Keating looks at why the current epidemic has been so severe:
As political scientist Kim Yi Dionne notes, a number of factors have combined to make this the most deadly Ebola outbreak in history, and most of them are political rather than biological.
For one thing, none of these countries has experienced an outbreak of the disease before, so knowledge of it is low. For another, the fact that it’s spread to multiple countries makes a coordinated response more difficult. (Liberia has now shut almost all of its borders.) As Dionne notes, all three countries have poor health infrastructure, due in part to years of civil war in Liberia and Sierra Leone. Liberia has just .014 doctors per 1,000 people, and a common joke is that JFK Medical Center, Monrovia’s main hospital, has long had the unflattering nickname “Just For Killing.”
Researchers still don’t know the exact cause of this particular outbreak, but it might have to do with the local practice of eating bats for food, according to Jonathan Epstein, an epidemiologist at EcoHealth Alliance. “It’s unclear whether it occurred due to butchering a bat, exposure to bat bodily fluids, or eating some food or fruit that was contaminated by saliva, urine, or feces from the bat, which may contain Ebola virus,” he said. Pig farms in Africa also often attract bats, which also may have been a cause.
Once the infected person begins to show symptoms—flu-like aches, nausea, and vomiting—local customs continue to play a big role. There aren’t enough doctors or supplies available to treat all the Ebola patients in the area, but even if there were, many locals are suspicious of Western medicine.
John Herrman reflects on the West’s detachment from these kinds of diseases:
I’ll read almost anything about infectious diseases, and in retrospect, most of this reading was cold and sociopathic. Richard Preston’s The Hot Zone was an escapist thriller; The Great Influenza was an apocalyptic period piece; The Coming Plague was an engrossing feat of science fiction world-building, about a planet that contrives, almost at random, new and hideous microscopic monsters to destroy sophisticated life, and that will not give up until it has succeeded. Nature finds a way, a narrator intones, except that this narrator is a doctor who has spent her whole life watching people die in pain and confusion, and I’m just sort of dozing off, because I’ve been reading too long and it’s time for bed.
This is of course an insane way to read about deadly diseases. It is also standard in areas of the world where these rare viruses feel utterly remote. It provides comfort that your incidental version of civilization at least shields you from the most vividly horrific diseases.
An Ebola vaccine is still at least a few years away:
There are quite a few preventative vaccines in development, with three to five that have been shown to completely protect nonhuman primates against Ebola. Some of these vaccines require three injections or more and some require just a single injection. Most of them are being funded by the U.S. government, so they’re in various stages of development, but none of them are ready to be licensed.
The hang-up point with these vaccines is the phase I trials in humans. That’s where scientists get frustrated because we know these vaccines protect animals and we don’t quite understand the regulatory process of why things can’t move faster. I can’t give you an answer as to why it’s taking so long.