The Ebola Virus Disease - Causes, Symptoms and Treatment
On February 2014, Ebola virus disease struck south-east of Guinea. It didn’t take long for the disease to infect a large population of the Guineans, killing some as it spread. On March 24, 2014 Ebola virus disease was confirmed as an outbreak in the country by the government, a disease on the loose.
The disease was not confined in Guinea alone. It spread to Sierra Leone, Liberia and Nigeria. It was confirmed as an outbreak in Liberia on March 30th, 2014; in Sierra Leone on May 25; and in Nigeria, on July 25.
By the end of July 1,323 cases were reported of people infected in these countries. The lives claimed by this disease amounted to 729 deaths.
History of Ebola
Ebola virus disease was first identified in 1976 in Zaire and Sudan. This disease was named after Ebola River found in Zaire (currently Democratic Republic of Congo).
The first outbreak of this disease emerged in southern Sudan, currently South Sudan. This Ebola virus known as Ebola-Sudan (Sudan ebolavirus) resulted in 248 people infected. The mortality rate was 53%.
The second Ebola virus disease outbreak was in Yambuku, Zaire. This Ebola virus disease known as Ebola Zaire (Zaire ebolavirus) resulted to 318 people infected. The mortality rate was 88%.
The third strain of Ebola virus was detected in Reston, Virginia, U.S in 1989. This Ebola virus disease known as Ebola Reston resulted from infected monkeys which were imported to Reston, Virginia from Mindanao, Philippines. This type of Ebola virus does not affect humans, only animals. The cases documented of people infected by this strain of virus didn’t show any symptoms.
The third type of Ebola virus is Tai Forest Virus (Tai Forest ebolavirus). It was detected in 1994 in Cot d’ Ivoire. It was discovered after a female ethnologist accidentally injected herself when performing a necropsy on a dead chimpanzee.
The last strain of Ebola virus is Bundibugyo virus (Bundibugyo ebolavirus). This type of Ebola virus was discovered in Bundibugyo, Uganda in November 2007. It had a mortality rate of 25 percent of the cases reported.
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Causes of Ebola Virus Disease
A rare disease, Ebola tends to be a deadly infectious disease when it hits a region. It is more of an infectious than contagious disease. The disease formerly known as Ebola hemorrhagic fever is caused by a virus which belongs to the family of Filoviradae.
Ebola virus disease is mainly found in remote areas of Central and West Africa close to tropical rainforests. It has a fatality rate of between 25 percent to as high as 90 percent depending on the strain of the virus.
Scientists are not sure how an outbreak of Ebola starts, how humans are first infected or in which manner the Ebola virus first appears. This is because scientists don’t know for sure the natural reservoir of Ebola virus though speculations revolve around fruit bats.
Nonetheless, it is known a person is infected with Ebola virus when he/she comes into close contact with an infected animal or person through body fluids such as secretions and blood, and organs. This includes when caring for an infected person without using protective clothing, and coming into contact with a dead animal or person infected with Ebola virus.
Eating of bush meat both primates and non-human primates (wild animals) does lead to a person infected with the virus if the animal was infected.
Also, when a person touches contaminated objects and/or surfaces or is exposed to them such as needles contaminated with infected body fluids (secretions), he/she can be infected by this disease as witnessed in the recent outbreak in West Africa (2014). Over 60 health workers died of infection from the Ebora virus disease as they didn’t have protective clothing such as gloves.
Health workers, those who take care of infected persons and those handling the dead bodies for burial are the most at risk of contracting the disease.
Ebola is not an air-borne, water-borne or food-borne disease. It is similar to HIV/AIDS. It is spread through contact with body fluids of an infected person. Consequently, it is less of a contagious disease than Bilharzias and Tuberculosis.
It is transmitted from one person to another when an infected person starts manifesting the symptoms of Ebola. An individual cannot be contagious if he/she is not symptomatic (is not showing symptoms of Ebola).
Signs and Symptoms of Ebola Virus Disease
The symptoms of Ebola virus disease commence from 2-21 days after a person is infected. The virus damages the organs of the body and interferes with the immune system rendering it useless in fighting the infection.
When the immune system of the infected person is overpowered as is the case with HIV/AIDS, the health of the person further deteriorates. “Ultimately, Ebola causes levels of blood clotting cells, called platelets, to fall, which can lead to severe bleeding,” states WebMd.
Ebola is a disease which kills quickly in a short duration of time.
The initial signs and symptoms of the disease are:
- Muscle and joint pains
- Sore throat
- Low-back pain
The World's Most Dangerous Virus
The symptoms become severe as the disease turns worse to include:
- Bleeding inside and outside of the body (eyes, nose, ears, mouth and rectum)
- Swelling of the eyes
- Swelling of genital
- Experiences increased pain in the skin
- The roof of the mouth looks red
- Difficulty breathing
- Rashes appear all over the body. The rashes contain blood.
- Chest and stomach pain
- Weight loss
As the disease becomes worse by the day, it can lead to the following complications:
- Severe bleeding
- Failure of several organs to function properly or stop functioning altogether
According to MedlinePlus Medical Encyclopedia, an estimated 90% of patients infected by Ebola die. However, a startling fact as indicated by MedlinePlus is, “Patients usually die from low blood pressure (shock) rather than from blood loss.”
Patients who survive from the disease may manifest unusual problems such as hair loss, weakness, sensory changes, headaches, fatigue; eye, testicular and liver inflammation.
The symptoms of Ebola vary from one person to another. Some recover from the disease quickly while for others it takes time when early and proper care is undertaken. Nevertheless, scientists are still baffled why some people recover while others don’t make it. They speculate or believe among other reasons to do with how healthy a person is, that is how strong or weak the immune system of the person is.
People who are lucky to survive from the disease may recover slowly from the effects of the disease. It will take weeks before they recover fully including gaining weight and strength as the virus is still in the body. The virus remains in the body for weeks before it disappears. This is why infected people are advised not to be involved in sexual intercourse with uninfected partners for several weeks as they may spread the virus disease to them. Unless they use condoms.
Tests and Treatment
The first obstacle faced in diagnosing Ebola is the fact the early signs and symptoms are similar to other disease, such as malaria and typhoid. According to World Health Organization (WHO), the following diseases should be ruled out before analysis of Ebola is made: “malaria, typhoid, fever, cholera, shingellosis, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral haemorrhagic fevers.”
However, when the doctor suspects a patient has Ebola, the following tests will be carried out among others:
- Enzyme-linked immunosurbent assay (ELISA)
- Reverse transcriptase polymerase chain reaction (PCR)
Other tests according to WHO include:
- Antigen detection test
- Semen neutralization test
- Electron microscopy
- Virus isolation by cell culture
There is no cure for Ebola though scientists are working on finding effective vaccines or treatment drugs to treat the different strains of the Ebola virus disease, hopefully very soon. The antiviral medications do not work fully in treating the disease. They are meant to manage it.
The patients undergo supportive hospital care or standard treatment in order to reduce the symptoms and the possibility of leading the patient to recover fully from the disease. The supportive care includes:
- Maintaining the blood pressure
- Provision of oxygen in order to maintain normal breathing
- Provision of fluids and electrolytes through a vein in order to rehydrate the person since the infected person loses a lot of fluid,
- Provision of diet; and
- Treating secondary infections
Transfusion of fresh blood or platelets is required in cases when the patient is bleeding.
Types of Ebola Virus Disease
There are five types of Ebola virus known. Out of these five only one does not affect humans but animals. Ebola Reston (RESTV) does not affect humans but animals especially primates such as chimpanzees and monkeys.
The others are: Zaire ebolavirus (EBOV), Sudan ebolavirus (SUDV), Tai Forest ebolavirus (TAFV) and Bundibugyo ebolavirus(BDBV).
Zaire ebolavirus is the most dangerous of the Ebola viruses that affect humans. Some scientists believe the West Africa outbreak (2014) is caused by Zaire ebolavirus. This type of virus causes death at a rate of between 80 to 90 percent of the cases reported of Ebola virus disease.
Sudan ebolavirus comes in the second position at a fatality rate of 50 percent of the cases reported. In the case of Tai Forest ebolavirus, only one person was infected in Cot d’ Ivoire where the virus was detected. The person infected survived from the disease.
The Bundibugyo ebolavirus causes death at a rate of 25 percent.
Depending on the type of the Ebola virus which hits a particular region or country, the mortality rate resulting from the infection can be as high as 90 percent or as low as 25 percent.
The Ebola virus disease is the most feared disease despite the fact it is a rare disease. The reason lies on the fact when it hits a region, an outbreak is bound to materialize, and killing people in their majority as it spreads quickly, only to disappear never to be heard again for a long time. And it does this in a short period of time.
This perplexes scientists – it arrives from nowhere, causes havoc as it spreads fast only to disappear mysteriously just as it arrived inexplicably.
Reasons for Widespread of the Disease
The reason why Ebola virus disease spread quickly in West Africa was a result of lack of knowledge Ebola virus disease was on the loose leading to lack of preparedness. It was the first tie for Ebola virus disease to hit the four infected countries. This tied together with poor health facilities which lack the required resources, and cultural practices performed such as cleansing the bodies before burial or handling the dead bodies for burial led to the widespread of the disease. When health care workers treated patients infected with Ebola, they did not use protective clothing such as masks, eye shields and gloves.
The health workers were overwhelmed at the large number of infected people thereby they were unable to prepare themselves fully or in advance. Also due to the fact the early symptoms of Ebola virus disease are similar to other diseases, health workers didn’t know they were the early symptoms of Ebola. This was coupled with the fact the hospitals were poorly resourced with the required assets and instruments such as the needles were not disposed but reused on others without sterilizing them. The lack of clean needles was a big problem the health workers faced. Actually, a lot of infection from the virus disease took place in the hospitals.
In spite of the fact the villagers were warned by the government and scientists (mostly the case in Guinea) to stop eating bush meat, it fell on deaf ears. People still continued consuming them resulting to more infections. Not all bush meat was infected. They were cautioned to be careful especially when they come across a dead animal.
Cultural practices contributed to the widespread of the disease. In many African countries, before a dead body is buried, it must go through cleansing ceremony. This was the case in the infected countries such as Guinea. A dead body is contagious because the virus is still in the blood or body fluids. When a person comes into close contact with the dead body, the person will be infected. The cleansing of the body in preparation for burial was done without using protective clothing to avoid infection.
Another reason for the widespread of Ebola was many villagers distrusted (and still do) outside people (scientists), government and hospitals preferring to take care of their sick loved ones in their homes. One of the reasons for their distrust has to do with the belief the scientists invent diseases in order to get internal organs from the infected people.
A Worldwide Outbreak?
Not the case. Developed nations such as U.K and U.S.A have better health facilities and equipments required to combat an outbreak of a disease than in developing nations such as Africa. The governments of these developed nations have the required resources to locate, follow those who came into contact with infected people, deal with it, and bring it under control as their response time is fast; thus ensuring it doesn’t spread very far.
Infected countries such as Liberia have closed their borders to stop further widespread of the disease. Those who are leaving the infected countries have to be screened at the airport before leaving, and they have to be screened again when arriving at their destinations. Airport crew members have been taught how to spot a person showing the symptoms of Ebola and isolate him/her for further treatment.
One important thing to note is the Ebola virus disease does not spread very fast as is the case with air, water and food-borne diseases. In fact, past outbreaks of Ebola in countries such as Uganda (where the Ebola outbreaks have occurred many times) were well contained before it spread to wider regions and beyond the country.
As different drug companies in some parts of the world are working to come up with vaccines and alternative treatments, many people are praying and hoping before the end of the year or very soon, one or several of them will work. If no vaccine or drug treatment is found very soon, no one knows where it will hit next and how many people it will kill in its stay.
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