What can we learn from the African Ebola outbreak about the global threat of infectious diseases?

The current Ebola outbreak is the largest outbreak to date. Spanning four West African countries, it has already killed more people than the total number of people who have previously died from the disease.

Normally Ebola outbreaks are quite similar and start with a general cluster which is quickly contained. Although this outbreak currently has a mid-range fatality rate compared with other outbreaks, the reality of the virus spreading from third country to fourth country by air travellers highlights that things could have been different if this outbreak had been quickly contained.

The head of the Victorian Infectious Diseases Reference Laboratory (VIDRL) based at Melbourne Health and now part of the Doherty Institute, Dr Mike Catton, emphasises that we have to be vigilant to the threat of infectious diseases.

“We live in a small and ever-shrinking world, so although West Africa is still a long way from Australia, which is helpful in relation to the West African Ebola outbreak, we are a very connected globe. There are other viruses like Middle Eastern Respiratory Syndrome virus (MERS) and SARS which are closer and probably greater threats to us. As such, vigilance and preparedness is very important and amplifies a key role for places like the Doherty Institute,” Dr Catton says.

VIDRL, in its role as a diagnostic and public health lab, houses one of only three high-security PC4 suit labs with the highest level of containment in the southern hemisphere. The PC4 lab has restricted access and to enter people must wear a heavy-duty suit with a dedicated air supply. After leaving the lab, a chemical shower is required to ensure that diseases aren’t brought back into the outside world.

Having this lab within the Doherty Institute enables senior scientist Dr Julian Druce and his team to test for infectious diseases, including dangerous ones like Ebola, without risk of harm to the scientists or the public.

It also bestows important responsibility on the Doherty Institute and VIDRL, which plays a number of important roles to ensure that we are safe from the constant threat of infectious diseases on a state, national and international level.

A current priority for Dr Druce’s team is fulfilling general public health responsibilities and testing for infectious diseases such as measles, which is still an issue despite it previously being eradicated from Australia. Technology has changed the speed of delivery and enabled a high degree of accuracy in testing for these diseases.

“We can do very rapid tests that can turn around an answer in a few hours from the sample arriving at the front door to going through whatever containment facility that is needed, to initial processing, to an answer coming out – whether it be from an adjacent suburb or on the other side of Australia,” Dr Catton says. 

“We can also now go from a virus being newly detected somewhere in the globe to having a test that we’re confident will work quite quickly, in a matter of days.”

Dr Druce’s team also does testing for travel-related viruses such as dengue fever, and local viruses including influenza. The Doherty Institute houses the WHO Collaborating Centre for Influenza to which Dr Druce’s team provides sample material, in order to identify the virus strain to put into the next year’s flu shot.

This highlights the importance of the Doherty Institute’s structure, which has already provided opportunities for collaboration with other teams in the new building. 

“Our infectious diseases physicians and clinicians used to be based in the Royal Melbourne Hospital but have since moved to the Doherty Institute, which immediately created a better relationship as we regularly see the scientists in the tea room,” Dr Druce says.

“Having these facilities means that Australia can be better prepared for combating infectious diseases, like those we’ve seen in West Africa.”

www.mdhs.unimelb.edu.au