Ebola: Another Fatal Viral Infection Native to Africa
Viral, bacterial, fungal, parasitic and other types of infections have inflicted high mortality rates since before they or their causes were properly defined. In the 21st century, modern medicine has been quite successful in controlling morbidity and mortality caused by various diversified microorganisms.
The strides made by modern science, together with the advent of novel technologies, have both treated and prevented global infections, and even eradicated some of them. Smallpox has been certified by the World Health Organization (WHO) as having been eradicated, and polio is on its way to attaining a similar status. Simultaneously, as medical science defeats existing diseases, novel infections caused by different species of unfamiliar microorganisms present new and more difficult challenges.
Fatal hemorrhagic fever caused by the Ebola virus, first identified in the latter half of the 20th century, is one such infection challenging science to find a treatment or a vaccine. Several devastating viral infections such as HIV-AIDS, yellow fever, African sleeping sickness and hepatitis, among others, have been common on the African continent. Ebola is another addition to this list of fatal viral infections native to Africa.1 The tropical hot and humid climate there provides excellent conditions for microbial growth. Dense vegetation, extensive wildlife and open water are the perfect scenario for breeding vectors for infection such as mosquitoes.
The spread of Ebola to humans has been linked to deforestation in central Africa. Ebola viral infections are frequently observed in birds, reptiles and mammals, including primates such as gorillas and chimpanzees. The most common way to catch the Ebola infection is through direct contact with body fluids of infected animals. The clearing of rain forests brought humans and infected animals into close proximity.
Restricted or inaccessible emergency medical help and an underdeveloped healthcare system in most parts of central Africa aggravate the problems of both diagnosis and treatment. Perennial political turmoil in countries prone to viral epidemics, extreme poverty and widespread malnutrition are deterrents to philanthropic and medical organizations that hospitalize patients and provide medications.
Superstitions that lead patients to refuse treatment and archaic traditions such as washing corpses before cremation or burial trigger avoidable epidemics and unnecessarily claim innumerable lives. Since the identification of the Ebola virus in 1976, thousands have fallen prey to this deadly infection.2
The Ebola virus is associated with the family of viruses called Filoviridae. Of the five subtypes of Ebola currently known, four cause infection in humans: Ebola-Zaire, Ebola-Sudan, Ebola-Ivory Coast and Ebola-Bundibugyo.
Upon acquiring the virus, the human body almost immediately experiences the particular symptoms of Ebola infection. The onset of the disease is sudden because the virus has a short incubation period, commonly two to 21 days. The most staggering and disheartening statistic of Ebola infection is its morbidity rate, which touches the 90% mark, making Ebola one of the most destructive viruses known to mankind.
Once an individual is infected with Ebola, the disease spreads rapidly. Direct human-to-human contact, especially with the infected person's body fluids and secretions, is the most frequent mode of virus transmission. The infection can be contracted through the semen of an infected person even after seven weeks of clinical recovery. Repeated use of nursing equipment like needles, scalpels and syringes without proper sterilization also may contribute to the rapid spread of Ebola infection. Nosocomial transmission of the virus during the treatment of infected patients is common due to the lack of appropriate control measures by healthcare staff (i.e., wearing face masks or gloves).
Ebola hemorrhagic fever is characterized by a sudden rise in body temperature accompanied by headache, muscle ache and pain in the joints. Patients also experience intense body weakness and a sore throat. These initial symptoms are followed by diarrhea, vomiting, stomach pain and impaired function of liver and kidney. In some cases, dermatitis rash and red eyes along with internal and/or external bleeding are observed.
The mystery of how some patients are able to recover from Ebola infection is yet to be determined and is a challenge to researchers and scientists. One of the missing pieces in the Ebola puzzle is why people who die of the infection generally do not show any immune response to the virus. This may well be the launching platform for understanding Ebola .3
The diagnosis of Ebola infection is difficult, as the initial symptoms are similar to other viral infections and hence differential diagnoses for other infections are a strong possibility. A definitive diagnosis of Ebola is possible only in the laboratory through tests such as Antigen-capture enzyme-linked immunosorbent assay (ELISA), immunoglobulin M ELISA, reverse transcription polymerase chain reaction (RT-PCR) assay and virus isolation.4
Although a diagnosis is achievable in the laboratory, there is no conclusive treatment for the Ebola infection. Supportive therapy is the most common form of treatment, which includes fluid replenishment, maintenance of oxygen supply, blood pressure control and measures to prevent other opportunistic infections. The mystery of the origins of the Ebola virus and the intricacy of its biologic response in humans and animals is a hurdle yet to be overcome in the road to obtaining an effective treatment.5
Medical science has not been able to source a human or animal vaccine for Ebola, making global precautionary prevention of the infection an ambitious dream. Awareness campaigns and providing information of the Ebola infection and its modes of transmission, along with control measures in the affected areas of Africa, remain the paramount steps to be taken to prevent Ebola epidemics. Preventive measures such as isolation of patients, avoiding contact with infected persons' body fluids, safety precautions, like wearing masks and gloves and using sterilized equipments while caring for patients, are important.6
In mid-2012, as another Ebola epidemic struck central Africa, especially Congo and Uganda, the absence of an absolute treatment or a vaccine again came to the forefront. The history of viral infections initially endemic to Africa and then becoming pandemics has become common knowledge.
HIV-AIDS has proven how rapidly contagious infections may be transmitted across continents. The terminal nature of AIDS, combined with the social stigmas attached to its transmission, has helped to spread awareness about the illness. Society must learn from previous experience to prevent future outbreaks.7 With long-distance travel for education, profession or leisure becoming more common, sufficient preventive steps must be implemented to stop infections like Ebola from spreading. As the research and development of medicines and vaccines for Ebola stalls, prevention is of paramount importance.
Ebola epidemics are becoming more frequent and claiming more lives. The focus should and has shifted to developing and marketing a cure and/or a vaccine as soon as possible. The healthcare industry globally should help expedite this development process.
Conquering Ebola should be of prime importance not only for those in the affected regions in Africa, but for the world healthcare community. A vaccine and/or effective treatment would address one of the world's most potent viral threats.
References
- Africa Guide. "Illness & Disease." www.africaguide.com/health.htm#diseases. Accessed 15 September 2012.
- Laino C. "Africa, the infectious continent." MSNBC. www.msnbc.msn.com/id/3072106/ns/us_news-only/t/africa-infectious- continent/. Accessed 15 September 2012.
- Centers for Disease Control and Prevention. "Ebola Hemorrhagic Fever Information Packet." www.cdc.gov/ncidod/dvrd/spb/mnpages/ebola.pdf. Accessed 15 September 2012.
- World Health Organization. "Ebola haemorrhagic fever." www.who.int/mediacentre/factsheets/fs103/en/. Accessed 15 September 2012.
- Human Diseases and Conditions. "Ebola Virus Infection." www.humanillnesses.com/Infectious-Diseases-Co-Ha/Ebola-Virus-Infection.html#b. Accessed 15 September 2012.
- King JW. "Ebola Virus Treatment and Management." Medscape. emedicine.medscape.com/article/216288-treatment. Accessed 15 September 2012.
- University of California San Francisco Medical Center. "AIDS Treatment." www.ucsfhealth.org/conditions/aids/treatment.html. Accessed 15 September 2012