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Saturday, July 19, 2014

The Ebola Virus: A potential Worldwide Pandemic?

Movies and Novels have long used fictional Ebola outbreaks as popular pandemic plots. However, now fiction seems closer to becoming a reality.

Since the first reported case of the recent Ebola Outbreak believed to have started in Liberia in December, 2013, Ebola has killed over 600 people on the African continent. This is the most deadly and alarming outbreak of Ebola in history.
Ebola had first appeared in 1976 with two simultaneous outbreaks in Sudan and the Democratic Republic of Congo. The latter occurred near the Ebola River, hence the name. Within 7 weeks, 280 of the 318 people infected were dead. This accounted for a fatality rate of almost 90%. Since then, there have been 28 documented Ebola Outbreaks, mostly confined to rural Africa. However, the most recent outbreak has hallmarks to make it a potential pandemic which could affect other continents such as Europe, Asia, and the Americas.
Of the 5 know types of Ebola Viruses, the "Zaire" type is by the far the most aggressive and deadly kind. This is the same type which was identified in the initial deadly 1976 outbreak and also in the current crisis.
Ebola is thought to be carried by Fruit Bats which can transmit the Virus to other animals such as primates (monkeys, gorillas, chimpanzees) who then become ill. These animals are most likely to come into contact with humans and initiate the transmission of the Virus. In fact, in 1989, 1990 and 1996, monkeys imported from the Philippines to the United States, tested positive for the Ebola Virus. Fortunately, these were a less aggressive and transmittable type of Ebola and no humans were infected.

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Once humans are infected, the Virus spreads quickly from human to human through miniscule droplets of secretions, blood or other bodily fluids. It is believed the Ebola Virus can survive for several days outside the human body. This makes it possible to become infected even without coming into direct contact with another infected human.
After Ebola is transmitted, it may take 2-21 days for a person to show signs of the disease. Due to this unusually long “incubation period", infected persons can travel long distances before they or anyone else would suspect the disease.
The earliest signs of the disease do not point directly at Ebola. Patients usually experience flu-like symptoms such as fevers, sore throats, muscle aches and intense fatigue. This makes it very likely that unsuspecting friends, relatives and health care providers come into contact with the Virus and become potential victims as well. It would take days before a suspicion of Ebola would lead to testing which could identify the Virus as the culprit.
Ebola’s first attacks the Immune System taking away the body’s defenses. The next victims are the organs and the body’s clotting mechanisms. This results in bleeding which can be seen externally, but creates far greater harm internally. Patients eventually succumb to blood loss and shock. Ebola is a fast and efficient killer, claiming the lives of up to 90% of all infected patients, typically within 10 days of falling ill.
Contrary to other Viral Diseases such as HIV, there is no treatment or cure for Ebola. Antiviral medications have not been shown effective. There is also no vaccination against Ebola to protect those at risk. Infected patients typically receive only supportive care such as Oxygen, hydration and treatment for infections, while time determines who lives and dies.
 While other outbreaks have been limited to remote locations in Africa, the most recent epidemic has spread to larger cities, like Conakry, home to 2 million people and the capitol of Guinea. Conakry is a hub for global travelers in Western Africa. An International Airport is nearby, making it far more likely for people who are unknowingly infected with Ebola to travel to distant destinations.
The WorldHealth Organization is calling for “drastic action” to contain the Ebola Virus which has spread from rural areas on larger cities. The Virus has now spread throughout Guinea, Liberia, and Sierra Leone, despite local and international efforts to contain it.

In recent days, 2 American citizens have been infected with the Ebola Virus. Dr. Kent Brantly, age 33, the medical director of the Ebola Case Management Center in Monrovia, the capital of Liberia, was announced last Saturday as having contracted the Ebola Virus. He had been treating Ebola victims in Africa since last October. Dr. Brantly, who was initially accompanied by his wife and children started feeling ill last week and isolated himself. His family has since returned to the United States. Today, it was announced that a second U.S. Health Care worker has contracted the Ebola Virus. Nancy Writebol, had been working as a Hygienist, decontaminating patients at the same Monrovia Hospital where Dr. Brantly contracted the Ebola Virus. Both a reported in serious condition.
The unique and potential catastrophic combination of the largest outbreak in history of Ebola, the most aggressive type of Ebola, and the presence of infected people in large African cities along international travel routes, make this current Ebola Epidemic a potential Global Pandemic. It is a matter of time before other continents are affected. Despite advanced health care systems in developed countries, the Ebola Virus has the potential to spread quickly among a highly mobile population. Due to the long incubation period, lack of specific treatments and high mortality rate, Ebola has the potential to kills thousands. Ebola is classified as a Category A Bioterrorism agent by the CDC for that reason. At this point, chances that Ebola remains an African problem are dim. Other continents and countries must prepare for a potential public health nightmare reminiscent of the movie “Outbreak”.




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