[Congressional Record Volume 160, Number 127 (Monday, September 8, 2014)]
[Extensions of Remarks]
[Pages E1346-E1347]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                       COMBATING THE EBOLA THREAT

                                 ______
                                 

                       HON. CHRISTOPHER H. SMITH

                             of new jersey

                    in the house of representatives

                       Monday, September 8, 2014

  Mr. SMITH of New Jersey. Mr. Speaker, last month, I convened an 
emergency hearing, during recess, to address a grave and serious health 
threat which has in recent weeks gripped mass media attention and 
heightened public fears of an epidemic--the Ebola virus.
   What we gained from the hearing is a realistic understanding of what 
we are up against, while avoiding sensationalism.
   Ebola is a severe, often fatal disease that first emerged in 1976 
and has killed 90% of its victims in some past outbreaks.
   Since March of this year, there have been more than 1,700 cases of 
Ebola, including more than 900 fatalities, in Guinea, Liberia, Sierra 
Leone, and Nigeria.
   This time, the average fatality rate in this outbreak is estimated 
at 55%--ranging from 74% in Guinea to 42% in Sierra Leone. The 
disparity in mortality rates is partially linked to the capacity of 
governments to treat and contain the disease and per capita health 
spending by affected country governments.
   There is also concern that, given modern air travel and the latency 
time of the disease, the virus will jump borders and threaten lives 
elsewhere in Africa and even here in the United States.
   In my own state of New Jersey, at CentraState Hospital in Freehold, 
precautions were taken. A person who had traveled from West Africa 
began manifesting symptoms, including a high fever. He was put in 
isolation. Thankfully, it was not Ebola, and the patient has been 
released.
   New Jersey Health Commissioner Mary O'Dowd reiterated to me 
yesterday that New Jersey hospitals have infection control programs in 
which they train and are ready to deal with potentially infectious 
patients that come through their doors. She also told me that 
physicians and hospital workers follow very specific protocols on how 
to protect themselves as well as other patients, and how to observe a 
patient if they have any concerns, which includes protocols like 
managing a patient in isolation so that they are not around others who 
are not appropriately protected.
   The commissioner also underscored that the federal government has 
U.S. quarantine stations throughout the country to limit the 
introduction of any disease that might come into the United States at 
ports of entry like New Jersey's Newark Liberty International Airport.
   As you know key symptoms of Ebola include fever; weakness; head, 
joint muscle, throat and stomach aches; and then vomiting and diarrhea, 
rashes and bleeding. These symptoms are also seen in other diseases 
besides Ebola, which makes an accurate diagnosis early on uncertain.
   Ebola punches holes in blood vessels by breaking down the vessel 
walls, causing massive bleeding and shock. The virus spreads quickly 
before most people's bodies can fight the infection, effectively 
breaking down the development of antibodies. As a result, there is 
massive bleeding within 7 to 10 days after infection that too often 
results in the death of the infected person.
   Fruit bats are suspected of being a primary transmitter of Ebola to 
humans in West Africa.

[[Page E1347]]

The virus is transmitted to humans through close contact with the 
blood, secretions, organs or other bodily fluids of infected animals.
   Some health care workers--such as heroic American missionary aid 
workers Dr. Kent Brantly and nursing assistant Nancy Writebol--
contracted the disease despite taking every precaution while helping 
Ebola patients. Both of them were treated at Emory Hospital in Atlanta, 
Georgia, in an isolation unit after having been flown to the United 
States in a specially equipped ``air ambulance.''
   While there is no known cure for Ebola, both Dr. Brantley and Ms. 
Writebol were given doses of the experimental anti-viral drug cocktail 
ZMapp, developed by a San Diego company called Mapp Biopharmaceutical.
   Mapp Biopharmaceutical has been working with the National Institutes 
of Health and the Defense Threat Reduction Agency, an arm of the 
military responsible for countering weapons of mass destruction, to 
develop an Ebola treatment for several years. The drug, which attaches 
to the virus cells much like antibodies their compromised immune 
systems would have produced, had never been tested in humans before Dr. 
Brantly and Ms. Writebol, who gave their consent to be the first human 
trials.
   There will be great hope if ZMapp works on the two Americans who 
bravely agreed to test its effect. Still, ZMapp is an experimental 
drug. Those who use it must be given the complete information on its 
use. Informed consent is vital in the use of any drug, but certainly 
one that has such limited trials among humans.
   There is also promising research done by the Tekmira Pharmaceuticals 
Corporation--funded by the U.S. Department of Defense--on their TKM-
Ebola, an anti-Ebola virus RNAi Therapeutic. TKM is on clinical hold, 
yet earlier preclinical studies were published in the medical journal, 
The Lancet and demonstrate that when siRNA targeting the Ebola virus 
and delivered by Tekmira's LNP technology were used to treat previously 
infected non-human primates, the result was 100 percent protection from 
an otherwise lethal dose of Zaire Ebola virus.
   Unfortunately, there are other issues that impact on the ability of 
the international community to assist the affected governments in 
meeting this grave health challenge. Some of the leading doctors in 
these countries have died treating Ebola victims. The non-governmental 
medical personnel who are there say they feel besieged--not only 
because they are among the only medical personnel treating this 
exponentially spreading disease, but also because they are under 
suspicion by some people in these countries who are unfamiliar with 
this disease and fear that doctors who treat the disease may have 
brought it with them.
   The current West African outbreak is unprecedented--and an anomaly. 
Many people are not cooperating with efforts to contain the disease. 
Some, such as Liberian-American Patrick Sawyer, refused to accept that 
they may be infected. His death sent chills through those outside the 
affected region who feared infected people leaving the area and 
arriving in metropolitan areas somewhere else in the world.
   Because of the stigma of Ebola, many people in the affected region 
are reluctant to acknowledge the possibility of having the disease and 
don't seek medical treatment. This phenomenon was common in the early 
days of the HIV/AIDS epidemic. Traditions also play a role in people 
not accepting suggested protocols. Many people are handling the bodies 
of their relatives who died of Ebola and burying them without taking 
proper precautions, and themselves become victims of this deadly 
disease.
   Medical missionaries have given of their time and talent at great 
risk to their health and their very lives to apply the Christian 
principles to which they have committed themselves.
   As we consider what we can do to meet this health challenge, I would 
suggest we need to reconsider the funding levels for pandemic 
preparedness. In the restricted budget environment in which our 
government operates today, funding to meet these pandemics has fallen 
from $201 million in fiscal year 2010 to an estimated $72.5 million in 
fiscal year 2014. The proposed budget for fiscal year 2015 is $50 
million, and we must not shortchange vital efforts to save the lives of 
people in developing countries, but also protect the health security of 
the American people. There are both practical and compassionate reasons 
to adequately fund pandemic response.
   Dr. Tom Frieden, one of the witnesses we had, has tried to assure 
the American public that our government is doing what we can to address 
the Ebola crisis. USAID; WHO; the World Bank; DFID, the British 
development agency; the African Development Bank, and many other 
governments, international organizations and companies are joining to 
meet this crisis.
   To those who say there is no plan, I would say that planning is 
underway to overcome obstacles to effective efforts to contain this 
virus. We have seen great success in treating HIV/AIDS, malaria, and 
tuberculosis. Polio has been largely eliminated. Tropical diseases are 
being treated through a public-private partnership. Still, we must take 
more seriously the research, surveillance, treatment, and prevention of 
diseases that limit the lives of people in developing countries.
   This is why I have introduced the End Neglected Tropical Diseases 
Act. H.R. 4847 establishes that the policy of the United States is to 
support a broad range of implementation and research and development 
activities to achieve cost-effective and sustainable treatment, control 
and, where possible, elimination of neglected tropical diseases. Ebola 
is not on WHO's list of the top 17 neglected tropical diseases, but it 
does fit the definition of an infection caused by pathogens that 
disproportionately impact individuals living in extreme poverty, 
especially in developing countries.
   Ebola had been thought to be limited to isolated areas where it 
could be contained. We know now that is no longer true. We need to take 
seriously the effort to devise more effective means of addressing this 
and all neglected tropical diseases.

                          ____________________