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Waiting for the Great Plague | TIME ONLINE



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They bleed internally, are highly infectious: people who are Ebola infected. The virus that causes the disease is one of the deadliest on Earth – more than half of everything that infects dies. Since August 2018, things are back in the Democratic Republic of Congo. Authorities have registered about 1,400 cases, more than 950 people have died.

The eruption has been the second largest in history (see infobox). And the end of the epidemic is not in sight. Recently, the number of new infections increased sharply, only in April there were about 400 new cases. Experts fear that the virus soon spreads to neighboring countries and never disappears from the area fought by the rebels in eastern Congo.

And yet, this outbreak is different from the first: medicine is no longer empty-handed for Ebola, as it was five years ago when the epidemic became a transnational threat. This time there is a vaccine, better education, coordinated mitigation: achievements that have only become possible because doctors and epidemiologists have learned from the most devastating Ebola outbreak in history and have been able to research vaccines.

Progress is now evident in the current eruption in the Congo: more than 100,000 people have already received a vaccine, which according to initial analyzes protects almost all vaccinees (Lancet: Henao-Restrepo et al., 2016). He was sure that the number of people infected and killed would be much, much higher if this vaccine were not available, said Tedros Adhanom, director-general of the World Health Organization (WHO) in January.

Even more important than the serum itself, however, may be how it was found. This will provide lessons for the development of additional vaccines and treatment strategies that could control known – and even unknown – epidemics in the future.

To understand how difficult it is to find vaccines against unknown pathogens, it is important to understand how an outbreak approaches: local helpers and international disaster relief teams are setting up emergency stations, developing medicines and testing. They try to treat patients and prevent infection from healthy – and they are often completely overwhelmed. They are looking for people who have not yet started the disease, but are exposing the population to risk or, as in the case of Ebola, to bury the deceased not to become infected. Epidemiologists identify individuals who have had contact with infected people and may have been infected. The forces are trying to break the chain of transmission.

Faced with all these acute problems in an area of ​​disease, there seems to be little room for them
research of a pathogen. For this, samples also
take out and file potential transmitters, such as bats and mosquitoes, or transmission routes. Also because of this
time to analyze, document and investigate the body damage of those most frequently infected. In the worst case
Researchers may even prevent emergency aid because their work
additional arrangements and costs additional money.

"Less learned from outbreaks"

and
However, research in difficulties is very important, explains Jeremy Farrar:
The only chance to learn something about a pathogen is the outbreak.
Farrar is a physician and director of the Wellcome Trust, all over the world.
second largest philanthropic foundation, which is heavily involved in the field of global health. "We have a lot to do in the past.
Little has learned from outbreaks. "As a negative example, Farrar Sars calls the virus Sars, the heavy,
could trigger fatal pneumonia in 2002
and 2003 have spread from southern China around the world.
Nearly 1,000 people died in the first millennium pandemic.
That was no longer, he was lucky, says Farrar. But why
Medical assistants and women were so busy, the virus in
To keep chess there was no time for research. If the Sars virus, the
still sleeping in frugivorous bats living in caves in China,
Come back, stay there with empty hands. "We do not have a
diagnostic test, no medication, no vaccine ".

Ten years later, it was much better. In the midst of the great Ebola pandemic in West Africa, the vaccine was tested, which is now widely used. This was only possible because the employees and scientists began to work together. Ebola has shown that "research does not have to negatively impact the humanitarian response," says Farrar. In other words, on the one hand, managed to contain the disease and, on the other hand, learn enough about the virus to better prepare for the next outbreak. O WHO, their partner organizations and national governments have learned from the mistakes of the past.

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