Ian C. Ellul

Ebola virus disease or Ebola hemorrhagic fever is a disease of humans and other primates caused by one of the five species of the Genus Ebola virus i.e. Bundibugyo, Zaire, Reston, Sudan and Taï Forest. The Pteropodidae family of fruit bats are considered to be the natural reservoir of the Ebola virus. In lay man’s terms, the virus interferes with the endothelial cells lining the interior surface of blood vessels and coagulation. As the blood vessel walls become damaged and the platelets are unable to coagulate, patients succumb to hypovolemic shock.

The index case of the Ebola virus disease was the headmaster of the local school of Yambuku, a Congolese village near Ebola River. This headmaster had toured along the Ebola river in August 1976, after which he became ill and died shortly after. Family members, as well as 11 of the 17 staff members of the small Yambuku hospital, run by Flemish nuns, also fell ill and died shortly after. The outbreak was eventually contained by quarantining local villagers in their communities, sterilizing medical equipment and providing protective clothing to medical personnel.

Today, almost 40 years after the initial emergence, it has come to haunt us again. Last March the WHO reported a major Ebola outbreak in Guinea, followed by Liberia, Nigeria and Sierra Leone. Since then, people from around the globe have died from this disease. The reason is not that the disease has gone pandemic but because of the numerous people, originating from various countries, who work in the affected areas. The two principal categories of people who have been affected are missionaries and WHO workers.

Interestingly, during the past 40 years, we have experienced Ebola in various countries. Ebola imported human cases have been reported in Switzerland, South Africa and Nigeria, and Ebola virus disease outbreaks have been reported in Congo and Sudan. On the other hand, Italy and the US have reported Ebola Reston outbreaks in imported monkeys from Philippines, whilst China and the Philippines have reported Ebola Reston outbreaks in imported monkeys or domestic pigs. Fortunately, the Reston strain appears less capable of causing disease in humans than the other four Ebola species.

Obviously the recent outbreak has placed irregular immigration in the limelight, in view of the fact that Malta and Italy (most notably, Lampedusa) are considered to be Europe’s southern gatekeepers for irregular immigrants. In fact, Malta currently hosts asylum seekers from the four implicated African countries, i.e. Guinea, Liberia, Nigeria and Sierra Leone. Obviously health authorities are doing their checks and crosses but one must also appreciate the fact that it is logistically impossible to monitor the entire 250km coast of Malta and Gozo between dusk and dawn on a daily basis. Co-operation between European and non-European countries is thus of utmost importance to effectively rise up to these challenges through a concerted effort.