Can Ebola virus become endemic in the human population?

[cronus]

http://link.springer.com/article/10.100 ... ltext.html

Can Ebola virus become endemic in the human population?

The 2014–15 Ebola virus (EBOV) outbreak, originally reported during March 2014 in the Western African nation of Guinea, has shown itself to be resistant to traditional containment methods, with over 28,000 infections and 11,000 deaths over 18 months. Recently, news that a Scottish nurse had relapsed to EBOV disease with neurological symptoms at 10 months after recovery have astonished experts. The prolonged nature of the outbreak has led to questions whether EBOV can become endemic in the human population, an undesirable outcome due to the large amount of resources required to keep this virus under control. In this commentary, we discuss aspects EBOV disease with those caused by pathogens considered endemic in humans, as well as factors which may contribute to sustained EBOV transmission in humans.

Ebola virus (EBOV), of the genus Ebolavirus and family Filoviridae, was historically regarded as a re-emerging pathogen, in which natural infections of humans are sporadic and unpredictable, often with several years passing by before the emergence of a new case. EBOV infection is associated with high case fatality rates (CFR) in humans (up to 90%), but past disease outbreaks due to EBOV lasted only several months on average, and fatal cases numbered at most in the hundreds (CDC.gov, 2014). As such, EBOV was considered a minor public health threat in Africa at the time. Perceptions of this virus changed when the largest documented EBOV outbreak, first reported during March 2014, ran rampant through the Western African nations of Guinea, Sierra Leone and Liberia, causing over 28,000 infections and 11,000 deaths over the past 18 months (WHO.int, 2015a).

Continued efforts by the local and international communities are having an observable effect in mostly confining EBOV transmission within the countries mentioned above, and the numbers of new weekly cases have been declining from a peak of over 700 in mid-September 2014 (WHO.int, 2015a). Since April 5th, 2015, the numbers of new cases reported weekly have fluctuated between 9 and 35, and this number has been less than 10 since July 26th, 2015 (Fig. 1). However, getting to zero cases overall has proven to be a challenge and of the three most heavily affected countries, only Liberia has been declared EBOV-free, on September 3rd, 2015 (WHO.int, 2015b). During this prolonged outbreak, some experts have questioned whether EBOV can become endemic within a human population (WHO Ebola Response Team, 2014) (NPR.org, 2014), a situation characterized by low levels of sustained virus transmission between humans, and the potential for a new outbreak to occur if this transmission is not successfully halted.

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[mistermack]

You wish !

[JimC]

In the long term, if it did, it would almost certainly result in greatly reduced lethality. Pathogens adapt to us, and we to them...

[Tero]

Not sure what the history of failed viruses is. Ebola has succeeded in part due to the need to handle and give people a burial in those cultures.

[cronus]

I'm interested in seeing if it'll spread via sexual contact and how that'll skew birth rates. Watched 'Children of Men' on DVD again the other night. Great movie before its time. A virus might reduce in lethality over many generations, that is only beginning with HIV despite a number of decades passing.

[mistermack]

Not sure what the history of failed viruses is. Ebola has succeeded in part due to the need to handle and give people a burial in those cultures.

It's not so much the need to handle, as the wish to handle, due to cultural customs. In those rural parts of Africa, it's commonplace and pretty much expected for the bereaved relatives to stroke and caress the dead relative, in a great show of grief. ( or so I've read. )
It's not purely an African custom either. My aunt did exactly the same at her brother, my uncle's funeral in the West of Ireland, a decade ago.
Apparently, the virus is at it's most infectious, just after death. So that kind of contact is incredibly risky, but it's been hard to break the cultural traditions.