West Africa Ebola Outbreak Surpasses 3700 Infected

Ebola virus

More than 3700 people have been infected with the Ebola virus in West Africa. (Courtesy of Frederick A. Murphy/CDC)

The Ebola outbreak in West Africa the biggest outbreak on record — has been a hot topic in the news this summer. What exactly is the Ebola virus? How does it spread? More importantly, can the outbreak be stopped?

According to the Centers for Disease Control and Prevention (CDC), as of September 8, 2014, there have been 3707 suspected and confirmed cases of Ebola in West Africa. The death toll currently stands at 1848. The outbreak, which is believed to have begun in Guinea, has spread to Liberia, Sierra Leone, Nigeria, and Senegal.

Ebola spreads through direct contact with the bodily fluids or secretions (blood, vomit, saliva, fecal matter, or urine) of an infected person. Infection can also occur if a person comes in contact with items or environments that have been infected by an Ebola patient, such as soiled clothing, bedding, or used gloves and needles.

The majority of new cases occur among those who have taken care of infected relatives, or those who have prepared infected bodies for burial. Health care workers are at a particularly high risk of infection due to the lack of protective gear and/or improper training in the use of decontamination techniques.

Ebola symptoms typically appear eight to 10 days after exposure to the virus. Symptoms are flulike in nature, including headaches and fever, along with aches and pains. The appearance of a rash and digestive distress, such as vomiting and diarrhea, occur next. In half of the cases, Ebola patients experience hemorrhaging, vomit blood, or bleed underneath their skin or from their eyes and mouths. Death from Ebola typically occurs when blood vessels deep within the body leak fluid, causing the patients blood pressure to plummet, eventually leading to organ failure.

Ebola was first discovered in 1976. At first, it was thought that the virus originated in gorillas and that humans were infected after eating contaminated gorilla meat. New research however, indicates that fruit bats are natural reservoirs of the disease. The virus is transmitted to humans when they eat food that has been drooled or defecated on by bats. Infection also occurs when humans come into contact with surfaces covered by infected bat droppings and then touch one of their mucous membranes, such as their eyes or mouth. Bat hunting indeed is a common practice in Guckdou, the village in Guinea where the current outbreak is believed to have originated.

There is currently no vaccine or cure for Ebola, and 60-90 percent of those infected die from the virus. The main treatment for Ebola is monitoring the patient and providing fluids and medications to maintain their blood pressure, as well as treating other secondary infections as they occur.

While a tested vaccine does not yet exist for the Ebola virus, biomedical companies are currently developing treatments. ZMapp, developed by Mapp Biopharmaceuticals, Inc., is one experimental treatment. This treatment which has not yet been tested in humans for safety or effectiveness consists of a combination of three different monoclonal antibodies that bind to the protein of the Ebola virus, mimicking an immune response by the body to the virus.

This experimental treatment was used on two infected Americans who were brought to the United States for treatment. The treatment was procured by a private humanitarian organization, which employed one of the Americans. Both Americans have since been released from the hospital and are on their way to full recovery.

Two other experimental treatments are also in the early-stages of development at other companies (Tekmira and BioCryst Pharmaceuticals) and a third company (NewLink Genetics) is currently developing a vaccine for the virus.

The lack of tried-and-true treatments has led to an ethical dilemma regarding whether experimental treatments should be used to quell this outbreak. The World Health Organization (WHO) convened a panel of ethicists in early August to discuss the situation. The ethicists came to the conclusion that it is ethical to offer unproven interventions with as-of-yet unknown efficacy and adverse effects, as potential treatment or intervention. The idea being that, when there are few other options, some action is better than no action at all.

Due to their nature, experimental treatments for the Ebola virus exist in limited supply. These drugs cannot be purchased nor are they available for general use. However, all three companies have ramped up production of their treatments, though human safety trials have yet to begin.

According to the CDC, no confirmed cases of Ebola virus have been reported in the United States, aside from the two American healthcare workers that were transported to and treated under quarantine in Atlanta. The CDC has public health expert teams onsite in West Africa to aid with the effort to stem the outbreak of the virus. The CDC has also put protocols into place to protect against the spread of disease in the remote possibility that an infected traveler arrives in the United States.

More to Explore

CDC – Ebola Hemorrhagic Fever

WHO – Global Alert and Response: Ebola Virus Disease

WHO – Ebola Virus Fact Sheet

The New York Times Ebola Coverage

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