Ebola: a Deadly Virus

Ebola. The natural and human history of a deadly virus is written by David Quammen. Quammen is an American science, nature and travel writer from Cincinnati, Ohio that has written many books on the topics of science and natural history. He is currently a contributing writer at National Geographic but has also contributed publications to a wide variety of newspapers and media outlets such as The New York Times (En.DavidQuammen.com, 2018). His knowledge and experience on these topics come from his extensive travels to many remote areas of the world. This book is largely just an excerpt from his 2012 popular release titled Spillover, which dives into other deadly viruses such as HIV, along with Ebola and other diseases that are of animal origin. His objective with this book is to give further detail about the deadly virus alongside details of the somewhat recent 2014 outbreak in West Africa and bringing them together in hopes to make sense of the mysteries surrounding Ebola virus.

    The book opens up in an area along the border of central western Africa. In this area lies the satellite village of Mayibout 2, named after the Mayibout village. In early 1996 the village and its community were struck by a terrible outbreak following the killing and eating of a chimpanzee. The members of this community exhibited many symptoms such as fever, headaches, muscle pains, and bloody diarrhea to name a few. In total eighteen people were infected and later taken to a local hospital for care. Of the eighteen, four individuals quickly died upon arrival and were then returned to the village for ceremonial burial services. The bodies were never investigated for information regarding their sudden sickness and death. More and more cases began to arise by those who were taking care of the original eighteen sick individuals. Friends, family, and loved ones also became sick, bringing the total of infected individuals up to thirty-one.

    Trained virologist Eric M. Leroy and his colleagues from Paris, France gathered facts and details from the outbreak and later determined that the cause was a disease known and Ebola hemorrhagic fever, now termed Ebola virus disease or EVD. They also deducted that the virus was originally transmitted to the community members by the consumption of the chimpanzee. You see, Ebola is categorized as a zoonosis disease. A zoonosis disease is a disease that can be transmitted to humans from an animal. So, without knowing that the chimpanzee was infected with the deadly virus, the village community unknowingly transferred the virus from the chimpanzee to themselves. This infected chimp became a clue of sorts to the scientist. The clue that chimps and gorillas, just like humans, are highly susceptible to Ebola. The difficult part is now determining the reservoir host. The Mayibout outbreak was a part of a pattern of Ebola outbreaks across different regions of Africa. These patterns dating back to 1976, when the first recorded arrival of Ebola was documented, to our current day. The origin of these patterns is still a mystery.

     A short period following the Mayibout outbreak, a biologist by the name of J. Michael Fay spent months investigating the deadly disease across the Ebola-stricken landscape. With the help of local crews from those areas, he collected many samples in hopes to determine the origin of the virus along with its potential carriers.

    The world experienced the scary and harsh reality of the severity of Ebola in 2014 with the largest recorded outbreak occurring in West Africa. It was deemed a public health emergency of international concerns by the World Health Organization. It is said that upwards to 60% of those infected during the outbreak died. As headlines of the outbreak occurring in Africa multiplied, so did the fear of another spillover case. It became even more real when two Americans contracted the virus while in Africa and spread it to two more healthcare providers while being treated in the United States.

    The topic of host reservoir is one that consumes a vast majority of the middle-to-end potion of the book. To this day the definitive host reservoir for the Ebola virus has yet to determine. This is where the book seems to take on the persona of a mystery novel or a detective investigation. The CDC, the Center for Disease Control, has conducted a lot of research on the topic of host reservoir for the virus. Through this research, they keep landing on one common point. One common carrier of these nasty diseases. Bats! The number of infectious diseases that emerge from bats is quite an extensive list. Yet still more questions are left unanswered. Why do these bats that are carriers of these viruses not get infected and die themselves? Quammen, along with other microbiologists and scientists decided to investigate the immunology of bats to see what it is about these creatures that allow them to carry a virus while not being affected by the virus.

    My opinion on the purpose of the book is that it is meant to be informative. Meant to give the reader insight and history of the Ebola virus. To help understand where it came from, what it does, and where it could possibly be going. The book gives a sense of storytelling by Quammen. Giving his first-hand accounts through these investigations, while allowing the reader to ask their own questions regarding the topic. There is a lot left unknown or unanswered when speaking of Ebola. The main question is where does it come from? Secondly, I feel the biggest question is, where is it going to pop up next? Ebola virus isn't a steady running pathogen. It comes and goes. Shows up with no warning, infects and kills, then just disappears once the carrier is dead. It's those two points that make the disease so difficult to contain.

    I feel the book has achieved its purpose. It has given me the ability to get caught up with the past and present of the disease in a relatively short period of time. I have come out of this reading with far more knowledge about the virus than I had before. That's always the goal when reading scientific literature, right? To spark more interest and insight that can possibly lead to a further investigation of the topic. At times I do feel that Quammen assumes the reader has a background in microbiology or science which could allow Quammen to not have to really elaborate further on some points or put things in more of laymen terms. This makes some sections of the book a little hard to follow and stay engaged in.

    Ebola virus is no easy topic to cover. Its countless mysteries make it hard to really answer much of the questions you can't help but ask yourself while researching the topic. Other books on such topics are purely just informative and research-based. They have few points in where they allow the reader to feel like he or she is there in the conversation. I really enjoyed how Quammen wrote out his conversations with other researchers throughout the book. Allowing the reader to feel like he or she experienced the conversation first hand.

    As most of us in this class strive to be future health care providers, we must first gain a real understanding and knowledge of infectious disease and how one should handle relaying that information to the general public. Handle the complications of never really knowing how or why something like this is even here among humans. The challenges we face determining its origin and how we as a human population can contain it. That is where I feel the book has really achieved its purpose. To touch on the basics of all the points that eventually tie it all together, with the help of these true stories of these horrific outbreak occurrences detailed by Quammen through his travels and experiences in that region.

    Near the end of the book, Quammen asks of the reader one big question that stuck out to me. Why do we share these diseases with wildlife?. If wildlife and nature are so important for human survival, why is it that something we need to survive can also be the very thing that kills us? The answers to those questions are something we as humans may never truly know for sure. Research from the many scientists who study not only Ebola but many other zoonoses have come up with one thing that is for certain. Their data and countless observations display just one common factor. That is that People and gorillas. Chimpanzees and bats. Rodents and monkeys and viruses. We're all in this together.

    During the epilogue, Quammen is giving accounts of transmission of the disease. How it travels, transported within infected individuals and carried by either bus, plane or by foot to other countries. By late 2014 Quammen states that the Ebola outbreaks must stop being called just that, an outbreak, and start being called an epidemic. The definition of the term epidemic describes just what all these accounts of an Ebola outbreak are doing. Widespread occurrences of the virus in a particular place at a particular time. Will it ever emerge to be categorized as a pandemic? It's highly unlikely as the virus is generally seen in areas of poverty and is a very slow-moving virus when compared to others that fall under the pandemic category.

    I remember the 2014 outbreak. How scared the general public became as news broke about yet again another outbreak and how it had actually touched American soil. The constant news coverage about the individuals infected and how they transmitted it to healthcare workers caring for them. It was terrifying. But once contained and eliminated, it was gone. That was it. The talk faded out and we as a country kind of just moved on. As stated earlier, that is exactly what Ebola does. It shows its ugly face, does the damage for as long as it can or until it's contained at least, and then just goes away.

    So, what happens when the Ebola virus is silent? The evolution of the virus is being studied, and even more concerning information is being discovered. Viral adaptation is a large concern as it could mean that virus itself can eventually mutate itself into a form that can be even easier to transmit from human to human as more and more cases arise. Now that is something lose sleep over.

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