By Brian W. Donnelly, M.D., I.B.C.L.C., Pediatric Alliance — North Hills Division



“Paving The Road To Zero”


The Ebola virus outbreak has made the news again. In a strange, science fiction-esque story told by Faith Karimi and Joshua Berlinger, the virus was discovered hiding in the eye of doctor Ian Crozier, who had survived the original infection weeks before:

His case has left doctors stunned and highlighted the need for eye checkups for Ebola survivors.

Crozier, 44, was hospitalized at Emory University Hospital for more than a month in September after contracting the disease in Sierra Leone, where he worked at a hospital.

At the time, the hospital said he was the sickest of all the four Ebola patients treated there.

Crozier was discharged in October, and about two months later, he developed eye problems and returned to Emory. Doctors stuck a needle in his eye and removed some fluid, which tested positive for the virus.


The bigger story is that Liberia has declared itself free of the scourge, which is, indeed, cause for celebration. Elizabeth Cohen was there last year during the peak of the epidemic, when 4,000 people lost their lives:

I wish I were there to hug the wonderful people I met when I visited at the height of the epidemic in September, when any contact, even shaking hands, was forbidden.

In October, a Doctors Without Borders health worker carries a child suspected of having Ebola in Liberia. Nonprofits often have to fill in the gaps in West Africa, where the health care system was extremely limited even before the epidemic. Because of civil wars and extreme poverty, there aren’t enough doctors: Liberia has 0.014 physicians per 1,000 people, Sierra Leone has 0.022 and Guinea has 0.1. In contrast, the United States has 2.5 doctors per 1,000 people.

It was a horrible time. Ebola patients stood in line to get into hospitals that didn’t have a bed to spare. Thousands of children in West Africa were orphaned. Burial teams roamed the streets carrying victims to crematoriums.

“We went through just a horrific epidemic,” said Dr. Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, who visited the country in August. “It’s a searing memory that many of us will carry with us for the rest of our lives.”

Something else is seared in my mind, too: the realization that smart people failed to stop this epidemic before it got so terribly out of hand. The outbreak started in March, and when I arrived six months later, the response was still clumsy.


But Sierra Leone, which has had more reported cases than its neighbor, is having a harder time getting to zero cases. Mark Honigsbaum helps us understand why they are having trouble with this “molecular shark”:

“I fear that people have grown complacent,” sighed Professor Monty Jones, the president’s Special Adviser, when I caught up with him in early March at the State House, an imposing stone building with uninterrupted views over Freetown to Susan’s Bay and Destruction Bay. “The epidemic has been going on too long. They just want life to return to normal.”


Honigsbaum thinks the main reason why getting to zero new cases is so challenging for health officials is due to the belief people have that they are somehow immune to Ebola: “They do not think Ebola will affect them.”

Last month, CNN reported a recent spike of new Ebola cases in Sierra Leone and neighboring Guinea. Here’s hoping Sierra Leone can ramp up their efforts and finally get to zero. If not, Liberia’s happiness may be interrupted by more sadness: Viruses cross borders — sans passports.

And here’s hoping a vaccine can be developed very soon. That would be the equivalent of paving the “road to zero.”