the bodies of those deceased from Ebola.

TGI: At the moment, Ebola cannot be spread through the air. However, there are some scientists who have speculated that a mutated strain of the virus could potentially become airborne, making it more virulent. How true is this claim?
Dr. Adalja: All viruses have the ability to mutate and there are concerns about …

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