By Africa Check and May Olusola
In February 2014, an outbreak of the Ebola virus was identified in the south-eastern forests of Guinea, Africa. It was the first time the virus had been recorded in the West African state. By March, it had spread from Macenta, Gueckedou and Kissidougou to the capital city of Conakry. By April, cases were confirmed in two more districts – Dabola and Djingaraye – and in neighboring Liberia.
The disease has since advanced to the capitals of Guinea, Sierra Leone and Liberia, and it has killed two doctors, Dr Samuel Brisbane from Liberia and a Ugandan, with two more seriously ill.
To date, Nigerian officials are racing to prevent an outbreak in Africa’s largest city after a Liberian/US citizen from Liberia died in Lagos shortly after arriving at the airport. All entry points into Nigeria are on red alert.
Médicins sans Frontières has called this outbreak – the world’s largest recorded to date – “unprecedented”, due to its broad geographic spread. The World Health Organization (WHO) have recorded 1,201 cases attributed to the Ebola virus, including 672 deaths.
Ebola is a terrifying phenomenon: it kills up to 90% of infected people; death can occur in as little as a week; prior to death, patients may hemorrhage (bleeding internally and externally). There is no vaccination and there is no cure.
The origins of Ebola
This colorized transmission electron micrograph (TEM) obtained on March 24, 2014 from the Centers for Disease Control (CDC) in Atlanta, Georgia, reveals some of the ultra-structural morphology displayed by an Ebola virus vision. The Ebola virus is named after the Ebola River in the Democratic Republic of Congo, where the disease claimed its first known victims in 1976. A separate strain broke out simultaneously in Nzara, Sudan.
Unlike bacteria, which are single-celled organisms that multiply by dividing themselves, viruses require hosts to replicate: they take over living cells and then force the infected cells to reproduce the virus. While bacteria can be combated with antibiotics, the same is not true of viruses.
Ebola is a ribonucleic acid (RNA) virus and multiplies rapidly in its host by creating a high pathogen dose. Science writer David Quammen, who has investigated the origins and spread of the virus, writes that “[RNA viruses] produce acute infections, severe for a short time and then gone. Either they soon disappear or they kill you.”
In the process, “sneezing, or coughing or vomiting or bleeding or diarrhea facilitates transmission to other victims.”
There are five known species of the Ebola virus: Bundibugyo ebolavirus; Zaire ebolavirus; Reston ebolavirus; Sudan ebolavirus; and Taï Forest ebolavirus. All but the Reston strain can be fatal to humans and all but the Reston strain are found in Africa.
Until recently, the Zaire strain of Ebola was thought to be behind the current outbreak, with the US Centres for Disease Control (CDC) noting a 98% match between the West African and Zaire strains. The Zaire strain of Ebola is the most deadly: it attacks all organs in the body, including the skin, and can have a fatality rate of up to 90%. Since its first appearance – and excluding the current outbreak in West Africa – the strain has killed 1,098 of the 1,388 people it has infected, an average case fatality rate of 79%.
However, a team of experts studying the West African strain reported in the New England Journal of Medicine recently that the Guinea outbreak is a new strain of the virus: though closely related to Zaire ebolavirus, the current strain is endemic to West Africa and developed parallel to the central African ebolavirus strain. According to the team’s investigation, the strain’s outbreak can be traced to the death of a two-year-old child in Gueckedou on December 6 last year.
How is Ebola transmitted?
The Ministry of Health has asked Ivorians, “particularly fond of porcupine and agouti,” a small rodent, to avoid consuming or handling the meat, as an unprecedented Ebola epidemic hit West Africa, claiming more than 100 lives. The virus can spread to primates and humans who handle infected meat — a risk, given the informal trade in “bush meat” in forested Central and West Africa. SanogoEbola is thought to be a zoonotic or animal-borne virus. The virus survives in a “reservoir” host – an animal or insect that carries the virus at no cost to itself – and is passed on to other animals or humans through contact with the bodily fluids, secretions or organs of the host animal.
Though it has not been conclusively proved, the fruit bat (Pteropodidae) is considered to be the natural host or “reservoir” of the Ebola virus. The exact manner in which Ebola enters human cells remains a mystery. Transmission to humans and primates is thought to occur through direct contact with the animal host, or through contact or consumption of the meat, bodily fluids or secretions of animals that have become infected by contact with the host. Guinea is a known wildlife trafficking hub and last month, the country’s government issued a warning to citizens to avoid eating traditional bush meat dishes.
Once it has presented itself in humans, Ebola is transmitted through direct contact, where broken skin or mucous membranes come into contact with the blood or secretions of the infected person. It may also be transmitted indirectly “through exposure to objects (such as needles) that have been contaminated with infected secretions”, according to the US Centers for Disease Control and Prevention. This means that healthcare workers and family and friends of those infected with the virus are at a higher risk of infection.
What does the virus do?
The Ebola virus causes a viral
hemorrhagic fever, a set of severe illnesses that are “multisystem” in that they affect various parts of the body’s regulatory systems. These viral diseases damage the circulatory system and may be accompanied by bleeding or hemorrhaging.
According to the WHO, patients begin to show symptoms anywhere from two to 21 days after exposure to the virus, mostly between days 8 and 10. Patients present with fever, weakness, muscular pain, headaches and sore throat. The generality of the symptoms at this stage makes it difficult to distinguish Ebola from various other diseases, including malaria, typhoid fever, meningitis or cholera.
As the disease develops, Ebola sufferers may experience vomiting, diarrhea, a red rash, difficulty in breathing and swallowing. The virus severely compromises the immune system, and affects liver, kidney and respiratory function, as well as the skin and blood. Blood clots may form and patients may experience hemorrhaging, bleeding internally and externally.
Treating Ebola
There is no vaccine or cure for the Ebola virus, though several vaccinations are currently being tested. According to CDC, treatment is limited and merely supportive of the body’s immune function: providing fluids, electrolytes and oxygen; keeping blood pressure constant; and treating additional infections with antibiotics.
It is unclear why some people infected with the virus survive where so many do not, but it is thought to relate to the strength of the individual’s immune system, the strain of the virus and the viral dose the person has been exposed to.
In addition to supportive and symptomatic treatment, health workers can only really control the spread of the virus: isolating those infected, raising awareness of the virus and how it is spread in affected communities, ensuring appropriate protective gear is worn by all in contact with Ebola sufferers and ensuring the quick and safe burial of those who have succumbed.
Reported cases of Ebola
Dr Brantly in white protective gearMore than 670 people have been killed and over 1,000 including two Americans are battling with the Ebola virus outbreak in Africa. The World Health Organization is calling it the largest recorded outbreak of Ebola.
CBS reports Missionary doctor Kent Brantly, 33, is one of two Americans in the region who have contracted the deadly disease.The father of two had been treating Ebola victims in Monrovia, Liberia, when he began to notice symptoms related to the virus. Now Brantly is himself a patient, fighting for his own survival in an isolation unit on the outskirts of Monrovia, Liberia, after contracting the deadly disease.
“I’m praying fervently that God will help me survive this disease,” he said in an email sent to his colleague, Dr. David Mcray, who worked with Brantly at John Peter Smith Hospital in Fort Worth, Texas. Brantly “went into Ebola exhausted” from treating Ebola patients, Mcray said after speaking with him on Monday, July 29th. His prognosis is grave and efforts to evacuate him to Europe for treatment have been thwarted because of concerns expressed by countries he would have to fly over en route to any European destination, Mcray said.
Dr. Sheik Umar Khan, 39 year old chief Ebola specialist in Sierra Leone contracted the disease last week, after giving an interview to Reuters saying how he feared for his life because of his work. “I am afraid for my life I must say, because I cherish my life. Health workers are prone to the disease because we are the first port of call for somebody who is sickened by the disease. Even with the full protective clothing you put on, you are at risk” he told Reuters.
Unfortunately, Khan succumbed to the deadly virus a few days later. He treated more than 100 Ebola patients in Sierra Leone and was the only specialist Sierra Leone had in viral haemorrhagic fevers.
Dr. Samuel Brisbane, one of Liberia’s high profile doctor at the country’s largest hospital, died Saturday at a treatment center on the outskirt of Monrovia. Brisbane was the first Liberian doctor to die in the outbreak.
Patrick Sawyer, a 40-year-old father of three who died in Lagos, Nigeria may have sparked a worldwide spread of the killer disease after being allowed on two flights while infected. According to the UK Mirror, the revelation has sparked a desperate race to find dozens of passengers who flew on the same jets as the 40-year-old American. British doctors and border officials have been warned to be on the lookout for people in the UK showing signs of the disease.
Sawyer, a former Minnesota resident was allowed to board an ASKY Airlines flight in Liberia, where Ebola is rife, despite vomiting and
suffering from diarrhea. His sister was recently killed by the virus.
Decontee Sawyer, his wife, told KSTP-TV her husband planned to visit his family in Minnesota next month. “Patrick could’ve easily come home with Ebola. Easy. Easy. It’s close; it’s at our front door. It knocked down my front door” she added.
UPDATE
On August 2nd, a chartered air ambulance equipped with a sophisticated isolation unit flew Dr. Brantly from Liberia to Emory University Medical Hospital in Atlanta, Georgia where he is being treated. 11alive News Atlanta captured Dr. Brantly walking into the hospital from the ambulance. The second American doctor with the Ebola virus, Nancy Whitebol, is expected to arrive in the states from Liberia in a few days.
Africa Check, a non-profit fact-checking website. For more on them see www.africacheck.org and follow them @africacheck. May Olusola is the Publisher of MannaEXPRESS.
