EBOLA VIRUS /
INFECTION, ALL YOU
NEED TO KNOW
HOW DOES EBOLA
ENTER THE BODY IN
THE FIRST PLACE?
Ebola is not known
to infect people
through the air --
you must come into
contact with the
virus somehow in
order to be at risk
for infection,
Bhadelia said. It's
transmitted
through exposure to
an animal that
carries the virus
(such as a bat or
primate), through
exposure to the
bodily fluids of a
human who is
infected and
symptomatic, and
through exposure to
items that have
been contaminated
with the virus.
People who are
"providing care for a
household
member ... when
they're cleaning up
vomit or diarrhea,
they come into
contact [with the
virus], and the way
it's transmitted is
there's virus in the
fluids," she said.
"That virus gets
into your own body
through the nose,
mouth and such."
Ebola can also
survive outside the
host for a
significant period of
time -- as long as a
couple of days -- at
room temperature.
"That's why
infection control is
such a huge part of
this," Bhadelia said.
"If you have
sterilization of
equipment, if you
have availability of
disinfectant, things
like IVs ... and if
you're able to clean
all those
environments and
isolate patients
effectively, the
outbreak would
never take a
foothold." This is
why places with
good infection
control and medical
infrastructure face
absolutely no risk
for outbreaks from
this pathogen, she
added.
WHAT HAPPENS IN
THE BODY ONCE
INFECTION OCCURS?
Once the Ebola virus
makes its way into
the body, it gets in
the body's cells and
replicates itself.
"Then it comes
bursting out of our
cells and produces
this protein that
wreaks havoc,"
Bhadelia explained.
The protein is called
ebolavirus
glycoprotein, and
attaches to the
cells on the inside of
the blood vessels.
This increases
permeability of the
blood vessels --
leading to blood
leaking out of the
vessels. "The virus
causes
derangement in the
body's ability to
coagulate and
thicken the blood,"
she said. Even
people who don't
show hemorrhagic
symptoms will
experience this
leaking of blood
from the vessels --
which can
eventually lead to
shock and,
ultimately, death.
The Ebola virus is
also a master of
evading the body's
natural defenses: It
blocks the signaling
to cells called
neutrophils, which
are white blood cells
that are in charge of
raising the alarm for
the immune system
to come and attack.
In fact, Ebola will
infect immune cells
and travel in those
cells to other parts
of the body --
including the liver,
kidney, spleen and
brain.
Each time one of
the cells is infected
with the Ebola virus
and bursts, spilling
out its contents,
the damage and
presence of the
virus particles
activates molecules
called cytokines. In a
healthy body, these
cytokines are
responsible for
provoking an
inflammatory
response so that
the body knows it's
being attacked. But
in the case of an
Ebola patient, "it's
such an
overwhelming
release [of
cytokines], that's
what's causing the
flu-like symptoms"
that are the first
sign of Ebola,
Bhadelia said.
WHAT DO THE
SYMPTOMS LOOK
LIKE?
Ebola generally
starts with flu-like
symptoms. Though
it's known for the
extreme
hemorrhagic
symptoms -- the
bleeding out of the
eyes, etc. -- not
everyone will
experience these.
"In fact, only 20
percent of people
will have [these
extreme
symptoms]"
Bhadelia said. "Some
people may
succumb to the
illness before it gets
to that point, some
may have minor
bleeding, some may
just have bleeding
of the gums, or
bruising."
The flu-like
symptoms typically
occur in the first
stages of the
illness, before the
person gets sicker
and starts to
experience more
severe symptoms
such as vomiting,
diarrhea and low
blood pressure. The
extreme bleeding
occurs toward the
end of the illness.
People who die from
infection with Ebola
virus usually end up
dying from multi-
organ failure and
shock. "The shock is
from the bleeding --
now you're bleeding
in different parts of
your body, and the
blood is leaking out
of your blood
vessels," Bhadelia
explained. "Even if
[you don't have] the
hemorrhagic
features, you're still
leaking blood."
HOW IS IT THAT
SOME PEOPLE HAVE
SURVIVED THE
DEADLY INFECTION?
It largely has to do
with two factors.
The first is the
person's health in
general -- his or her
immune system
and ability to bounce
back from a viral
infection. The
second is the type
of exposure he or
she got. Recovery
may be more likely
if it wasn't a severe
exposure --
meaning, perhaps
they were exposed
to someone who
was only early on in
the illness, and the
amount of virus in
the bodily fluids
was not yet that
high, Bhadelia said.
In addition, what is
known about Ebola
is that it requires a
known marker on
the surface of
human cells
themselves, which
it uses to gain entry
into the cells.
Researchers have
found in a
laboratory setting
that some people's
cell lines actually
lack this marker, or
it may be mutated
somehow, so that
the Ebola can't get
into the cells.
However, Ebola
research is still very
much in its infancy,
and knowledge
about how the virus
behaves is still
evolving, Bhadelia
said.
Still, findings like
these do pave the
way for potential
treatments. Right
now, she said,
research is being
done to develop
treatments that
work in several
different ways. One
of the ways is to
block the virus from
replicating itself
once it's inside the
cell. "It basically
provides a full stop
and doesn't let the
virus copy its
genetic material
over and over again
to create the new
viruses," Bhadelia
said. Another way is
to help the body's
immune system
create an effective
response to Ebola
by exposing the
immune system to
an attenuated
version of the virus.
That way, "it can
create an effective
response so when
the real virus comes
around, the immune
system doesn't get
evaded the way it
does regularly." And
yet another way is
to actually create
antibodies
specifically against
the virus, so "you're
giving the immune
system a boost
from the outside,"
she said.
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