Could An Ebola Outbreak Happen In America?
History of Ebola
Ebola virus was isolated first in 1976 and there are 5 subtypes of the family known. Four can be transmitted from human to human and one is listed only in primates – the last time that I checked humans were also considered as primates so I am not sure about that classification. The most deadly is the Zaire subtype and it is believed to be transmitted through the urine, feces or bite of the fruit bat. The virus has also been found in porcupines, primates and wild antelope. The fruit bat is found in Africa and the Middle East. The reason this virus has become epidemic is because it can be transmitted between humans and not just between urine/feces/bite of an animal and humans. –disease transmition is one of the bigger reasons to have good sanitation and to cook all animal products till it is WELL DONE to be sure all pathogens are killed. The previous largest outbreak occurred in Uganda during 2000-2001 with 425cases/224deaths. Since 1976 there have been more than 20 EVD outbreaks across Central Africa. If you remember we had an outbreak of Hanta virus back in 1993 and the bird flu [H5N2] in 2004 in south central Texas. But they never became epidemic because they did not transmit between humans.
1. Sudden onset of fever from 101.5 to as high as 105F, intense weakness, sore throat, headache, muscle and abdominal pain
2. Profuse vomiting and diarrhea can start within 1-2 days after first symptoms
3. Bleeding from nasal and oral cavities along with hemorrhagic skin blisters and internal bleeding (hallmark of disease)
4. In fatal cases it leads to renal function failure, multisystem organ failure in 3-5 days
5. Die within 8-9 days
If the patient survives beyond 2 weeks then they will have a better outcome.
How spread from human to human
So far it cannot be spread during incubating period which can be from 8-9 days, not until fever starts, but can spread from then on through post mortem period when the body is being prepared for burial. The easiest way it is transmitted through blood, urine, feces, vomit, breast milk and semen (virus can live in this for 62 days). It can also spread through sweat, saliva and tears, if you come in direct contact with these secretions. If you have an open sore or you touch the infected patients secretions then touch your mouth, nose or eyes the virus can be transmitted.
How to treat
Since Ebola is a virus it does not have a cure. What can be done is supportive methods including: IV fluids, oxygen, medication to control fever and headache, blood and platelet transfusions, electrolyte balance, IV medication for vomiting, oral and IV nutrition, medication for pain, anxiety and agitation.
Healthcare providers who take care of these patients need to use full Personal Protection Equipment including eyewear or goggles, facemasks, gloves, gown, shoe covers and in some cases use positive pressure headgear and negative pressure patient room.
Several hospitals in West Africa have closed their doors because they are short of staff due to staff coming down with the Ebola Virus or they are afraid of going to work in case they come down with the virus.
CDC suggests testing people who acquire a fever within 21 days of being exposed to Ebola virus or who have traveled to infected areas.
National Institutes of Health will begin a human vaccine trial in September 2014, this vaccine contains no infectious Ebola virus genes and works by entering a cell and delivering the new genetic material. The new genes that are inserted cause a protein to become expressed, which in turn produces an immune response in the body, has shown early promise in a primate model.
Another approach to help infected patients involves transfusing blood or plasma from those patients who have recently recovered from Ebola virus, is based on the premise that the plasma from recovered patients contains life-saving antibodies. This is experimental treatment that has been used, according to recent reports during this epidemic, although results of such treatment have not been formally reported.