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| The Ebola virus. Image credit to the BBC |
Now Africa is faced with a new threat in the form of the Ebola virus; the death toll is rising in the three African countries-Guinea, Liberia and Sierra Leone-where the outbreaks occcurred this year. The Ebola virus, part of the haemorrhagic fever viruses, is extremely contagious and has a fatality rate of about 90%, meaning that 9 out every 10 people with the infection will likely not survive; though the rate so far has been about 50% and 60%. First reported in 1976 along the Ebola River in Zaire (now the Democratic Republic of the Congo), there was no outbreak between 1980 and 1993; some outbreaks occurred in some years between 1994 and 2012; this year's outbreak is the worst since it was discovered in 1976.
And the dawning of this reality has evoked in me questions about how the world, especially Africa, will position itself to tackle future occurrences (probably not the Ebola virus, as it may be eradicated if we get all the necessary public health measures in place) of new viral diseases that may be far more infectious than Ebola and Lassa viral infections.
A few months back, a case of Lassa fever was reported in the Paediatrics department of our teaching hospital, the University College Hospital, Ibadan; we had what we call Grand Round, a weekly seminar on pressing health issues, where this Lassa fever case was discussed in full details: it was at this seminar that I learnt that the one-use, disposable protective suit won by the health personnel managing a patient with the disease costs about 20,000 naira (about $150) which majority of Nigerian patients, who by the way do not have health insurance, can't afford (as about 3 or 4 of this suit will be required daily by the health workers, who would take shifts, to manage the infected quarantined patient-that's between $450 and $600).
While the best option now in the current case of Ebola virus is to provide excellent public health measures (there is hope as the World Bank has pledged $200 million, in addition to the $100 million dollars the World Health Organization and the three affected African countries jointly committed, to fight the outbreak in the affected African countries, including Nigeria) such as various forms of isolation units in hospitals to manage cases of admitted patients who present with the flu-like symptoms that have been associated with the Ebola virus infection, and isolating and monitoring those who brought the patient to the hospital (the treatment centre should also have the constitutional licence to isolate and monitor the patient's family members who came into contact with him or her after the onset of the symptoms); this outbreak has bared the need to establish and fund a multidisciplinary medical research facility in Africa to, among many other research duties, have a department of Unknown Highly Infectious Diseases. This department will be staffed by African medical research experts in Africa and in the diaspora who will collaborate with renowned medical experts in top research institutions around the world to quickly get samples from patients with suspected infectious, but unknown, disease for analysis of the possible cause and the firm establishment of various transmission modes of such a disease; and also to begin search for potential therapeutic (including a cure) modalities based on the accumulated knowledge from the various experimental studies that would have been carried out on the viruses.
In addition, the question of the ancestry and evolution of that new infectious disease-causing agent must be answered. Though this is a more demanding task, success at it will give the medical world insight into how for instance the Ebola virus and Lassa fever virus evolved (underwent mutations) to acquire their infectivity and virulence (the capacity of the viruses to cause the disease in people after infecting them) if there was a time in the ancestry of the viruses when they were not infectious; or even if they were infectious right from their first generation-how have they adapted and improved on their infectivity and virulence? It will also help in making quicker decisions in terms of the best path to follow in designing a treatment protocol if a virus in the same family, or a new strain of the same virus emerges in the future to cause disease in humans. This is getting more demanding and would mean spending more time with the virus in the lab, right? There's a possibility of a test tube containing blood samples of the virus slipping and spilling on to the researcher handling it; there could be an accidental needle pricking while trying to inject experimental mice or rats with the virus (to study immune system response to the virus for possible vaccine development); and a researcher dare not casually leave the lab to take some snacks, without following long protocols involved in removing his or her protective suit, no matter how hungry he or she may be. Is there a way to totally avoid the possible unforeseen hazard of infection that these researchers face in the lab while maintaining the same quality and quantity of research they will be doing on these very highly Infectious disease-causing viruses? A way that will enable a researcher to easily have lunch during work? I guess the solutions are in the future; but the future, I believe, is already here with us. And this future is where the extra collaborators from the US, Japan and other countries with very advanced robotics technologies will come in.
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| The da Vinci Surgical System. Image credit to Robot Surgery. |
For over a decade now, robots have been designed and modified to carry out surgery both in the battlefield and in the operating theatre under full control of human surgeons who operate them remotely, giving rise to the concept of the term Robo-Surgeon. The most popular and widely used of these robo-surgery technologies is the da Vinci Surgical System developed by Intuitive Surgical in Sunnyvale, California. This Surgical System comprises of a surgeon's console (a room-like compartment where the human surgeon sits very comfortably, equipped with a high-performance 3-D vision camera and master control like video game pads), a patient operating table with four interactive robotic arms and a collection of surgical instruments called EndoWrist instruments. To carry out a major surgery, the surgeon sits in the console that is separated from the operating theatre in which the patient is lying on the operating table of the Surgical System, and through the high-performance 3-D vision camera system uses the master controls of the console to direct the robotic arms to carry out intricate surgical tasks with very high level of precision, leaving behind very minimal scar. This application of robotics in surgery can be replicated in the experimental studies of very highly infectious agents like the Ebola virus and other future viruses and bacteria.
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| A prototype of a robot that can be telecontrolled remotely by a human operator. Image credit to The Indian Express |
The future I imagine here will have the robotic arms replaced by more human-looking robots (something more like a Humanic from the TV science fiction series, Extant), but whose entire functions (movements, vision and decisions in the lab) will be under the total control of the researchers in the consoles outside the high bio-security labs in which these infectious samples are kept. Hence, the researchers will not need to be in these high bio-security labs in person, only their virtual presence, but they will be able to carry out their research works as though they were still in the labs; and moreover these Robo-Scientists, as I would prefer to call them, will be equipped with digital note-recording system to enable the human scientists controlling them to document the protocols involved in the research, any findings and results in the course of the research, and easily share them immediately with other labs around the world doing the same emergency research. This will speed up the development of therapeutic agents as results emerge from the work and are re-confirmed by other labs doing the same work in the shortest possible time. One more advantage: no human will be exposed to the infectious agents, only the Robo-Scientists and who can easily be sterilized. Sounds like science fiction, right? But the future is already here. And as the hundreds of millions of dollars committed to fight the Ebola virus outbreak begin to do its job; as the resolutions of the emergency meeting, in Geneva Switzerland, by the global health experts of the World Health Organization (click on the link for the resolutions of the meeting) on drafting new measures to tackle the Ebola outbreak, held between Wednesday and Thursday, are made known to the public--I strongly hope the medical and corporate worlds will share in this future I envision and begin to set in motions the wheels that will contain the emergence of very highly infectious diseases, such as Ebola, in the future.
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