Ebola haemorrhagic fever – The bloodening

Bailing James out again. This is an old On Dit article I wrote a while ago. I was going to add to it with more current research, but not enough time and it seemed like too much effort. I’ll save it for another article.

People are idiots

After mentioning to him that I was going to write the next Disease of the week article on Ebola, a friend remarked “Ah, yes. Emulsification of the bodily organs…”. Movies and books (such as Outbreak, Rainbow 6 by Tom Clancy and The Hot Zone by Richard Preston) give Ebola a face that’s melting, disfigured and zombie-like. This is all Total Bullshit™. As a rule of thumb, anything entertaining is built out of lies.

I'm not sure what happened here...

Lies corrected

Ebola haemorrhagic fever is a rather rare viral disease (totalling only ~1900 cases) that was discovered in 1976 after an outbreak in Sudan. It comes in four different subtypes, named after the place they were found in first: Ebola-Zaire, the most common and deadly strain with a 50-90% mortality rate; Ebola-Sudan, which has killed 404 of the 760 people it has infected; Ebola-Côte d’Ivoire, of which only two cases have been seen and so far non-fatal; and Ebola-Reston, found in Reston, Virginia in a bunch of macaques imported from the Philippines. Ebola-Reston was not found to cause disease in humans.

Ebola affects humans and other primates in much the same way. After an incubation period of 2 to 21 days, the infected patient will suddenly feel tired, extremely weak and feverish. Patients also are lacking in blood platelets and white blood cells. Other possible early symptoms include muscle aches, headaches and loss of appetite. Later stages may produce abdominal pains, nausea, diarrhoea, painful or difficulty in swallowing, bleeding into the gastrointestinal tract, bleeding at puncture sites and mucous membranes and, strangely, hiccups. In past outbreaks, hiccups were only present in the more serious cases, whereas survivors showed no sign of them.

Severe cases of Ebola haemorrhagic fever can also cause dangerously low blood pressure, rapid breath, shock, decreased urine production, widespread tissue death (particularly in the liver) and coma. Death usually occurs due to organ failure (usually kidneys or liver) or shock due to low blood pressure.

The name of haemorrhagic fever is a bit of a misnomer. Although the virus does attack blood-vessel walls and make them leakier, not all cases produce uncontrollable bleeding as a result. In the last large outbreak in 1995, excessive bleeding occurred only in half of the patients. These leakier vessels can leak fluid into surrounding tissues, thereby lowering blood pressure and causing pulmonary oedema (fluid filling the lungs).

There is little treatment available to Ebola victims. Generally, patients are simply pumped full of fluids to prevent dehydration and sinking blood pressure, and left to their own devices to get over it. Patients who recover from the disease are emaciated and weak. Many months of rehabilitation have to be endured for the survivors to even walk again. The virus can still be present in fluids for over 60 days after recovery.

Concept: Reservoirs

A so-called “reservoir” for the Ebola virus has not yet been found. A reservoir is a host species which the virus causes (usually) asymptomatic infection, so that it can survive in the environment. Viruses just lying around for long periods of time are usually degraded, so must be sustained in some living species. Since primates are equally as affected as humans, the reservoir is not likely to be a species of monkey. Viruses that kill their hosts  efficiently are selected against by natural selection. This is because a virus requires living cells to keep replicating. If its host is dead, it can no longer spread and therefore it becomes less common. Bats are suspected to be reservoirs, but no studies have confirmed it.

Increased interaction between infected monkeys and humans has increased the incidence of ebola haemorrhagic fever (Picture taken by Ashleigh Brook)

Contracting the disease occurs when coming in contact with the fluids of dead or alive infected animals or people. Health care workers have been infected due to improper isolation techniques and reuse of non-sterilised equipment. There are no treatments or vaccines for humans that are effective against ebola virus, although there have been some successful experimental vaccines for other primates.

As you can see, although it is based on a foundation of truth, even the worst case scenario of Ebola is nothing like the glamorised tripe of Hollywood. Next time Outbreak is on, you can tell your friends all the bullshit it purports and be shunned like the intellectual snob you are. Do it for Uncle Thomas. Do it for the truth.

TT

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4 Comments

Filed under Thomas' Corner

4 responses to “Ebola haemorrhagic fever – The bloodening

  1. Michelle

    You left out Ebola-Bundibugyo, the fifth subtype. There have been about 150 reported cases, with 37 deaths.

    • I did indeed. Thanks for the catch Michelle. Bundibugyo is the most recently discovered one (only in 2007, wikipedia tells me). The epidemic was caught quickly by the WHO and short-lived (ended after about 2 months).

      TT

  2. Meg

    The book the hot zone is NON FICTION. The cases in the book have happened. Marburg Virus is a relative to Ebola. This virus attacks the nervous system and begins to liquify parts of the body, including the muscles of the face. Causing the victim to develop a passive look as the muscles begin to deteriorate and drop. I admit the other books and movies may have over done things but Robert Preston only explained the symptoms in detail. You have basically repeated everything he put into his book. Scientists have RECOMMENDED reading The Hot Zone. Also before the making of his book Robert Preston made sure to interview many people who have witnessed cases of Ebola and Marburg. Have you?

    • It’s true that The Hot Zone was based on real events, yes. But, to my understanding and according to the majority of the literature I can find, the connective tissue of the face is not affected directly. That makes these exerpts:

      “[…]he became strangely passive. His face lost all appearance of life and set itself into an expressionless mask, with the eyeballs fixed, paralytic, and staring […] The eyeballs themselves seemed almost frozen in their sockets, and they turned a bright red.”

      “The connective tissue in his face is dissolving, and his face appears to hang from the underlying bone, as if the face is detaching itself from the skull. He opens his mouth and gasps into the bag, and the vomiting goes on endless.”

      a bit disingenuous.

      Certainly the connective tissue of the blood vessels are compromised and are well-described (it’s in the name of Haemorrhagic fever), but there are some poetic licences in the descriptions that don’t reflect what the virus infection is doing. Don’t get me wrong, the settings and science in the book are good, but it is also hyped up. Someone has in fact published a whole pedantic discussion of it here – http://qhr.sagepub.com/content/11/1/5.short.

      Also, none of the literature I’ve read on the ebola virus shows that it infects or affects the nerves directly. Then again, your body does strange things when blood isn’t getting to places and you have spotty necrosis due to blood not getting into places it’s supposed to.

      TT

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