Why have Ebola virus outbreaks always originated in the poor countries of West Africa? The nutritional status of a living organism is directly responsible for its ability to resist the development of a virus. As far back as 2001, a group of scientists at the University of North Carolina published in the Faseb Journal the results of research showing that people with nutritional deficiencies allow classic viruses to mutate, transforming them into dangerous mutants that can become lethal and spread. This applies to all viruses, including the common cold, Aids and Ebola. A subclinical selenium deficiency allows, for example, the human influenza virus to transform into a more virulent form and to infect other people more easily. Subsequent scientific publications have highlighted the importance of this aspect with regard to Vitamin C as well, and as shown in an article published in the Journal of Nutrition, vitamin C deficiency can not only promote pulmonary complications from influenza, but also have a metabolic interference on the body.

An adequate intake of minerals and vitamins therefore appears to be fundamental to antiviral defence, and on the basis of publications produced with Shankar in 1999 on the role of zinc in resistance to infections, University of Detroit researcher Ananda Prasad published in 2008 in Molecular Medicine a far more advanced synthesis on the defensive role of zinc and other minerals in the treatment and prevention of viral infections as well. Semba and Tang, of Johns Hopkins University in Baltimore, had already published data of this kind in the British Journal of Nutrition in relation to HIV infection. The implications of these data extend into the social and ethical sphere as well: when it comes to Ebola, in West Africa not even the minimum recommended intake levels of selenium, zinc or vitamin C in the diet are reached, and these countries risk becoming not only reservoirs of viruses that can be transmitted to those who eat adequately, but also hotbeds for the transformation of mutant viruses. What happens is that the Ebola virus strikes defenceless individuals, partially mutates within them and goes on to infect other malnourished people, until it encounters a resistant organism and can no longer continue its spread.

Can a well-nourished person with an efficient immune system contract Ebola? If so, what are the risks? Can they recover easily? The answer must come from medical knowledge. Ebola behaves like all viruses, without exception, and will therefore be able to infect people with immune or nutritional deficiencies and get the better of them, or infect people with an efficient immune system and be overcome. This means that in all likelihood a healthy person may become infected, albeit with greater difficulty than others, but will in all probability overcome the infection. This is not my opinion — always open to challenge — but rather the transposition onto Ebola of what happens with every virus in the world. With very high probability, this is what could occur. Those who fear the opposite — namely an invasion of Ebola causing millions of deaths in its wake — are instead putting forward an opinion unsupported by facts. We know that viruses do what they do. For what reason should Ebola do the opposite? Caution is essential, but my thinking is grounded in how viruses work and in previous experience (see SARS and bird flu), whereas the doomsayers play on emotions without having data to support them. The reading of events over these past few days — in which the extremely rare cases of people who have contracted Ebola in Western countries have recovered without treatment — is testament to this.

Beyond the individual cases of infected Western healthcare workers, should we expect the epidemic to cross the Strait of Gibraltar "en masse"? No. The Ebola virus has never crossed the Strait of Gibraltar from 1976 to the present day. Epidemics have always self-limited, halting their progress after sowing disease and death among people afflicted by disastrous social conditions. So far, all the Ebola epidemics that have broken out over the years have stopped when the virus encountered a better-nourished population with a more efficient immune system, exactly as all viruses do, including influenza. Today we will see individual cases or sporadic clusters of infections in some Western countries as well, which will receive enormous media coverage, in the face of a very low actual risk of spread.
Let us recall that there were moments when television news bulletins gave a daily war bulletin of ducks dying near the Danube, considered at the time to be fearsome carriers of bird flu. Today those same ducks continue to die, from time to time, near the Danube, without anyone worrying about it. The same will happen with Ebola. There will be cases (like the ducks) that cross the Strait of Gibraltar, causing no harm but instead triggering the feared responses — ones that were probably already anticipated. One need only look at what is happening in Italy, where people are going back to using useless face masks and where the psychosis of "fear of Africans" has reached levels typical of paranoid delusion. Unfortunately, in the very last few days, despite the phenomenon already being on the wane, the cases of bird flu in Baltic Sea seals were reported, on the front page of many newspaper editions.

We all know that the number of people infected in the affected areas is growing, but what do we know about the severity of the disease? The severity of the infection is visibly decreasing. The mortality rate caused by the virus is falling, as if in spreading, Ebola were encountering people who are more reactive and capable of defending themselves. The WHO data speak clearly: on 3 July, Ebola mortality across all of West Africa showed a rate of 61 per cent. By 9 August the figure had fallen to 54 per cent, and by 28 August to 50. In Sierra Leone, the total count as of 17 August shows an overall mortality rate of 36.8 per cent (717 infected and 264 deaths since the start of the epidemic); the report as of 9 October records an overall average mortality rate of 27.5 per cent (2,593 infected and 713 deaths since the start of the epidemic). This means that over two months there were 1,876 new infections resulting in 449 deaths. The mortality rate for the last two months has therefore fallen to 24 per cent, and this has occurred in the complete absence of specific therapies. Mortality is thus in clear decline, as one would rightly expect from the natural history of any virus of this type. Re-reading the data (always correlated to confirmed cases) from the latter part of October, the values remain within this range of intensity.

How is the disease treated? Are vaccines useful? It is treated like all viral diseases. Beta-glucans, vitamin C, zinc, manganese and copper are powerful supportive elements. Vaccines are suddenly being studied everywhere. It could take years before we understand whether they are useful, but companies want to bring them to market as quickly as possible to capitalise on fear.

In your view, are there commercial interests linked to Ebola that are interfering with accurate public information about the disease and with the way in which the emergency is being handled? In recent years, every disease for which a drug can potentially be used has always been backed by communications from companies, patient associations, various types of forums, associative blogs and more. Unfortunately, I find no such backing for Dengue or Chikungunya — diseases present in Italy as well — which have no possible treatment and therefore struggle to find sponsors…

Is it reasonable to think that the only true weapon for countering the spread of Ebola is fighting poverty?
The Director-General of the WHO, Dr Margaret Chan, published a significant article on the true causes of this epidemic in the 20 August issue of the New England Journal of Medicine. Since this is no ordinary person, but the world's highest health authority in the field of infectious epidemiology, it is worth quoting her words verbatim, knowing they will help many people to complete their own reflections: "Experience tells us that Ebola outbreaks can be controlled even without vaccines and specific treatments. Despite this, due to the tremendous confluence of poverty, inefficient health systems and fear, no one is talking about a rapid end to the epidemic. Coordinated efforts from the international community will be needed for many more months." Chan's article opens with a question: "Why is this Ebola epidemic so large, so severe and so difficult to contain?" The answer the doctor gives is in a single word: poverty.

In your view, what will happen in the coming months? How will Ebola evolve? For a few years, now that the fear surrounding influenza has faded, Ebola will dominate the headlines, then it will be overtaken by new viruses. If a prediction is needed, I put Marburg fever in first place, and in second the new avian influenza (H10N7) — the one that is now killing seals…
We will in any case go through a phase of intense media coverage; a psychosis will build up, forcing governments to feel obliged to take measures such as "temperature checks for anyone arriving from anywhere" (a goldmine for antipyretics) and the paralysis of many nations.

As with SARS (and the pattern is the same as it was then), trade relations with Africa and with China (today strongly positioned in sub-Saharan Africa) will be severed for at least a couple of years, then everything will gradually resume. Drugs will be purchased by governments and compulsory vaccines proposed for all manner of people — an approach capable of countering the current decline in voluntary uptake. There will be a few genuine Western deaths (far fewer than those from a weekend of road traffic) and many suspected but unconfirmed deaths reported across every media outlet before any confirmation. Nobody will ask why doctors and healthcare workers, among the most vaccinated people in the world, will fall ill more than ordinary people, and the world will carry on regardless… Ebola will continue to behave like all other viruses, seeking spaces in which to expand and stopping where organisms are capable of reacting.