What You Need to Know about the EBOLA OUTBREAK in West Africa

So, what exactly is Ebola?

Ebola is a virus of the family Filoviridae, and there are four species of the virus that are capable of causing disease in humans: the Zaire (also known simply as Ebola) virus, Sudan virus, Tai Forest virus, and the Bundibugyo virus. The Zaire virus, the deadliest strain, is the cause of our current outbreak and was first discovered in humans in 1976 in Sudan and the Democratic Republic of Congo (where there is currently a separate Ebola outbreak).

As the transmission electron micrograph above shows, Ebola is long in structure, and such a large surface area better enables the virus to encounter and take over nearby cells in an infected body. By attacking the body's white blood cells, Ebola prevents the immune system from responding to and killing the virus, and so, it proceeds to essentially take over all the cells in the body, making them into Ebola replication factories.

A person may experience symptoms any time between two and twenty-one days after direct contact with the Ebola virus. If symptoms do not arise after this period, then a person does not have Ebola. Initial symptoms include fever, muscle pain, weakness, sore throat, and headache. Since Ebola is a hemorrhagic fever virus, some patients may also experience internal and external bleeding. This happens when infected body cells attach to blood vessels and cause them to leak out fluids. Such bleeding causes the body's blood pressure to drop, and this can be fatal if it drops too low, causing the body to go into shock and the organs to fail due to a lack of blood, oxygen, and nutrients. Other late-stage symptoms of Ebola include vomiting, diarrhea, and impaired kidney and liver function.

Ebola is believed to have originated in bats of the Pteropodidae family. It is spread when bodily fluids — such as urine, feces, semen, breast-milk, saliva, and blood — of an infected individual enter into an opening of another animal or person. The virus is thought to have spread from bats to other wild animals, such as gorillas, and then to humans who consumed or hunted the infected animals. According to a gene study published in Science, the transmission of the disease in West Africa most likely began with one person infected by an animal, who then spread it to others through human-human contact.

In the beginning of our current outbreak, one of the common modes of virus transmission was through the handling of the dead, Ebola-infected bodies. In West Africa, the preparation and burial of the deceased is a respected, cultural tradition, but in doing so, people are exposed to infected bodily fluids, which can still contain up to one billion copies of the virus per one cubic centimeter of blood even after a person dies. To prevent the spreading of the virus through the preparation of the dead, Liberia — who was hit the hardest and has a total death count of 2,950 as of October 10, 2014 — ordered that all bodies be tested for Ebola before they are handled and buried by families. However, since there are only two testing centers in the country and the dead bodies were accumulating, the country began to cremate all the bodies, even if some had died from natural causes. Likewise, health authorities in other countries are taking control and burying or cremating the dead bodies themselves to prevent contamination among the general public. This, however, is angering many people who want to bury their deceased relatives themselves, and in Guinea, residents reacted by attacking and killing health workers. Because of such resistance, the response efforts to stop the spread of Ebola were hindered.

Why is the current Ebola outbreak a “big deal?”

Every day, I hear people comparing Ebola to the flu, and asking “Why are we making such a big deal over Ebola when there are other diseases and sicknesses that are more common and causing more deaths in our society?” (The flu, as an example, kills between 3,000 to 49,000 people a year in the United States.)

Well, one major difference between Ebola and other health conditions, such as the flu, has to do with the availability of vaccinations. Every year, several flu vaccinations are readily available to the public, which allow people to build up immunity and hence quickly fight off the infection if they get it in the future. But, for Ebola, there are no vaccinations readily available, and because it has such a high mortality rate, this is frightening. Yes, scientists are in the process of creating two vaccines and treatment drugs, such as ZMapp (which was initially developed twelve years ago by the United States Army Medical Research Institute), but these drugs and vaccinations are still in clinical trials. Since they are not yet made readily available to the public, they are unable to help the thousands of people currently infected and at risk.

Additionally, according to the World Health Organization, the number of diagnosed Ebola cases can rise from 1,000 new cases each week to between 5,000 and 10,000. Therefore, the total number of cases can reach 1.4 million by January 2015 if sufficient help is not provided. With an average death rate of 50%, an estimated 700,000 people are projected to die in three months time.

Does Ebola seem like a “big deal” yet?

To prevent the World Health Organization’s dismal — but very probable — predictions from coming true in a few months, many international organizations, including the World Health Organization, the International Red Cross, and the Center for Disease Control and Prevention are coming to the aid of West Africa. The Center for Disease Control and Prevention opened up an Emergency Operations Center where experts educate the public about the virus, organize response efforts, and identify and monitor people who have been in contact with an Ebola-infected person (a method called contact tracing). However, tracing and following up on every person who has been in contact with an Ebola victim is not an easy task, and because of this difficulty, the Ebola virus is continuing to spread. As of now, quarantine of Ebola patients is one the main preventative measures being used in trying to stop the spread of the disease.

In addition to the help given by international organizations, the United States is stepping up to the plate and is planning to send 4,000 specially trained troops to Liberia; as of October 14, 565 troops were sent. The United States is also devoting $750 million to the first six months of its operations to be used to train local health workers and construct medical facilities to hold more Ebola victims. So far, three labs have been established to test and treat people for the virus (see the picture above for the protective gear that must be worn at all times in the lab).

But, as Liberia’s president Ellen Johnson Sirleaf said back in August in an interview with Katie Couric, help is “not in the numbers required and not with the supplies and logistics that are required to fight this disease.” Therefore, as a global community, we must step up our game and do everything possible to help combat this outbreak.

Ebola in the United States

Presently, there is one case of Ebola in the United States. Thomas Eric Duncan, brought the disease back from Liberia and was diagnosed on September 30, 2014 in Texas. He later died on October 10. Nina Pham, the healthcare worker who treated Duncan, contracted the virus from him and is now being treated. This is the first known transmission of Ebola in the United States.

Concerns have been raised about whether Duncan put his fellow passengers on the plane at risk for Ebola, but since he did not show symptoms on the plane, he could not have transmitted the disease. Therefore, there is no need to test the other passengers. However, as an added safety precaution, health officials have begun using contact tracing in Texas to ensure that the disease does not spread.

Is America at risk?

According to the Centers for Disease Control and Prevention, America is not at risk of an outbreak, but our troops, volunteers, and the millions of residents in West Africa are. It is crucial that we prevent Ebola from spreading to other regions and countries, or else the death toll will continue to rise. Ebola is a force to be reckoned with, and we must, as a global community, unite and work together to stop it in its tracks.

What do you think of the Ebola outbreak? Do you think countries outside West Africa are at risk of an outbreak? Do you believe the international community is doing enough to help control the outbreak? The United States mandated screening at five major airports, but do you think this is enough to ensure that Ebola is kept out of the United States? What other preventive measures should we put into place? Please share your thoughts about this major health crisis and respond to the poll below.

Additional information on the Ebola outbreak:

For a timeline summarizing Ebola’s arrival in the United States, click here.

For a live, updated map of the reported Ebola cases around the world, click here.

For continuing coverage on the West African Ebola Outbreak, check out the Ebola Virus Outbreak NBC News page.

For information about the separate Ebola outbreak in the Democratic Republic of Congo, click here.

For information on how you can help combat Ebola, click here.

Picture Credits:

Ebola Virus: CDC Global (via flickr and available for use under the CC License)

Sierra Leone: Into the Ebola Epicentre: European Commission DG ECHO (via flickr and available for use under the CC License)

The Fight Against Ebola in Guinea: European Commission DG ECHO (via flickr and available for use under the CC License)

References:

“2014 Ebola Outbreak in West Africa” Centers for Disease Control and Prevention October 12, 2014

“About Ebola Virus Disease” Centers for Disease Control and Prevention October 3, 2014

Barnes, Julian “US Military Sends Experts to Mobile Ebola Labs in Liberia” The Wall Street Journal October 7, 2014

Berman, Mark; Sun, Lena; Halsey, Ashley “Travelers From West African Countries Will Face Stronger Ebola Screening At U.S Airports” The Washington Post October 8, 2014

“Cases of Ebola Diagnosed in the United States” Centers for Disease Control and Prevention October 12, 2014

Davis, Charles “Ebola Vaccine: Is It Safe?” MedicineNet.com September 9, 2014

“Ebola Crisis: Outbreak Death Toll Rises to 4,447 says WHO” BBC News September 15, 2014

“Ebola: Health Care Worker Tests Positive at Texas Hospital” BBC News October 12, 2014

“Ebola Virus Disease” World Health Organization September 2014

“Estimating Seasonal Influenza-Associated Deaths in the United States: CDC Study Confirms Variability of Flu” Centers for Disease Control and Prevention September 12, 2013

Lupkin, Sydney “Ebola in America: Timeline of a Deadly Virus’s Arrival in the US” ABC News October 13, 2014

Miklaszewski, J. & Kube, C. “Another 100 US Troops Arrive in Liberia to Fight Ebola” NBC News October 14, 2014

Novack, Sophie “Four Reasons Why This Ebola Outbreak is Different” National Journal August 8, 2014

“Red Cross Team Attacked While Burying the Dead Ebola Victims” Fox News September 24, 2014

Schnirring, Lisa “Texas Contact Tracing Identifies 50 for Ebola Fever Monitoring” University of Minnesota October 3, 2014

Tam, Ruth “This is How You Get Ebola, as Explained by Science” PBS September 20, 2014

“What CDC is doing” Centers for Disease Control and Prevention October 9, 2014

Podcast:

“Ebola In the Skies? How he Virus Made It To West Africa” Narr. Michaeleen Doucleff. Morning Edition. NPR. August 19 2014 National Public Radio. Web.

Interview:

Couric, Katie. Katie Couric Interview the President of Liberia About the Country’s Ebola Crisis August 24, 2014

Published articles:

“Contact racing During An Outbreak of Ebola Virus Disease” World Health Organization September 2014

Gire, S., Goba, A., Andersen, K., Sealfon, R; Park D,. Kanneh, L,. . . . Sabeti, P.(2014) Genomic Surveillance Elucidates Ebola Virus Origin and Transmission During the 2014 Outbreak” Science (347), 1369-1372

Meltzer, M., Atkins, C., Santibanez, S., Knust, B., Petersen, B., Ervin, E., Nichol, S., Damon, I., Washington, M. (2014)“Estimating the Future Number of Cases in the Ebola Epidemic- Liberia and Sierra Leone, 2014-2015” Centers for Disease Control and Prevention 63 (03), 1-14