Class Opening

• Instructor has mixed feelings on how to begin the class after recent events.
• Important announcement regarding visa revocations for several international students at BU.
• Encourages students on visas contemplating leaving to communicate with him without fear about their grades affecting their decision.

Course Structure Changes

• Instructor is conflicted about course wrap-up, usually focused on politics and global health systems.
• Plans to include relevant current concerns while reviewing historical contexts of infectious diseases.

Next Week's Topic

• Proposed topic: Historical context of infectious diseases, specifically:
• Pandemic influenza from a century ago.
• Cholera outbreak in Soho, London (1854).
• Acknowledges that students may find the topics less compelling in the present context but still sees value in learning from the past.

Content Adjustments

• Cuts two weeks of health systems/programs into one and a few readings.
• Will introduce a new reading: Interview with Atul Gawande on ending USAID.
• Last week will focus on global mental health and ethics.

Student Input Invitation

• Invites students to submit their preferred topics related to global health for the next week's lessons through a Google Form link.
• Previous student preferences highlighted topics like the opioid crisis and global abortion policy.

Emerging Infectious Diseases

• Defined as new pathogens or known pathogens appearing in new areas.
• Examples: Ebola, Nipah virus, Marburg, COVID-19.
• Often have high case fatality rates (ranges from 25% to 75% in some instances).

Ebola Overview

• Recognized for about 40-50 years; prior cases might have been misdiagnosed or underreported.
• Incubation period: 2-21 days, meaning symptoms appear after exposure could take up to three weeks.
• Reclassified from hemorrhagic fever—only a minority of cases show hemorrhaging.

Historical Context of Ebola

• Initial outbreaks mainly in rural Africa, connected to bushmeat consumption and contact with bats, the virus's natural reservoir.
• Transmission typically involves a jump from bats to nonhuman primates, leading to human infection.
• Largest outbreak occurred from 2014-2016 in West Africa, resulting in over 28,000 cases and more than 11,000 deaths.

Modern Vaccinated Responses to Outbreaks

• Introduction of two major vaccines for Ebola post-2014 crisis:
• Ervebo: used for ring vaccination strategies during outbreaks.
• Dabdana-Muvea: prophylactic vaccine.

Ring Vaccination Strategy

• Concentrates on vaccinating contacts of known Ebola cases to prevent further spread.
• Vaccinate all close living contacts first, expanding to family members and healthcare workers.

Communication Challenges in Disease Response

• Early responses to outbreaks often encountered misinformation and resistance due to cultural beliefs.
• Effective communication requires alignment with local contexts; avoid scientific dismissal of traditional beliefs.

Case Study: Casey Hickox

• Nurse returning from Ebola crisis faced unjust detention in New Jersey, sparking media and legal challenges.
• Renowned for advocating the rights of medical volunteers and maintaining ethical humanitarian response in Ebola management.

Conclusion for Class

• Instructor emphasized importance of engaging student interests for future classes while addressing historical and contemporary issues in global health.