No fears of Ebola epidemic in Finland

The haemorrhagic fever-causing Ebola virus has been known about for some 40 years, but the numbers of people infected and the extent of the epidemic in West Africa are now greater than at any time before. However, the virus is only spread by direct contact with a person who is sick with the virus, and its spread can be prevented effectively. "In countries with good health care systems and where there are contingency plans for infectious diseases, it is possible to halt the spread of the virus", says Veli-Mikko Niemi, Director-General of the MSAH Department for the Promotion of Welfare and Health.

The severity of the Ebola epidemic in West Africa has awakened worldwide fears of the spread of the disease. In Finland, concern has increased at the few cases of Ebola found elsewhere in Europe, and there was one suspected case in Finland that turned out to be unfounded. Niemi points out that while it is impossible to completely prevent individual cases in a globalised world, people in Finland should not live in fear of any sort of epidemic.

"The virus is transmitted only through close contact with people who have the disease, who have died or who are sick, or with their bodily fluids. There are hardly any Finns in the area of the epidemic, and for that reason alone the probability of the disease spreading here is small. If a case of infection is proven, the health care system will be able to prevent the disease from spreading. We have guidelines concerning acute haemorrhagic diseases, and the hospital districts are equipped to treat patients."

Niemi attributes Finland's strength in communicable disease prevention to its tradition of cooperation. "In some countries you find that authorities do not inform one another about issues, but we have good cooperation among different spheres and levels of government. The usual epidemics we get here are linked to water or food, and treating them always requires that the authorities cooperate with one another, so their functionality has been tested in practice."

Poverty contextHigh levels of poverty have an impact on the spread of Ebola in Liberia, Sierra Leone and Guinea. The civil wars that have afflicted the region have caused turmoil, the level of education is low, there is scant awareness of Ebola, and infrastructure is flimsy. As a result efforts to eradicate the disease early on were delayed and health care at the frontline of the epidemic has not been sufficiently robust.

"There were too few doctors and nurses, and they didn't have sufficient protection until the arrival of international assistance. The lack of protective clothing meant the loss of many health care staff to the virus, which has compounded the situation," Niemi explains.

Fortunately, the situation of the three most affected West African states is not indicative of the scope that exists for tackling the disease. Nigeria has been able to prevent the spread of Ebola by swiftly identifying and quarantining infected people, and by tracing possible contacts and exposures. Niemi says that the focus of activity against Ebola in Africa will also be after the most critical stage of the disease.

"The best way to help now is by providing financial aid, and Finland has already channelled humanitarian funds for this through organisations such as the Red Cross. In the future, it will be important to develop health care preparedness in these countries."

A second course for warding off the harmful fallout of Ebola and other epidemics is international cooperation. Assessing health threats and risk prevention will not succeed by the action of individual states alone. Niemi stresses that Ebola is another cruel reminder of the dangers of infectious diseases that have almost been forgotten about in industrialised countries.

Slow mutationEbola is not an airborne or waterborne disease. Becoming infected requires contact with someone who is sick or with the bodily fluids of someone who has succumbed to the disease. It is not contagious during its incubation period, but only when the symptoms of the disease become apparent. In its current form, Ebola kills between 50-70 per cent of those infected with it. A person who has recovered from the disease can still spread it for a couple of months, for instance via semen or sexual activity.

Niemi does not think it likely that Ebola will mutate so that it spreads through the air.

"Researchers consider it extremely improbable that an airborne Ebola virus will develop. The virus has been known about for decades, and during that time it has hardly altered at all. Ebola is not a rapidly mutating virus like the influenza virus. It evolves far more slowly."

Text: Paula Mannonen & Mark Waller