EBOLA: The Next Pandemic?

West Africa is reporting its first epidemic of Ebola virus in the country of Guinea, and it looks like it’s spreading fast.  At least 86 cases and 59 deaths have been attributed to the deadly disease, with cases now being reported in the neighboring countries of Liberia and Sierra Leone. In Liberia, 6 total cases have been identified, with 5 deaths. Ebola virus was first reported in 1976, when 602 cases in the Democratic Republic of Congo resulted in 431 deaths.

WHAT IS EBOLA?

Ebola, named after the river where the first victims were identified, is a virus (there are several variants). It causes a hemorrhagic fever with a 25-90% death rate, much higher than even the worst of the influenza pandemics of the past century.

Symptoms begin presenting about 2 weeks after exposure. Ebola patients develop the sudden onset of what first appears to be influenza: Aches and pains, cough, sore throat, shortness of breath, fever with chills, general ill feeling, and even hiccups are commonly seen at this stage.  Nausea is also noted, often accompanied by abdominal pain, diarrhea, and vomiting.

Later, The central nervous system is affected: Severe headaches, altered mental status, seizures, and sometimes coma lead to life-threatening conditions.

Evidence of disorders in clotting factors are seen in advanced stages of the disease. Manifestations include:

• Spotty Rashes
• Bruises
• Broken blood vessels in the skin
• Collections of blood under the skin after injections
• Bloody vomit or sputum
• Spontaneous nosebleeds
• Bleeding from gums
• Blood in bowel movements

Once bleeding disorders occur, the likelihood of survival is slim. Although deaths from severe hemorrhage have occurred in women giving birth, multiple organ failure leading to shock is the usual cause of death.

WHAT WE KNOW

Not much. How Ebola manages to infect humans is poorly understood. Primates like monkeys and apes are possible vectors, although birds, rodents, bats, pigs, and insects may be more likely to transmit the disease. Although the virus can be transmitted to dogs, they don’t seem to get sick from the disease. It appears to be transmitted through saliva and other bodily fluids, although a 2012 Canadian study suggests that the virus may be transmitted in air droplets.

PREVENTION AND TREATMENT

As an outbreak of ebola progresses, bodily fluids from diarrhea, vomiting, and bleeding become very contagious. Poor hygiene and lack of proper medical supplies in underdeveloped countries cause wide-scale epidemics. The best you can do is isolate sick individuals and stock up on masks, gowns, and gloves.

There is no known treatment, cure, or vaccine for Ebola at present.

So why does this matter to citizens of countries thousands of miles away? Guinea is the world’s largest exporter of bauxite, the ore used to make aluminum. Therefore, exports from the country go to many of the world’s manufacturing plants. The advent of air travel can easily spread the disease throughout the world is just 24 hours.

The other disturbing fact is that at least eight health-care workers who cared for Ebola patients have died. If this happened worldwide, the emergency medical response would be crippled.

This may be a third-world disease now, but it wouldn’t take much to make Ebola hemorrhagic fever, indeed, the next great pandemic.

Joe Alton, M.D.

Joe Alton, M.D., aka Dr. Bones