by Dr. Scott Saunders, M.D.
The mention of a relatively newly discovered virus strikes fear in the hearts of many. This virus causes hemorrhagic fever and death in up to 90% 0f cases, mostly in Africa. We hear the name Ebola and its diagnosis is like a death sentence that can spread everywhere without knowing it.
In June 1976, the first known case of Ebola virus was found in Sudan, Africa. The Sudan outbreak infected 284 people and killed 151. However, the cause of this illness was unknown until it caused an outbreak in Zaire (now called the Democratic Republic of Congo) a few months later. There were 318 cases and 280 deaths near the Ebola River, from which we derive its name.
Where did Ebola come from?
Viral hemorrhagic fevers, such as those with Ebola, are nothing new. Marburg’s disease first occurred in 1967, while the Ebola fever appeared in 1976.
Ebola has infected other mammals; the entire genome of the virus has been found in pigs. But testing in outbreak areas found no carriers except bats. The most likely reservoir to date is four species of bats, such as the fruit bat. While no known case of direct transmission from bats to humans is known, the population eats bats in the epidemic area. Handling bat meat could potentially initiate an outbreak of this illness.
Could Ebola be a Bio-Weapon?
The use of infectious diseases to destroy enemies has been around since before Alexander the Great used putrefying carcasses to conquer the known world in 330 BC. They didn’t know exactly what caused the diseases, but they knew their enemies would get sick and die.
The Americas had little resistance to disease brought over by the European explorers. Smallpox, measles and polio killed and dwindled the Native American Indians population. Thus, a disrupted society made it easy for settlers to conquer the Americas.
Ebola sounds like it would be a great weapon since it’s so deadly, can spread rapidly, and has no cure. However, it has some characteristics that make it a poor choice as a bio-weapon:
- It doesn’t last long in the environment.
- Victims aren’t contagious until they get symptoms.
- It isn’t easily spread to non-intimate contacts.
- People who have Ebola die quickly so they can’t continue to spread it.
- It is easy to control the spread of disease with good hygiene.
- Once there are no cases of illness, the disease is gone from the population.
- There is no non-human host or reservoir to spread disease.
While we hear about hundreds, or even thousands, of Ebola infections and deaths, we must also remember this is happening in an area where there are few resources for infection control. Even then, it only affects around 0.2% of the population. While it is a fearsome disease, it is not a good bio-weapon.
How is Ebola Diagnosed?
The CDC web site on Ebola indicates the most current diagnostic criteria:
“Diagnosing Ebola in a person who has been infected for only a few days is difficult, because the early symptoms, such as fever, are nonspecific to Ebola infection and are seen often in patients with more commonly occurring diseases, such as malaria and typhoid fever.”
A person with early symptoms of Ebola who has had any potential contact with the disease should be isolated and tested to confirm infection.
Tests that are used to detect the presence of the virus include
- Looking for antibodies made by the host
- Looking for the DNA of the virus
- Or actually isolating virus particles
Area resources determine which test to use. The antibody test is the quickest, but it is also the least reliable.
What are the Characteristic Symptoms of Ebola?
The symptoms of Ebola begin 2 to 20 days from the date of infection. Early signs and symptoms include:
- Joint pains
- Muscle aches
Over days, as the symptoms increase a victim may have some or all of the following:
- Nausea and vomiting
- Red eyes
- Raised rash
- Chest pain
- Stomach pain
- Weight loss
- Bleeding from the eyes, and any body orifice
- Internal bleeding
How Can we Prevent Ebola?
Where the major Ebola outbreak occurred in Liberia, the Firestone rubber tree plantation has a hospital that cares for about 80,000 people. After the first case of Ebola in March 2014, the company instituted an infection control program. It included community and health care worker education, voluntary quarantine, and a special Ebola unit in the hospital. Because of the company’s response strategies, their rate of infection was less than half of the rate of the population in the area.
To become infected, there needs to be close contact. But, transmission doesn’t always happen with close contact. The index case of the Firestone hospital, for example, was a woman who was caring for a relative with Ebola in a different city. When they discovered she had it, she went to the Ebola unit in the hospital and her family went into quarantine. Neither her husband nor her three children contracted the disease. Unfortunately, she died. From this we learn that good infection control measures stop the spread of disease.
The virus is found in all body fluids, including:
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