In recent times, we have had several viral outbreaks, and I must tell you that in the last 20 years, the medical and health world has had a lot to do with regard to keeping humans safe, while technology has been improving to ensure that everything goes easy with both health and humans in general. Anyways, I am not talking about technology, what do I really know about it? I am just an end user, who can operate the buttons, and use the manual to my good. I do not understand anything about physics or engineering, so let's stick to the health aspect. As I said before, in the last 2 decades, we have fought more viral epidemics than physical wars. Let me do a quick list of viral epidermic or pandemics. There was the SARS outbreak 2002, H1N1 influenza pandemic in 2009, Swine flu outbreak in 2009, COVID-19 pandemic in 2019, Ebola virus disease in 2014, MERS outbreak in 2012, H7N9 avian influenza in 2013, Zika virus disease outbreak in 2015, Chikungunya virus disease in 2013, and viruses like the Lassa fever virus which had an outbreak as far back as 1969, resurfaced. A lasting solution hasn't been seen for so many of these viruses, but hopefully, in the nearest future, we would have found vaccines for them all. In today's post, I will share about Ebola Virus. I will be sharing what causes Ebola, the pathophysiology of Ebola, Signs and Symptoms, Diagnosis, and Treatment.
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The Ebola virus Disease, which so many people call Ebola is a disease that is caused by the Ebola Virus. The Ebola Virus is of the virus family Filoviridae, which are negative-sense single-stranded RNA viruses with a thread-like shape. It can be transmitted to humans from wild animals and spread from human to human. It is a significant cause of Hemorrhagic fever. As at the time of writing this post, there are 6 species of Ebola viruses (and I do hope that we do not have more). These species are; Zaire ebolavirus, Sudan ebolavirus, Taï Forest ebolavirus (formerly Côte d'Ivoire ebolavirus), Bundibugyo ebolavirus, Bombali ebolavirus, and Reston ebolavirus.
Zaire Ebolavirus is still the most important of them all. It is the most virulent species that has caused the majority of Ebola outbreaks like the recent outbreak in the Democratic Republic of Congo (DRC), and West Africa in 2014. Sudan ebolavirus was first identified in Sudan with a fatality rate of around 50%, It has caused so many outbreaks. Bundibugyo ebolavirus has a similar fatality rate to that of Zaire Ebolavirus. Reston ebolavirus has not infected humans before but it has been found in apes and monkeys. According to the Centers for Disease Control and Prevention, Ebola was discovered first in the Democratic Republic of congo, near the Ebola River. According to the World Health Organization, the recent outbreak between 2014 to 2016 which was majorly in West Africa resulted in over 28,000 reported cases, with over 11 thousand deaths. The Outbreak spanned Senegal, Italy, Sierra lonne, Nigeria, Mali, United States, United Kingdom, Guinea, and Liberia.
Fruit bats are believed to be hosts of the Ebola Virus, which can then be zoonotically transmitted from animals to humans from the consumption of animals such as Apes and Chimpanzees. Once humans are infected, it can be transmitted from human to human via body fluids (Sweat, Semen, Saliva, feces, Breast milk, Blood, and Urine) and enters into the body of a person via mucus membrane or cuts n skins. I remember when there was a recent outbreak of Ebola, people were really scared to the extent of not keeping pets in their homes, so they do not get zoonotic transmission. When the virus gets into the body of an individual, it causes the response or activations of both inate and adaptive immune system. It doesn't end there as the virus causes the cells damage as a result of cytokines being released, and impairs the coagulation cascade preventing fibrin clot, and causing liver damage.
The Incubation period (time between the exposure to the virus and the appearance of the first symptoms of the virus) for Ebola virus is between 2 to 21 days, with common symptoms being fever and chills, fatigue, headaches, myalgia, Maculopapular Rash (usually occur between day 5 and 7 of clinical manifestation) in the neck, face, arms, and trunks, Nausea, vomiting, diarrhea, hypotension and shock, increased bleeding risk (hemorrhagic fever), hematochezia, mucosal bleeding, petechiae, purpura, meningoencephalitis (occurring between day 8 to 10 of clinical manifestation), pulse-temperature dissociation, myocarditis, pericarditis, Conjuctivitis and Uveitis. With Ebola, multiple organs can start to fail rapidly, leading to death.
Diagnosing Ebola Virus disease can be done using Antibody-capture enzyme-linked immunosorbent assay (ELISA) technique, serum neutralization test, electron microscopy, reverse transcriptase polymerase chain reaction (PCR) assay, antigen-capture detection tests, and virus isolation by cell culture.
Treatments of Ebola includes rehydration of patients using IV fluids, treatment of the symptoms associated with the viral infection, drug therapy, immune therapy, and other supportive care, novel treatments such as Remdesivir, Monoclonal antibodies, and using Convalescent plasma. Post recovery complications of Ebola Virus disease include Spinal Cord Injury, Hepatitis, Uveitis, and Psychosis. In 2020 the Ervebo vaccine was approved by the US food and Drug Adminstration (FDA) as a vaccine to protect people from the Zaïre Ebola Virus, and prequalified for people above the age of 18 except for pregnant and breastfeeding mothers.
Prevention of Ebola are to avert the vulnerable from getting infected by the virus, reducing interactions with wild-life such as Fruit Bats, apes, Monkeys, forest antelope and porcupines, and do not consume their meat uncooked. When there is an outbreak, it is important to identify people who already have the virus, and separate them from healthy people treating them and monitoring them for up to 21 days.
Conclusion
It is no doubt that Ebola virus is predominant in Africa, sensitizing and vaccinating a large population of the general public will help take us to a point of herd immunity. Even currently, I do not think I have seen anyone who has taken the Ebola Ervebo vaccine around me, so I wonder what would happen if there is another outbreak.
https://www.who.int/news-room/fact-sheets/detail/ebola-virus-disease
https://www.cdc.gov/vhf/ebola/about.html
https://www.hopkinsmedicine.org/health/conditions-and-diseases/ebola
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691429/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4173971/
https://www.statpearls.com/ArticleLibrary/viewarticle/20849
https://www.nature.com/articles/s41572-020-0147-3
https://www.sciencedirect.com/science/article/pii/S0896841119306572