Ebola

News & Information About Ebola

Category: Information (page 2 of 3)

Facts, Information and General Knowledge about Ebola

Ebola VS Swine Flu

The term “swine flu” can be a little misleading. In reality swine flu is a term coined to describe the 2009 H1N1 outbreak of influenza. The swine flu pandemic was the second H1N1 pandemic recorded with the first being the 1918 “Spanish Flu” which claimed between 20 and 100 million lives.

Swine flu vs ebola

Image of H1N1 influenza virus, taken in the CDC Influenza Laboratory.

H1N1 is easily treated in modern hospitals and the case fatality rate is low compared to Ebola. Vaccination is possible with sufficient antibody production reached in approximate ten days. Considering the short generation time for the virus and airborne transmission it would pose a significant risk without a vaccine or modern medicine as it did in 1918. H1N1 strains of flu are notable for their lack of discrimination; the strain infects all age groups unlike other types of flu which have a greater effect on children and the elderly.

Trait Ebola Virus Swine Flu
R 0 2.2 Mean ~1.16-1.75
Generation Time 5 (CDC), 11 (WHO) 2.4-3.1 days
Mortality Rate 25-90% / ~70% 2014 Outbreak 0.03% (2009)
Airborne No Yes
Waterborne No No
Primary Transmission Bodily Fluids (Almost All) Airborne
Vaccine In Trials Yes
Primary Hosts Humans, Primates, Bats Swine, Humans
Type RNA Virus RNA Virus
Deaths per Annum Very Low Prior to 2014 Relatively Low, 2009 outbreak ~15000
Largest known Outbreak 2013/14 West Africa 1918 “Spanish Flu” and 2009 “Swine flu”
First Isolated 1976 Novel “Swine Flu” 2009
Last Pandemic Never Recorded 2009-2010
Patient Isolation Required No
Contact Tracing Required No
Possible Age Thousands of Years Thousands of Years

The above table shows Swine Flu vs Ebola on a basic level. Symptomatic comparisons are not provided since there is no current outbreak of H1N1. However there is a page for the comparison of the symptoms between Ebola and Influenza.

The 2009 outbreak of “Swine flu” saw at least 600000 confirmed cases globally. The pandemic was declared as over in 2010 by the World Health Organization. The virus has a lower R0 than Ebola but a significantly faster generation time.

The 2009 pandemic attracted controversial opinions from critics around the world claiming that the media and global health organizations had inflated the perceived risk in order to encourage vaccination.

List of Experimental Treatments

Several experimental treatments for Ebola are currently available and although none have been officially tested and approved several promising results have been observed.

Experimental Ebola Drugs

By Chandres (Own work) [CC-BY-3.0 (http://creativecommons.org/licenses/by/3.0)], via Wikimedia Commons

Brincidofovir

An experimental anti-viral drug that has shown some initial potential for the treatment of Ebola. The drug is currently in phase 3 human trials for the treatment of cytomegalovirus, adenovirus, and smallpox. An urgent authorization has been provided by the FDA for testing as a treatment for Ebola. The drug was tested with the first American case of Ebola. The patient died 4 days after receiving the drug.

Lamivudine

Traditionally used as a treatment for HIV and Hepatitis B, it acts as a nucleoside analog reverse transcriptase inhibitor. The drug was tested by Dr. Gobee Logan in Liberia as an off label treatment for Ebola. The doctor claims significant improvement in the survival chance of patients upon receiving the medication. No official experiments have been conducted to confirm the efficacy of treatment and fears have been raised around the potential damage to the liver of a patient.

TKM-Ebola

This drug has been placed on a suspended hold after phase one clinical trials resulted in flu like symptoms among test subjects. The drug  is a combination of Small interfering RNAs. Three of the seven proteins present in the Ebola virus are targeted by the drug. Experimental administration of the drug is permitted in patients already infected with Ebola however healthy individuals may not receive the treatment at this time.

ZMapp

ZMapp is notably the best known potential Ebola treatment having been administered to several patients who survived Ebola infection. The drug is in limited supply as it is grown in a genetically modified tobacco plant and cannot be synthesized in a laboratory. In one example of testing 3 Liberians received the drug with two surviving. Supply of the medication is currently exhausted according to the manufacturer however several governments around the world have limited supplies of the drug. ZMapp contains neutralizing antibodies that allegedly provide passive immunity to the Ebola Virus.

 

How does Ebola Spread?

Ebola is frequently portrayed as a virus that is transmitted via direct contact with an infected individual but this can be misleading. The term is technically correct and not unfair to use but can result in misunderstanding by the general public and even so called medical experts. Ebola has been observed to transmit through direct contact with a single virus. Direct contact with the virus is not akin to direct contact with an infected patient. Contact with the virus can occur in the absence of the individual if the virus survives on a surface or in fluids.

How does Ebola Spread (Handshake)

By Tobias Wolter (Own work) [GFDL (http://www.gnu.org/copyleft/fdl.html), CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0/) or CC-BY-SA-2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/2.5-2.0-1.0)], via Wikimedia Commons

The virus is known to survive outside the human body on several surfaces including plastic and glass and can survive for several days outside a host if contained in bodily fluids. The virus is found in all human fluids in sufficient amounts to allow for transmission. Tears, Mucus, Sweat, Urine, etc. all contain the virus and are all infectious. In contrast HIV is not transmitted with common bodily fluids and usually only via blood or intimate contact.

Any and all objects that come into contact with Ebola must be disinfected or destroyed. Blankets and clothing used by sick individuals are of particular concern and are often burnt after use. The following table attempts to describe the possible transmission methods based on current knowledge from the CDC, WHO & Doctors in the field. The table is expected to change as a broader understanding of the virus is reached.

Action Transmission Potential Reason
Sexual Intercourse Highly Probable Bodily Fluids
Sharing Needles Highly Probable Bodily Fluids
Sharing Eating Utensils Probable Saliva Contamination
Sharing Food Probable Saliva Contamination
Sharing Drinks Probable Saliva Contamination
Sharing Clothing Probable Sweat/Bodily Fluids
Sharing Bed Linen Probable Sweat/Bodily Fluids
Being Sneezed On Probable Bodily Fluids
Being Coughed On Probable Bodily Fluids
Contact with Sweat Probable Known Transmission
Contact with Urine Probable Known Transmission
Contact with Feces Highly Probable Known Transmission
Contact with Blood Highly Probable Known Transmission
Kissing Highly Probable Saliva Contamination
Hugging Probable Sweat/Bodily Fluids
Hand Shaking Low Probability Sweat/Bodily Fluids
Breast Milk Consumption Highly Probable Known Transmission
Semen Contact Highly Probable Known Transmission
Bush meat consumption Probable Known Transmission
Contact with Ebola Body Highly Probable Known Transmission
Sharing a home Low Probability Not Airborne

A key point to remember is that current knowledge of Ebola indicates that the virus must be transferred to the host directly by entering through open wounds, the mouth or the eyes. As an example shaking hand in itself may not transmit the virus but if the virus is transferred via sweat from one hand to another and a person touches their face there is an increased risk of transmission. By the same thinking sharing a home does not always result in transmission however it does increase the chances of physical contact which could lead to transmission.

Common Questions:

Can Ebola spread in sewage?

Yes Ebola can and will spread via raw sewage however there is no evidence of transmission via treated water. Modern water treatment facilities add chemicals to filtered water including chlorine which is known to kill the Ebola virus. Ebola is not considered a waterborne virus either further reducing the chances of infection via treated tap water.

Will I get Ebola from from being near an infected person?

Currently there is no indication that simply being near a person infected with Ebola will transmit the virus. The reality however is that by being in close proximity the chances of transmission occurring are increased substantially. There is some evidence to support limited aerosol transmission which also indicates a higher risk for close proximity transmission. The virus is classified as a bio safety level 4 agent requiring extreme protective measures to prevent infection. Health care workers are often infected while providing care to patients.

Can my pets carry Ebola?

Very Likely. Some studies indicate that dogs may be asymptomatic carriers of the virus. A dog would need to consume infected meat or bodily fluids to become a carrier.

Can I get infected from a public restroom?

Yes, Ebola can survive outside the human body for several hours. Restroom activities have a high risk for transmission.

Are the experts wrong about how Ebola is spread?

Possibly, it took several years for doctors and scientists to fully understand how HIV was spread. The understanding of Ebola will increase as more experience is gained.

My neighbor has Ebola, am I safe?

Most likely, Ebola requires contact transmission. If you are not in direct contact with you neighbor the chance of transmission is low.

 

How long does Ebola survive outside the body?

Ebola is only known to transfer via bodily fluids but it can survive outside the human body for several hours and is further confirmed to survive in bodily fluids outside a host for several days. The common flu is able to survive for three days outside the body while Ebola can survive for up to 6 days according to the CDC (CDC Website:”Several Days”). By contrast HIV can only survive without a host for a few minutes in addition to requiring a high viral load for transmission.

The virus is susceptible to UV and rapidly becomes inactive upon exposure to sunlight when not surrounded by bodily fluids. Multiple studies have confirmed that the virus deteriorates upon being dried. When the ambulance collected the first American patient from his apartment he vomited on the way to the ambulance which was allegedly only cleaned several days later leaving multiple people concerned that the virus may be transmitted to pets or residents in the area. Dogs are known carriers of the Ebola virus and likely carriers in an urban setting where pets are common.

The virus is able to survive for particularly long periods at low temperatures. In one experiment the virus remained infectious for up to 5 weeks at 4 degrees Celsius. Ebola outbreaks have historically occurred in Africa where temperatures that low are uncommon and rarely last for more than a few hours even during the harshest of winters. The upcoming winter in America could change the dynamics of transmission during the snow season if the outbreak is not contained.

Ebola is an incredibly infectious virus with a single particle required for successful infection of a host. The virus is sensitive to several detergents including bleach and chlorine making basic hygiene the first line defense against transmission. Avoiding infected patients and minimizing contact with people are common methods used to stop the spread of the virus.

List of Historical Outbreaks

Ebola was first isolated in 1976 during the first recorded outbreak in the Democratic Republic of Congo known as Zaire at the time. The West African outbreak of 2014 is the largest since it was isolated. The virus was named Ebola after a river near the village where the first documented case occurred.

The below table shows previous outbreaks of Ebola including the strain and the mortality rate per outbreak. The mortality rate of the Reston strain is far lower than other strains. It is widely believed that the Reston strain could be utilised and patents to this affect are already in the public domain.

Year Country Strain Cases Deaths CFR
1976 Zaire EBOV 318 280 88.00%
1976 Sudan SUDV 284 151 53.00%
1976 England SUDV 1 0 0.00%
1977 Zaire EBOV 1 1 100.00%
1979 Sudan SUDV 34 22 65.00%
1989–1990 Philippines RESTV 3 0 0.00%
1990 United States RESTV 4 0 0.00%
1994 Gabon EBOV 52 31 60.00%
1994 Côte d’Ivoire TAFV 1 0 0.00%
1995 Zaire EBOV 315 254 81.00%
1996 Gabon EBOV 37 21 57.00%
1996 South Africa EBOV 2 1 50.00%
1996–1997 Gabon EBOV 60 45 75.00%
2000–2001 Uganda SUDV 425 224 53.00%
2001–2002 Gabon EBOV 122 96 79.00%
2002–2003 Republic of the Congo EBOV 143 128 90.00%
2003 Republic of the Congo EBOV 35 29 83.00%
2004 Sudan SUDV 17 7 41.00%
2004 Russia EBOV 1 1 100.00%
2007 Democratic Republic of the Congo EBOV 264 187 71.00%
2007–2008 Uganda BDBV 149 37 25.00%
2008 Philippines RESTV 6 0 0.00%
2008–2009 Democratic Republic of the Congo EBOV 32 14 45.00%
2012 Uganda SUDV 24 17 71.00%
2012 Democratic Republic of the Congo BDBV 77 36 47.00%

Limited studies have concluded that the virus may be considerably older. A study observing RNA mutations placed the potential early strains of the virus at around 800 years old. Ebola outbreaks have traditionally been limited to small villages and residents have been observed implementing isolation of the sick without the intervention of Western medicine.

The plague of Athens ending 430 B.C. has been compared to an ancient Ebola virus. Historical accounts of the plague cite symptoms similar to Ebola most notably an “empty cough” which is not consistent with other possible diseases including small pox and measles. There is insufficient evidence to fully understand the exact cause of the plague.

Ebola may have existed for thousands of years without human knowledge. Prior to the 2014 outbreak, the virus was considered likely to burn out quickly due to low incubation periods and sudden deterioration of an infected individual to death.  The 2014 strain appears to have a slightly longer incubation period which has given rise to the suspicion it has mutated.

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