Hot Topics: Ebola’s Comeback, and Bad Bottled Water

March 17, 2021
Saskia v. Popescu, PhD, MPH, MA, CIC
Saskia v. Popescu, PhD, MPH, MA, CIC

That an entirely new outbreak of Ebola would be triggered by a latent infection 5 to 6 years after the initial infection is deeply worrisome.

Coronavirus disease 2019 (COVID-19) has been dominating every facet of our lives since early 2020 and often, it’s hard to see the forest for the trees. Infectious diseases don’t stop during a pandemic. Sure, we saw a drop in seasonal respiratory viruses like influenza this year, but the catheter-associated infections don’t stop. Health care-associated infections (HAIs) simply don’t stop during a pandemic—in fact, they become a bigger concern as we navigate through unknown territory. The same concern is coming up more and more with emerging infectious diseases like Ebola. Here are some issues we should be keeping an eye on.

Ebola Outbreak in Guinea Sparked by Previously Infected Individual

The Ebola outbreak in 2014/2016 was devastating for West Africa. Globally, we all experienced the fallout of the largest Ebola outbreak in history and one that revealed a deeply vulnerable health care system within the United States. In the latest outbreak within Guinea, at least 18

people have been infected with Ebola virus disease, and nine have died. What is sparking concern though isn’t just that this is a new outbreak in an area that has already experienced the hardships of Ebola, according to the journal Science, but a much more impacting finding: “The virus causing the new outbreak barely differs from the strain seen 5 to 6 years ago, genomic analyses by three independent research groups have shown, suggesting the virus lay dormant in a survivor of the epidemic all that time. ‘This is pretty shocking,’ says virologist Angela Rasmussen of Georgetown University. ‘Ebolaviruses aren’t herpesviruses’—which are known to cause long-lasting infections—'and generally RNA viruses don’t just hang around not replicating at all.’”

Why is this concerning? We know that survivors can shed virus in semen, but that an entirely new outbreak would be triggered by a latent infection 5 to 6 years after the initial infection is deeply worrisome. Understanding more of how additional infections and even outbreaks might be sparked by survivors is still something we’re working to address.

Moreover, the concern for stigma in survivors is one we wholly need to address. Consider this case: “The current outbreak in Guinea was detected after a 51-year-old nurse who had originally been diagnosed with typhoid and malaria died in late January. Several people who attended her funeral fell ill, including members of her family and a traditional healer who had treated her, and four of them died. Researchers suspected Ebola might have caused all of the deaths, and in early February they discovered the virus in the blood of the nurse’s husband. An Ebola outbreak was officially declared on 13 February, with the nurse the likely index case.”

As news of this grows, it is so critical we ensure the protection and safety of survivors, avoiding stigma and any potential for adverse social outcomes. Now more than ever, we need to work to understand these nuances, what they mean for survivors, but also what they might mean for future medical treatment of those previously infected.

Acute Non-viral Hepatitis Cases Linked to Bottled Alkaline Water

This week the Federal Drug Administration (FDA) just released a report regarding a possible outbreak they’re investigating related to bottled alkaline water. The FDA report noted that “On March 13, the U.S. Food and Drug Administration was alerted to five cases of acute non-viral hepatitis (resulting in acute liver failure) in infants and young children that occurred in November 2020 with an unknown cause reported to the Southern Nevada Health District. All five patients had been hospitalized but have since recovered. All patients were reported to have consumed ‘Real Water’ brand alkaline water. These patients came from four different households.” The consumption of this water was the only known link between the cases. More investigations and findings are likely to occur, but outbreaks like this are definitely something to consider if seeing an uptick in non-viral hepatitis.