Everything you need to know about
the deadly EBOLA virus.

In February 2014 an outbreak of the Ebola virus
was identified in the south-eastern forests of
Guinea , the first time the virus had been
recorded in the West African state. By March, it
had spread from Macenta, Gueckedou and
Kissidougou to the capital Conakry. By April,
cases had been confirmed in a further two
districts – Dabola and Djingaraye – and in
neighbouring Liberia.
The disease has since advanced to the capitals
of Guinea, Sierra Leone and Liberia , and it
has killed two doctors, Dr Samuel Brisbane from
Liberia and a Ugandan, with two more being
seriously ill.
Now Nigerian officials are racing to prevent an
outbreak in Africa’s largest city after a Liberian
man died in Lagos shortly after arriving at the
airport last Tuesday. All its entry points were put
on red alert.
Médicins sans Frontières has called this outbreak
– the world’s largest recorded to date –
“unprecedented”, due to its broad geographic
spread. The World Health Organization (WHO)
have recorded 1,201 cases attributed to the
Ebola virus up to last week, including 672
deaths.
Ebola is a terrifying phenomenon: it kills up to
90% of infected people; death can occur in as
little as a week; and, prior to death, patients
may haemorrhage, bleeding internally and
externally. There is no vaccination and there is
no cure.
The Ebola virus is named after the Ebola River in
the Democratic Republic of Congo, where the
disease claimed its first known victims in 1976.
A separate strain broke out simultaneously in
Nzara, Sudan.
Unlike bacteria, which are single-celled
organisms that multiply by dividing
themselves, viruses require hosts to replicate:
they take over living cells and then force the
infected cells to reproduce the virus. While
bacteria can be combated with antibiotics, the
same is not true of viruses.
Ebola is a ribonucleic acid (RNA) virus and
multiplies particularly rapidly in its host creating
a high pathogen dose. The science writer David
Quammen, who has investigated the origins and
spread of the virus, writes that “[RNA viruses]
produce acute infections, severe for a short time
and then gone. Either they soon disappear or
they kill you.”
In the process, “sneezing, or coughing or
vomiting or bleeding or diarrhoea … facilitates
transmission to other victims”.
There are five known species of Ebola
virus: Bundibugyo ebolavirus; Zaire
ebolavirus; Reston ebolavirus ; Sudan ebolavirus;
and Taï Forest ebolavirus. All but the Reston
strain can be fatal to humans and all but the
Reston strain are found in Africa.
Until recently, the Zaire strain of Ebola was
thought to be behind the current outbreak, with
the US Centres for Disease Control (CDC) noting
a 98% match between the West African and Zaire
strains. The Zaire strain of Ebola is the most
deadly: it attacks all organs in the body,
including the skin, and can have a fatality rate of
up to 90%. Since its first appearance – and
excluding the current outbreak in West Africa –
the strain has killed 1,098 of the 1,388 people it
has infected, an average case fatality rate of 79%
.
However, a team of experts studying the West
African strain reported in the New England
Journal of Medicine recently that the Guinea
outbreak is a new strain of the virus: though
closely related to Zaire ebolavirus, the current
strain is endemic to West Africa and developed
parallel to the central African ebolavirus strain.
According to the team’s investigation, the
strain’s outbreak can be traced to the death of a
two-year-old child in Gueckedou on December 6
last year.

How is Ebola transmitted?

Ebola is thought to be a zoonotic or animal-
borne virus. The virus survives in a “reservoir”
host – an animal or insect that carries the virus
at no cost to itself – and is passed on to other
animals or humans through contact with the
bodily fluids, secretions or organs of the host
animal.
Though it has not been conclusively proved, the
fruit bat ( Pteropodidae ) is considered to be the
natural host or “reservoir” of the ebola virus.
The exact manner in which Ebola enters human
cells remains a mystery. Transmission to
humans and primates is thought to occur
through direct contact with the animal host, or
through contact or consumption of the meat,
bodily fluids or secretions of animals that have
become infected by contact with the host .
Guinea is a known wildlife trafficking hub and
last month, the country’s government issued a
warning to citizens to avoid eating traditional
bushmeat dishes.
Once it has presented in humans, Ebola
is transmitted through direct contact, where
broken skin or mucous membranes come into
contact with the blood or secretions of the
infected person. It may also be transmitted
indirectly “through exposure to objects (such as
needles) that have been contaminated with
infected secretions”, according to the US Centres
for Disease Control and Prevention. This means
that healthcare workers and family and friends of
those infected with the virus are at a higher risk
of infection.
The Ebola virus causes a viral haemorrhagic
fever, a set of severe illnesses that are
“multisystem ” in that they affect various of the
body’s regulatory systems. These viral
diseases damage the circulatory system and may
be accompanied by bleeding or haemorrhaging.
According to the WHO , patients will begin to
show symptoms anywhere from two to 21 days
after exposure to the virus, mostly between days
eight and 10. Patients present with fever,
weakness, muscular pain, headaches and sore
throat. The generality of the symptoms at this
stage makes it difficult to distinguish Ebola from
various other diseases, including malaria, typhoid
fever, meningitis or cholera.
As the disease develops , Ebola sufferers may
experience vomiting, diarrhoea, a red rash,
difficulty in breathing and swallowing. The virus
severely compromises the immune system, and
affects liver, kidney and respiratory function, as
well as the skin and blood. Blood clots may form
and patients may experience haemorrhaging,
bleeding internally and externally.
There is no vaccine or cure for the Ebola virus,
though several vaccinations are currently
being tested . According to the US CDC ,
treatment is thus limited and merely supportive
of the body’s immune function: providing fluids,
electrolytes and oxygen; keeping blood pressure
constant; and treating additional infections with
antibiotics.
It is unclear why some people infected with the
virus survive where so many do not, but it
is thought to relate to the strength of the
individual’s immune system, the strain of the
virus and the viral dose the person has been
exposed to.
In addition to supportive and symptomatic
treatment, health workers can only really control
the spread of the virus: isolating those infected,
raising awareness of the virus and how it is
spread in affected communities, ensuring
appropriate protective gear is worn by all in
contact with Ebola sufferers and ensuring the
quick and safe burial of those who have
succumbed.

By Africa Check

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