Thursday, December 25, 2014

Ebola: An Issue of Biological Defence

Many nations where Ebola (EBV) has been endemic and nations which have never seen an EBV outbreak before, have experienced civil war and or on-going conflict. Peacekeeping forces are exposed to a range of diseases for which there is no vaccine and few, if any therapeutics. While conflict and disease often go hand in hand, the unprecedented outbreak of Ebola in West Africa poses novel issues which must be addressed for both the war-fighter and peacekeeper.

Generally when military personnel come into contact with highly pathogenic and or transmissible disease it can be easier to contain within a defence structure, than civilian outbreaks; for the simple reason that military personnel can be vaccinated under mandatory vaccination schedules, ordered into quarantine or treated. The most significant issue with the current outbreak of Ebola across Guinea, Sierra Leone and Liberia is the severe lack of medical counter-measures and highly limited investigational new drug testing. In nations such as these, recovering from years of conflict, military personnel and military medical health workers are at significant risk as they are often on the front lines of clinical care and are mobile.

In November, a UN Nigerian peacekeeping soldier was brought to the Netherlands for treatment having contracted Ebola in Guinea while fighting the disease. Most military personnel working in clinical environments in Ebola Treatment Units and Centers (ETU's) and field hospitals, undergo a twenty one day quarantine at the end of their missions.In fact quarantine, voluntary or mandatory poses issues in maintaining force readiness. A vaccine or therapeutics which could counter this is essential not only to the local populations and health care workers who are literally on the front lines, but peacekeeping forces tasked with ensuring that peace is maintained.  If a vaccine or therapeutic were available this would alleviate the need for measures which essentially act as force reducers. In nations which rely on peacekeepers to maintain stability bio-defence becomes a real issue and force protection against Ebola, Malaria or other highly infections and often transmissible diseases, must take priority over severely limiting the availability of potential treatments and vaccines, with obvious safety criteria in place.

The risk to peacekeeping forces and military personnel such as those deployed on the Karel Doorman to help support efforts to end the Ebola outbreak however remain.

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