Ebola: Severe and Life Threatening Viral Disease

Ebola hemorrhagic fever, also known as Ebola, is one of the rarest and deadliest diseases.  The virus can affect people and non-human primates such as monkeys, gorillas, and chimpanzees.  The Ebola virus disease is a severe and life threatening viral disease. The virus comes from the virus family known as Filoviridae. There are five strains of the virus, but only four of the strains can cause harm. When the virus enters the body, it begins killing the cells and can potentially make them explode.  Ebola destroys the immune system and causes problems with the way a person's blood clots, which causes tremendous internal bleeding and therefore takes a toll on almost every region of the body and becomes fatal if not treated. Ebola is concentrated in Africa with the first reported death of Ebola being reported there.  The disease is considered an epidemic in some areas of Central Africa with many people regarding Ebola as one of the most feared diseases in the world due to the high mortality rate and the lack of an approved vaccine.

        The first outbreak of the Ebola virus was first reported in the 1970s in Zaire.  Up until 2013, most of the outbreaks occurred in the Central Africa region. In March 2014, the first case of Ebola was reported in Guinea, West Africa and from there it spread very quickly to neighboring countries, such as Liberia and Sierra Leone, which caused an epidemic in those regions.  The Democratic Republic of the Congo, or the DRC, is the southernmost country located in East Africa and Central Africa.  The DRC has now dealt with its ninth outbreak of the Ebola virus since researchers first discovered the disease.  There is no explanation to this day as to why the DRC is dealing with these continuous outbreaks.  The majority of the time the outbreaks die out fairly quickly because the outbreaks occur in remote areas.  With that being said, this does not mean the fatality rate is not extremely high.  The fatality rate from the virus ranges from thirty to ninety percent. Between March and October of 2014, over ten thousand cases of Ebola were reported in West Africa.  The outbreak that occurred between 2014 and 2016 in West Africa was the largest outbreak of Ebola since the disease was first discovered. There were more deaths during this outbreak than in all of the previous Ebola outbreaks combined. Ebola has also been reported in Spain and the United States as secondary infections, but the majority of the outbreaks occur in Africa.

        Most of the time, once a person has been infected by the Ebola virus, it takes a couple of weeks for the symptoms to begin to appear.  A person is not considered to be infectious until the symptoms begin to appear.  The early symptoms of Ebola include fever, fatigue, sore throat, muscle pain, and headaches.  Shortly after these symptoms appear the infected person begins to have vomiting, diarrhea, internal and external bleeding, such as blood in the stool and oozing from their gums. The liver and kidneys then begin to shut down.  Scientists have also noticed a person's white blood cell count and platelet counts will be low and liver enzymes are increased. People dealing with the virus at its worst stages normally lose six to ten quarts of fluid in a single day due to the extreme vomiting and diarrhea.  If a person does not survive the Ebola virus, death typically occurs within two weeks of the first symptoms appearing.

        Diagnosing Ebola is not easy because the symptoms of Ebola are similar to those of other illnesses, such as malaria and typhoid fever.  This can often result in a misdiagnosis. In order to diagnose Ebola, there has to be a combination of the symptoms of the Ebola virus and an exposure to the Ebola virus within 21 days of the onset of the first symptom(s).   Blood samples are taken from the ill person and must be tested to confirm infection. The Ebola virus can be detected in blood after the onset of symptoms and, in particular, a fever. However, it can take up to three days after symptoms start for the virus to be at detectable levels in the blood. The Ebola infection is confirmed when the lab test comes back positive.

        If a person survives an Ebola infection they can still have complications, which can be both physical and mental.  Ebola survivors have experienced hair loss, weakness, lethargy, weight loss, hearing loss, tinnitus, cardiac problems, as well as ocular complications.  Some survivors have reported having insomnia and hallucinations.  Another common complication that occurs after recovering from the virus is the stigma that goes along with the fact that a person had the Ebola virus.  Survivors often feel ashamed or embarrassed by their status with the survivors sometimes being avoided by others, which can cause emotional distress.

        It is believed that fruit bats of the Pteropodidae family are the natural Ebola virus hosts.  Ebola is spread to humans by close contact with the blood, bodily fluids, organs, or secretions of infected animals such as fruit bats, porcupines, or gorillas that are found dead or ill in the rainforest.  The virus then spreads from human to human through the blood, secretions, or other bodily fluids of an infected person and through contact with surfaces and materials which have been contaminated with these fluids, such as clothing and bedding.  Ebola is not an air borne disease. Health care workers can also become infected with the Ebola virus if infection control precautions are not taken when treating someone who has the virus.  Burial ceremonies where direct contact with an infected person occurs also promote the spread of the virus.  People remain contagious and infectious as long as the virus is in their blood. If an individual has been infected with Ebola, but does not show any type of symptoms from the virus, then that person cannot spread the disease.  More research and data on the transmission of Ebola through sexual transmission is needed in order to determine if this is a viable way for the disease to be transmitted, but early research indicates that if a man is infected with the virus, he can pass the virus to his sexual partner through his semen. 

Despite its severity, Ebola prevention and control is possible.  An important part of controlling an outbreak is to track the cases and trace where the virus originated and educate the community on safe burial practices and risk factors.  Wearing gloves when coming into contact with fruit bats, monkeys, and apes, with all meat being cooked thoroughly before eating it, can reduce wildlife to human transmission.  The World Health Organization suggests that all Ebola survivors and their sexual partners either abstain from sex or practice safe sex with the use of condoms until the semen has twice tested negative. They also believe survivors should be provided with condoms.  After a person has died, they should be buried promptly and protective measures taken when handling the body.  Also, identifying someone who has been exposed to the virus and monitoring them for twenty-one days, as well as separating sick people from healthy people, can help contain an outbreak.

The symptoms of Ebola are treated as they appear.  These treatments consist of fluids, electrolytes, oxygen therapy, with medications to reduce fever, control blood pressure, reduce diarrhea and manage pain.  The sooner the symptoms are treated, the more likely the person is to survive. At this time there is no antiviral drug licensed by the U.S. Food and Drug Administration to treat the Ebola virus in people. There are drugs being developed to treat the virus by stopping the virus from making copies of itself.  Blood transfusions from survivors and mechanical filtering of blood from patients are also being explored.  In 2003, The Public Health Agency of Canada discovered the vaccine for Ebola was 100 percent effective in monkeys. Due to the lack of interest from any of the pharmaceutical companies, the vaccine sat on the shelf until it was licensed by Merck in 2014.  The vaccine is still in clinical trials and is not yet commercially available.  However, Merck has a stockpile of the vaccine that equals hundreds of thousands of doses of the vaccine.  In addition, health officials have a plan in place to begin vaccinating people.  They plan to immunize the contacts, including friends, family, housemates, and neighbors of the person who becomes sick with the virus.   This will create a protective ring around the ill person to stop transmission. Health workers and other Ebola responders in the DRC will also be vaccinated.  When a person is diagnosed with Ebola, the health worker will trace the person's contacts and those people will be given the vaccine to prevent the spread of the virus. 

The prognosis for the Ebola virus is often poor.  The death rate for the disease ranges from 30% to 90%.  With early diagnosis and treatment, a person's chance of recovery and survival greatly increases.  As mentioned earlier, there are potentially some permanent effects for an Ebola survivor, such as hearing loss, ocular complications and cardiac problems.

The Ebola virus is a severe and life threatening viral disease.  The fatality rate from the virus ranges from thirty to ninety percent.  The early symptoms of Ebola include fever, fatigue, sore throat, muscle pain, and headaches.  Diagnosing Ebola is not easy because the symptoms of Ebola are similar to those of other illnesses, such as malaria and typhoid fever.  If a person survives an Ebola infection they can still have complications, which can be both physical and mental.  Ebola is spread to humans by close contact with the blood, bodily fluids, organs, or secretions of infected animals such as fruit bats, porcupines, or gorillas that are found dead or ill in the rainforest.  Despite its severity, Ebola prevention and control is possible.  The sooner the symptoms are treated, the more likely the person is to survive.  The prognosis for the Ebola virus is often poor.  With such a poor prognosis and the lack of an approved vaccination, it is quite easy to see why Ebola hemorrhagic fever is one of the most feared diseases in the world.

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