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The Ebola Outbreak
"You have to admire its simplicity. It's one billionth our size and it's beating us,"
Dustin Hoffman, Outbreak. Warner Bros. Pictures
 
If you haven’t heard by now, Ebola has become a serious health issue in Africa. This disease was named after the Ebola River in Zaire, where the virus was first discovered. Although smaller outbreaks have occurred in the past, this newest rash of cases has killed nearly 3,000 people in West Africa (out of a total of nearly 6,000 reported cases1). The World Health Organization (WHO) and Center for Disease Control have projected 1.4 million people could be infected by January 2015 and increased the estimated mortality rate from 50% to 70%2. But, before widespread panic sets in, let’s go over some of the facts and myths of this disease.

Don’t panic just yet. Pirates of the Caribbean. Walt Disney Pictures.
Symptoms

This disease is caused by Ebolaviruses (there are 5 strains, 4 of which can infect humans) and begins with flu-like symptoms of fatigue, fever, and muscle/joint/abdominal pain. Vomiting, diarrhea, and loss of appetite can also be exhibited. In nearly half of these cases, patients will develop Ebola Hemorrhagic Fever, which causes bleeding from mucosal tissues (gastrointestinal tract, eyes, ears, nose, vagina, and gums). Blood can also be found in the patient’s stool or vomit.
Transmission

Ebola is thought to be a zoonotic disease, meaning it is transmitted from animals to humans. Bats are the most likely animal reservoir. The disease can then be passed on to animals like gorillas, chimpanzees, or duikers (a type of antelope). Humans can contract the disease by handling or eating one of these infected animals. Between humans, Ebola can be transmitted through contact of bodily fluids of the infected. Bodies of deceased patients can still be infectious, as is the semen of survivors for up to three months.
Part of the reason this has been so difficult to contain in Africa is the health care setup. Medical workers there may not wear protective clothing when dealing with the infected, and needles may be reused. Many facilities have been decimated by political or social unrest, and as such, lack basic equipment like gloves, masks and needles3. In addition, misinformation is fanning the flames of this disease.

Mythbusters, Discovery Channel.
Myths

Some troubling myths4, 5have popped up during this outbreak. Some of the more rampant ones include:
  • Antibiotics, onions or salt water will protect you. Ebola is a virus and as such, antibiotics have no effect on it. Bad breath or not, there is no food or liquid diet that can prevent Ebola from infecting you.
  • International health care workers brought Ebola to West Africa. This is perhaps the most disturbing myth. Locals perceive healthcare workers as a potential threat, going so far as to attack and kill some of the workers who came by. Villagers see patients being taken to hospitals only to die, leading to rumors that the hospital is actually killing people. A lack of cooperation makes it difficult to educate locals and track down infected people for isolation.
  • American patients being brought back from Africa pose a risk to the rest of us. A certain outspoken billionaire decided to proclaim that bringing the infected Americans back to the U.S. put us all at risk. Ebola is not like SARS. It is not airborne and cannot be transmitted by casual contact. In addition, we have the proper equipment and care facilities to isolate and manage these patients. The two Americans who were brought back stateside were safely quarantined, treated, and discharged. Just a few days ago, the first case of Ebola was diagnosed stateside in Dallas, Texas. However, it should be noted that he had been visiting Liberia. The Dallas County Health Director, Zachary Thompson, commented, "Unless you have exchanged bodily fluids with this individual this is a low risk for people in Dallas County. We have a great infrastructure to deal with an outbreak6".

You can bump the U.S. cases here to 1, but Ebola still isn’t an issue in the U.S.
  • The United States is purposely withholding a cure from Africa. While Ebola has no known cure, hope was kindled when those infected Americans were successfully treated with a drug known as ZMapp™. However, there has been some public outcry that we are not sharing this with our friends in Africa. This is addressed in the next section...
Treatment

ZMapp™ (Mapp Biopharmaceutical) is a combination of three humanized monoclonal antibodies designed to recognize Ebola glycoproteins and inactivate it. To this point, ZMapp™ has been used to treat two people in the U.S. While it has been successfully tested on non-human primates7, its safety and efficacy in humans has not been fully validated yet. But, the WHO has decided to fast-track the use of this therapy and TKM-Ebola, which is made by Tekmira Pharmaceuticals and utilizes small interfering RNA to disrupt Ebola protein production. Blood transfusions of Ebola survivors are also being investigated since their antibodies may allow for passive immunity.

While some might be wary of testing these early-phase drugs in Africa, the WHO stated, "it is ethical to offer unregistered therapeutic interventions to Ebola patients in the context of the current outbreak, while ensuring that as much information on their safety and efficacy is collected as possible8." President Obama has stated the U.S. will help by building 17 Ebola treatment centers and deploying 3,000 military personnel (including doctors) to help combat the infection9.

Will ZMapp™ and TKM-Ebola help stop
the spread of Ebola?
There is still much to be learned, but we are hopeful that the educational facts in this blog can help stem public ignorance on Ebola. You can check out the references below for more information or contact us if you have any comments: techserv@biolegend.com. And, should you want to contribute to the fight against Ebola, you can donate with the American Red Cross, Doctors Without Borders, and AmeriCares.
  1. Ebola death tolls.
  2. Ebola mortality rate.
  3. Poverty fueling Ebola spread.
  4. Ebola virus: busting the myths.
  5. The most destructive myths about Ebola.
  6. Ebola diagnosed for first time in U.S.
  7. Nature article on ZMapp™ and non-human primates.
  8. Treatments beginning in West Africa.
  9. Obama pledges help for Ebola outbreak.

Just when I think I got the hang of science...
Contributed by Ken Lau, PhD.
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