Ebola has a typical case fatality rate averaging 70% which in itself presents a terrifying prospect for those infected by the virus. The 30% of cases that survive may go on to develop potentially long term symptoms resulting from the damage caused by the virus. As many as half of the survivors have reported health troubles after the initial recovery.
Loss of Vision
One of the most common complaints after surviving Ebola is the deterioration of vision. No studies have been done concluding that Ebola has an impact on vision and it is not possible to confirm without a doubt that vision damage is caused the virus but possible related causes could be from damage to the blood vessels surrounding the eyes and long term inflammation.
The severe headaches that accompany the early Ebola symptoms may linger for up to 18 months in survivors. Survivors need to avoid the use of Aspirin after recovering which may limit the treatment options for some. Joint and Muscle pain have also been noted by survivors.
Survivors are often faced with the difficult task of returning to their lives after being isolated from society for an extended period of time. A significant stigma exists resulting in further isolation and exclusion by community members. Trauma counseling is suggested but regrettably not always available in remote or impoverished regions.
Ebola outbreaks have typically been limited in size and as such very few studies have been conducted on the long term effects of the virus. In the future there will certainly be more extensive studies done and it is foreseeable that the questions around liver and cardiovascular damage will need to be answered. It is not entirely clear how many of the after effects are caused by Ebola itself or the treatments typically used but it is certain that surviving Ebola is just the beginning of the journey for many people.
A Congressional Hearing took place in the United States today. Here are some points of interest from Dr. Frieden’s statement. As well as some points from questioning, up until 2 pm US Eastern Time:
- Points from Dr. Thomas Frieden, Director of the CDC’s statement:
- In his statement, Dr. Frieden acknowledged that “From the time the situation in West Africa escalated from an outbreak to an epidemic, we have anticipated that a traveler could arrive in the United States with the disease… we remain confident that Ebola is not a significant public health threat to the United States… Cultural norms that contribute to the spread of the disease in Africa – such as burial customs and inadequate public-health measures – are not a factor in the Untied States.”
- “…fluid losses on average 5-7 liters in 24 hours over a five day period.”
- 114 individuals might possibly have had contact with Thomas Duncan. 10 of those were direct contact, 38 others were potential contact, all are being monitored.”
- Points from Questioning:
- Questions surrounding a travel ban were raised by Rep. Fred Upton (R-Mich.) about whether it would be appropriate. Dr. Frieden did not agree because he claimed that porous West African borders would mean that people could still enter the US from other countries, and believes that knowledge and information on the patients serves public health interests better. Rep. Henry Waxman (D-Calif.) agreed and asked for clarification from Dr. Frieden about what he perceived would be a “bureaucratic apparatus” if implemented. Frieden maintained the current policy with increased measures made more sense than a ban.
- The question raised by Rep. Fred Upton around Presidential power to impose a travel ban was answered by Rep. Michael C. Burgess (R-Tex.) who cited the Pandemic Influenza Strategic Plan of 2005 which was updated in July 2014 to include hemorrhagic fever. Rep. Burgess asked about supplies of Personal Protection Equipment to which he was told there were no current shortages and suits could be delivered anywhere in the country within 24 hours.
- After a question about vaccines from Rep. Bruce Braley (D-Iowa.) it was confirmed that both companies working on vaccines planned trials in West Africa if the first rounds were successful.
- At one point, Chairman, Rep. Tim Murray ( R-PA.) asked for clarification as to when the CDC team was sent to Texas Presbyterian Hospital which was verified as the day the diagnosis was confirmed.
- Rep. Diana DeGette (D-Colo.) at one point blasted Dr. Frieden asking him to accept that the situation in Texas was unacceptable and should not happen again. He agreed.
- Rep. Kathy Castor (D-Fla.) called the situation a “Wake up call for America”.
Projecting the path of Ebola is not a simple task. There is a lack of historical data to accurately model an outbreak as large as the current one in West Africa meaning all predictions and projections should be treated as speculative. The data used to model any prediction is based off official statistics and does not generally take into consideration under reporting or incorrect data.
The simplest of models use basic but unfortunately inaccurate mathematics to calculate the number of cases at a point in time by adding the growth rate daily. This is simple mathematics and a good way to get a quick idea of the potential number of cases but a virus does not always continue to spread in an exponential fashion. Several factors can change the growth rate including geography, intervention, weather and human behavior.
More accurate models will attempt to factor in the doubling rate of the virus and perhaps include basic limits around populations of an affected area. These models provide more realistic data to work with but still do not provide an accurate model.
The following projections forecast the Ebola outbreak and potential case count for October as follows:
20000 Variable Transmission
11000 Exponential Smoothing
15000 Exponential Cumulative
It is very likely that we will see more than 15000 cases by the end of October 2014 based on current reporting. The CDC report which predicted between 550000 and 1.4 million case by early next year factored in under reporting. Adjusting the 15000 by a factor of 2.5 to reach 37500 potential cases of Ebola within the next 30 days with as many as 26000 dead.
Predictions around the spread of Ebola in the USA are impossible at this stage. It is possible that the first case of Ebola in the USA will have a first wave of infections based on reports that the patient was infectious for as many as 4 days and further reports indicating that he was in contact with family members including children. It is likely that 3-12 cases could have been generated based on the current information available.
The 1995 film Outbreak presents the fictional Motaba virus as a rapidly spreading and deadly virus originating from the Democratic Republic of Congo with the first discovery in 1967. It is fairly obvious that the Motaba virus although fictional is based on the Marburg/Ebola virus.
Although there are several direct references to the Marburg/Ebola virus, the made-up Motaba virus has some key differences. This comparison between the real Ebola Virus and the artistic interpretation in “Outbreak” is a great way to see the references and where Hollywood had a hand in the scripting.
||Ebola 2014 (Real)
||Motaba (Outbreak Fictional)
||“Typical” hemorrhagic fever
||“Typical” hemorrhagic fever
||None (Vaccine in Trials)
||Original Strain Only
||Fluids with Possible Aerosol
||2nd Strain Airborne
Hollywood took a few liberties most notably increasing the mortality rate to 100% and adding airborne transmission to the 1995 strain of Motaba but many traits are shared between the two viruses and several of the scenes are portrayed in a reasonably accurate way. We do not see too many pictures of Ebola Victims appearing on Facebook or Twitter in 2014 for several reasons, most importantly the cultural beliefs we share around the dead in Africa. The few photos that have made their way onto the Internet certainly remind us of the fictional Motaba depictions in “Outbreak” but it should be remembered that Hollywood is paid to entertain us while a virus has no such agenda or ideology.
Ebola Real vs Motaba Outbreak Film
Curing a virus is no small task and Ebola, which has a rapid mutation rate and many opportunities to develop immunity is no different. In retrospect the 1995 Outbreak Film detracted from reality with simplistic solutions to the challenge of an epidemic. However, the reality we face in 2014 is far more dire and will require massive intervention from the entire world.
Preparing for a viral outbreak may seem extreme but if you are in a high risk country affected by Ebola it can’t hurt to be prepared. Although there is no immediate risk that Ebola will spread in a significant way several worst case scenarios have been put forward leaving many people feeling compelled to stock up on supplies.
There are several common items worth keeping and many of them have a long shelf life or can be kept forever. Modern technology has provided smart items like the LifeStraw Personal Water Filter which can be kept virtually forever provided it is stored in a dry, cool and dark place. Most of the items that you may want to keep on hand are fairly straight forward.
- Water, essential and easy to rotate storage if you already using bottled water
- Drums/Bottles to store additional water
- Water Treatment Tablets
- Canned food, be careful though since it can be very expensive
- N95 Respirators or Masks are the minimum suggested by the CDC
- Flashlight, the crank-able kind that does not require batteries.
- Vitamins can be essential when food is scarce
- Latex Gloves
- Swiss Army Knife or similar
- First Aid Kit
- Trash Bags
- Food that can be stored for long periods of time (Rations etc)
- Seeds to grow your own food if possible
It would be difficult to advocate going out and buying a truck load of supplies but if you really want to do that of your own accord it helps to buy the right things. Always remember that you should only buy things you really need and can truly afford. Consider your purchases carefully to ensure that you do not create waste in your purchases and rather rotate or cycle foods and simply make better purchasing decisions in your regular life for example buying a crank torch the next time your battery powered torch breaks.