On the ground in Western Africa: from the outbreak to the elapse of Ebola
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I was sitting in the chair of the airplane back to Beijing when I started writing the memoirs to recollect my three journeys to Western Africa. All of the trips were related to the Ebola epidemic and covered different stages, from the outbreak peak to the post-Ebola era. Each journey was taken for a different task, but all of them represented the urgent and specific support from the Chinese Center for Disease Control and Prevention (China CDC) during the Ebola epidemic in Western African.
As the first international support force during this epidemic, China rapidly reacted to help the three major affected countries, Guinea, Sierra Leone and Liberia, to fight against Ebola. Three experts were sent to each of these countries, respectively, to train the local health workers to use freely offered sanitary and biological protection supplies. The training went smoothly under the active cooperation of local health workers, and the supplies were soon delivered to the Ebola Treatment Units (ETUs) and the diagnostic laboratories in Guinea. This was the first time that China has sent public health specialists to countries outside of Asia to support disease control.
With the elapse of new Ebola cases, the Ebola diagnostic laboratories run on international aid were closed one by one. In contrast, China CDC strengthened the laboratory work force to avoid a potential flare-up of the Ebola epidemic. In the end of 2015, I came back to Freetown as the lead of the fourth team for the fixed P3 lab to perform Ebola testing together with nine other Chinese colleagues.
In the end of January, 2016, we have helped to diagnose the latest and hopefully the last Ebola case in Sierra Leone. In the meantime, aside from the swab tests of the dead for routine Ebola surveillance, the laboratory have taken part in a project focused on virus persistence in the survivors (Virus Persistence Study, VPS), collaborating with MOHS of Sierra Leone, the WHO and U.S. Centers for Disease Control and Prevention (US-CDC) (Deen et al., 2015). During the post Ebola era, the proper management and care of the Ebola survivors is one of the most important tasks for the control of Ebola. The VPS yielded a good scientific reference for survivor counseling, and this project is also a representative example for international cooperation for disease control in Africa.
In the post-Ebola era, the international support of public health to Western Africa should not be diminished but strengthened. The risk of a flare-up of Ebola still exists (Wong et al., 2016), considering the unknown reservoir of Ebola viruses that may persist in animal hosts. Furthermore, the disease surveillance capacity of many African countries is yet unbelievable weak, and the risk of importing yellow fever and Zika virus also exists. Thus, China CDC quickly reacted to this global health situation and empowered the fixed P3 lab with the capacity to test for yellow fever virus and Zika virus in West Africa in March, 2016.
From its commencement in February 2015, the fixed P3 lab has been playing an important role in virus detection and training the local health workforce. Based on the previous contribution and the current capacity of the laboratory, the MOHS of Sierra Leone authorized the designation of the laboratory as the “National Reference Laboratory for Viral Hemorrhagic Fevers” and the “National Training Center for Virus Detection and Biosafety” in the end of June, 2016, before our team left the country. Dr. Gao was invited back to Freetown to attend the unveiling ceremony (Fig. 4). He gave a speech to emphasize the developing orientation of the P3 lab. Dr. Gao also talked with the president of Sierra Leone, Ernest Bai Koroma, about the possibility for China CDC to strengthen our support of the research on and pre-warning of tropical diseases.
Supporting the people of Western Africa during the Ebola epidemic is the first step of the action ‘moving the disease control frontline onto the “battlefield” anywhere in the world’ of the China CDC. In the future, additional young scientists and specialists in disease control are needed to work on the ground of Africa. I am proud to have witnessed this process and contributed a little based on what I learned over the past few years. The trip from public health to global health has just begun.
I would like to thank Dr. George F. Gao, Dr. Guizhen Wu, Dr. Abdul Kamara and Dr. Rong Wei for their great support during my three visits of Western Africa. I am also grateful for the kind help from Dr. Ming Chen and Dr. Hao Cheng on the preparation of this manuscript.
- Deen GF, Knust B, Broutet N, Sesay FR, Formenty P, Ross C, Thorson AE, Massaquoi TA, Marrinan JE, Ervin E et al (2015) Ebola RNA persistence in semen of ebola virus disease survivors—preliminary report. N Engl J Med. doi:10.1056/NEJMoa1511410
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