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Saturday, August 2, 2014

Everything you need to know about Ebola

Right now, West African countries are experiencing the worst outbreak of Ebola in history. Guinea, Nigeria, Sierra Leone, and Liberia have confirmed more than 700 deaths from the disease, which has swept through those countries since appearing just six months ago. In this outbreak, it’s killing more than half of the people it infects — which makes it one of the less lethal strains of Ebola to emerge recently. Perversely, this relatively low mortality rate has a lot to do with its quick and devastating spread; Ebola is the sort of malicious evolutionary creation that exploits anything and everything it can find. It is the disease on which virtually all viral-horror thrillers are based.
Remember that, much like HIV, Ebola is a new disease. The first recorded cases came in just 1976, in and around Zaire and Sudan. Ebola isn’t the sort of long-standing historical hardship that we can shrug off as part of the human experience, like cancer or the flu — this thing is younger than many people alive today, and it’s out to get us.
ebola 4Ebola was first discovered by doctors from the Institute for Tropical Medicine in, of all places, Belgium. It wasn’t hard for these scientists to pinpoint the source of the mysterious and horrific symptoms suddenly moving through several rural areas in Zaire: looked at under a microscope, infected cells displayed an enormous, worm-like structure. It wasn’t a parasite malaria, but a super-sized virus they dubbed Ebola. Soon, this was amended to Ebola Hemorrhagic Fever. The team could not then imagine the actual human suffering the disease could cause — starting with nausea and vomiting, progressing to bleeding from mucous membranes, lesions, skin peeling, excessive swelling, and eventually death through any of a number of means.
Like HIV, Ebola is an RNA virus, meaning that its genome is made from the flimsier, more mutation-capable cousin to DNA that animal cells use only transiently. Unlike HIV, however, Ebola is not a retrovirus. This means that its RNA blueprint is not converted to DNA and inserted into the host cell’s genome. Ebola basically hijack’s a cell’s machinery and redirects it to making more copies of Ebola. After a while, these copies leave the cell — violently. Many of Ebola’s more famous symptoms exist so the disease can spread from host to host, rather than as a natural result of its survival strategy. Viscous little bastard, isn’t it?
Despite even extreme measures, health workers are putting themselves in extreme danger.
Despite even extreme measures, health workers are putting themselves in extreme danger.
For several decades after its emergence, Ebola sprang up over and over throughout Africa. Outbreaks tended to begin as a result of contact with primates or fruit bats, the latter of which can carry the disease without symptoms. Ebola’s high lethality tended to work against it in the long term, limiting potential to spread by making the infected immobile and easily identified. Nearly 300 people died in the early infections, stopped mostly by quarantine zones and education campaigns. Ebola caught the public’s attention through its sheer brutality, but there was an assumption: this is an African problem. People assumed (correctly) that this was most likely due to poor infrastructure and education — it’s not the sort of thing that could affect the first world.
Note the monkey...
Note the monkey…
Ebola is the basis or the major influence for two famous scenarios you’ve probably seen a hundred times. One: The doctor who accidentally pricks his or her finger with a syringe full of deadly virus. Two: A foreign research monkey ferries a deadly foreign virus onto American shores and infects the researchers. The second of these two incidents, which involved a novel strain of the virus eventually called the Reston virus for the Virginia town in which it was discovered, has become an intractable part of our culture. Though nobody died of Reston virus, there were several infections — and that was all that was required to capture the public imagination.
In reality, we need never have worried. While there is no cure, fighting Ebola is all about quickly quarantining the infected and observing heightened hygiene routines for a few months. This ought to be easy, but superstition about the disease and about foreign medicine in rural Africa has led many to hide their infections in the early stages, and others to actively resist global health workers. Additionally, like malaria, Ebola is especailly deadly to people who are already weakened by things like dehydration or malnutrition. If Reston had turned out to be a deadly Ebola strain, our more affluent and science-friendly culture would have been able to deal with it quite effectively.
Map of recent Ebola Virus Disease Outbreak in West Africa, including new cases. Source: WHO International Business Times/Hanna Sender
Map of recent Ebola Virus Disease Outbreak in West Africa, including new cases. Source: WHO International Business Times/Hanna Sender
Ebola’s maddening ability to flare up anywhere, at any time, with any severity, slowly fell back before determined public health work. In 2007 an outbreak killed over 100 people — and in 2012 the virus appeared and killed just a single young girl. The senselessness of the disease was a big part of the fear it was able to create in Africa and around the world. Still, the last 10 years or so have seen a steady relaxation about the disease. This latest outbreak puts an end to that, as the death toll in the last half-year quickly approach 50% of the disease’s lifetime impact.
This isn't what you generally think of when you think "foreign aid," but this is what's needed.
This isn’t what you generally think of when you think “foreign aid,” but this is often what’s needed.
Fighting this outbreak is going to take a lot of determination. Both local and foreign health workers get sick very often, despite masks, sterile clothing, and attempts to avoid direct contact with the infected. Additionally, only top-level biohazard labs are even allowed to do research on Ebola in the Western world, so the progress of pure medical research is slow.
The future of Ebola is very likely to be much like its past: slow, tortured, and terrible. The solutions are banal and difficult to pitch at fundraising dinners — not miracle cures, but multi-language leaflets, boxes of soap, and pay for often destitute foreign health workers.
This will not be the last outbreak of Ebola — but it could be the last major outbreak. If the situation is handled properly, both by international organizations and local African societies, this is a very beatable disease. As always with this Ebola, if is the operative word.



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