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Exclusive: Anthony Banbury, chief of the UN's Ebola mission, says there is a chance the deadly virus could mutate to become infectious through the air
The Telegraph UK
By Katherine Rushton
02 Oct 2014

There is a ‘nightmare’ chance that the Ebola virus could become airborne if the epidemic is not brought under control fast enough, the chief of the UN’s Ebola mission has warned.

Anthony Banbury, the Secretary General’s Special Representative, said that aid workers are racing against time to bring the epidemic under control, in case the Ebola virus mutates and becomes even harder to deal with.

“The longer it moves around in human hosts in the virulent melting pot that is West Africa, the more chances increase that it could mutate,” he told the Telegraph. “It is a nightmare scenario [that it could become airborne], and unlikely, but it can’t be ruled out.”

He admitted that the international community had been “a bit late” to respond to the epidemic, but that it was “not too late” and that aid workers needed to “hit [Ebola] hard” to rein in the deadly disease.

Mr Banbury was speaking shortly before the first Ebola diagnosis was made in the US on Tuesday evening. The man, who contracted Ebola in Liberia before flying to Dallas, Texas, is the first case to be diagnosed outside Africa, where the disease has already killed more than 3,000 people.

The number of people infected with Ebola is doubling every 20 to 30 days, and the US Center for Disease Control and Prevention has forecast that there could be as many as 1.4m cases of Ebola by January, in the worst case scenario. More than 3,300 people have been killed by the disease this year.

Mr Banbury, who has served in the UN since 1988, said that the epidemic was the worst disaster he had ever witnessed.

“We have never seen anything like it. In a career working in these kinds of situations, wars, natural disasters – I have never seen anything as serious or dangerous or high risk as this one. I’ve heard other people saying this as well, senior figures who are not being alarmist. Behind closed doors, they are saying they have never seen anything as bad,” he said.

However, he added that the UN now has the “political will” and most of the materials it needs to bring the epidemic under control. He flew to Ghana on Sunday, and is leading a mission which aims to rein in the spread of Ebola within the next 90 days.

“We have the political will. We are getting them [the resources]. They are not quite there but we are getting them. Now is the time to implement, implement, implement. It is all about speed now.

“There is a limited window of opportunity. We need to hit it and we need to hit it hard. We haven’t done that but we are doing it now.

"Certainly we are late but the expectation is that we are not too late. We are going to have a very big, fast effort…I have never seen the UN move at this speed or with such coordination. We are seeing the kind of response we need, but yes, it’s a bit late.”

Although experts agree that the risks from Ebola are severe they do not believe the virus could become airborne.

Professor David Heymann CBE, chairman of Public Health England and professor of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine, said no virus transmitted by bodily fluids - as Ebola is - had ever mutated to airborne transmission.

"There has never been a virus transmitted in this manner that converts to a respiratory virus, and there is no evidence that this has ever occurred in the epidemiology," he said at a discussion programme on the virus in London on Wednesday night. He mentioned HIV and Hepatitis B as example of viruses transmitted by bodily fluids that had "never converted to a respiratory virus".

Dr Jeremy Farrar, Director of the Wellcome Trust, added that a sense of proportion should be kept when discussing Ebola.

“The chances of Ebola becoming airborne are extremely small. I am not aware of any viral infection changing its mode of transmission. It’s important we retain a sense of proportion and not exaggerate the risks for it changing and becoming airborne," he told the Telegraph. "There is already enough fear and panic surrounding this epidemic.

"Of more concern is that the virus could become endemic in Western Africa, so unlike big outbreaks like this we could have smaller numbers of cases but circulating continuously. This is where we need to focus our efforts and attention – on trying to stop this outbreak before it establishes itself in Western African countries.”

The UN team will need to spend the first 30 days getting emergency infrastructure and training in place, ensuring that aid workers and medical supplies are ready to be deployed wherever there is a new Ebola outbreak. They aim to control the disease as far as possible within those communities.

“We intend to see a significant improvement in the 30 to 60-day window, so that by 90 days the curve is headed in the right direction. We are putting resource in place very fast, and we will continue to flow in. It is not all there at the moment,” Mr Banbury said. “That’s the theory and that’s the plan. If it spreads in an urban setting, then it’s a different story.”

“I would not say I am confident we will succeed [in the 90-day plan] given the absolutely merciless numbers of the spread and what needs to be done to get it under control. These are extremely, extremely ambitious targets, set by doctors. We are blowing down bureaucratic barriers to get things done…but I don’t know if it will be enough…I would not want to give the impression that we can wave a magic wand.”

It is a mistake to treat the Ebola epidemic as just a medical crisis, he added. Instead it is a logistical and economic crisis, whose impact is strongest in those countries hardest hit by Ebola – Guinea, Liberia and Sierra Leone – but which may be felt around the world.

“Farmers are being impacted. Markets are being impacted. We will probably see much higher food prices and other people, like restaurant workers, will lose out on wages,” he said

“The crisis is far beyond a medical one. It is very much an economic crisis, both macro and micro. It is going to affect food security and have a devastating impact on the livelihoods of hundreds of thousands of people who were able to earn a living as farmers and food workers but are not any longer. The economic shock around this is terrible.”

Other experts, however, believe the risk of the virus becoming airborne risks being overstated.

Professor David Heymann CBE, chairman of Public Health England and professor of Infectious Disease Epidemiology at the London School of Hygiene and Tropical Medicine, said no virus transmitted by bodily fluids - as Ebola is - had ever mutated to airborne transmission.

"There has never been a virus transmitted in this manner that converts to a respiratory virus, and there is no evidence that this has ever occurred in the epidemiology," he said at a discussion programme on the virus in London on Wednesday night. He mentioned HIV and Hepatitis B as example of viruses transmitted by bodily fluids that had "never converted to a respiratory virus".


 


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