Ebola – More Than You Ever Wanted to Know on the Technical Side

A lot is known about Ebola which was first seen in two outbreaks simultaneously occurring at Nzara, Sudan, and in Yambuku, Democratic Republic of Congo near the Ebola River in 1972. What isn’t known is how to cure it.

That isn’t surprising since it is a viral infection, not bacterial. There is almost no treatment for any viral infection such as the yearly flu strain or the common cold.

Some bacterial infections can still be treated with antibiotics (first accidentally discovered just prior to WWII by British researcher Alexander Fleming), but due to the over use of antibiotics in animal feed and by lazy doctors who give into patient demands to treat their kid’s cold, and extreme use of mutagenic anti-bacterial soaps particularly in the U.S., newer strains of bacteria have evolved which are not treated by existing antibiotics – this situation is only getting worse and Congress is ignoring the need for legislation to ban all such use in healthy animals.

Also, TV commercials drive people to buy and use anti-bacterial soap and spray every surface with Lysol by inspiring a sense of guilt for failing to protect their children.

This is simply a marketing ploy with zero scientific basis. In reality, the soaps cause bacteria to mutate sometimes into more dangerous forms, children need to be exposed to many diseases to build their immune systems, and killing germs with Lysol means only the most hardy bacteria survive to spread.

According to the CDC these are the basic facts about Ebola with some commentary from my decades of experience in medical reporting as indicated by brackets like this []:

Ebola virus disease (EVD), which was formerly known as Ebola hemorrhagic fever, is an often fatal illness in humans with a mortality rate of about 9 out of 10 patients.

The outbreaks occur mostly near tropical rainforests in Central and West Africa – specifically in small villages where sanitation and medical knowledge are in short supply.

Ebola originates in animals and passes to people, [probably because villagers are eating infected animals which aren’t cooked sufficiently to kill the virus or from feces contaminating other food].

Although not certain, Ebola is thought to incubate in fruit bats as the natural animal host, widespread in the bat population and occasionally infecting humans which then pass it along through bodily fluids [via sex or contamination during the handling of infected individuals or burial of victims].

“Severely ill patients require intensive supportive care. No licensed specific treatment or vaccine is available for use in people or animals,” WHO quote. [Supportive care mainly consists of giving large quantities of fluids intravenously, oxygen, transfusions and oral electrolytes which are all in short supply in remote locations of third world countries.]

“In Africa, infection has been documented through the handling of infected chimpanzees, gorillas, fruit bats, monkeys, forest antelope and porcupines found ill or dead or in the rainforest.,” WHO.

Infections are also known to spread from monkeys (a food source in parts of Africa) but they are not considered the primary reservoir of the disease, in other words, they have also been infected by fruit bats.

There are three Filoviridae family (filovirus), viruses including genus Marburgvirus, genus Cuevavirus and genus Ebolavirus.

There are five known varieties of the Ebolavirus genus:

    Bundibugyo ebolavirus (BDBV)

    Zaire ebolavirus (EBOV)

    Reston ebolavirus (RESTV)

    Sudan ebolavirus (SUDV)

    Tai Forest ebolavirus (TAFV)

RESTV and TAFV have not been responsible for large outbreaks and RESTV is found in the Philippines as well as the People’s Republic of China. They can infect humans but pose no serious threat and there have been no reported human fatalities from either RESTV or TAFV, although they can be fatal to animals.

Again, according to the WHO, any men who recover from Ebola remain infectious for a minimum of 7 weeks through their semen.

Caring for Ebola patients and burial rituals which involve direct contact with the deceased are common methods of infection.

The incubation period for Ebola appears to range from 2 to 21 days from date of infection to initial symptoms.

The symptoms of Ebola resemble those of malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral haemorrhagic fevers.

That not only makes it difficult to know which patients should be isolated, it also means that medical supplies are routinely used up very quickly since it is only prudent to take extreme measures when anyone appears with any of these infections.

Fluid samples from victims are extremely dangerous and the tests necessary to conclusively diagnose Ebola require sophisticated laboratory equipment and trained technicians.

WHO Information:

“Since 1994, Ebola outbreaks from the EBOV and TAFV species have been observed in chimpanzees and gorillas.

RESTV has caused severe EVD outbreaks in macaque monkeys (Macaca fascicularis) farmed in Philippines and detected in monkeys imported into the USA in 1989, 1990 and 1996, and in monkeys imported to Italy from Philippines in 1992.

Since 2008, RESTV viruses have been detected during several outbreaks of a deadly disease in pigs in People’s Republic of China and Philippines. Asymptomatic infection in pigs has been reported and experimental inoculations have shown that RESTV cannot cause disease in pigs.”

Routine disinfection of animal enclosures in breeding facilities is thought to be sufficient to prevent the spread of the infections in animals.

Prevention in clinical environment:

“When in close contact (within 1 meter) of patients with EBV, health-care workers should wear face protection (a face shield or a medical mask and goggles), a clean, non-sterile long-sleeved gown, and gloves (sterile gloves for some procedures).

Laboratory workers are also at risk. Samples taken from suspected human and animal Ebola cases for diagnosis should be handled by trained staff and processed in suitably equipped laboratories,” WHO.


Preparedness and response

Ebola response road map August 2014 http://www.who.int/entity/csr/resources/publications/ebola/response-roadmap/en/index.html

Ebola and Marburg virus disease epidemics: preparedness, alert, control, and evaluation Interim manual – June 2014 http://www.who.int/entity/csr/resources/publications/ebola/manual_EVD/en/index.html

Infection control

Ebola surveillance in countries with no reported cases of Ebola virus disease http://www.who.int/entity/csr/resources/publications/ebola/surveillance/en/index.html

Ebola event management at points of entry, Interim guidance


Infection prevention and control guidance summary, Ebola guidance package http://www.who.int/entity/csr/resources/publications/ebola/evd-guidance-summary/en/index.html

Infection prevention and control guidance for care of patients with Filovirus haemorrhagic fever http://www.who.int/entity/csr/resources/publications/ebola/filovirus_infection_control/en/index.html


WHO risk assessment: human infections with Zaire Ebolavirus in west Africa http://www.who.int/entity/csr/disease/ebola/evd_westafrica_who_riskassessment_20140624.pdf?ua=1

Meeting the social challenges:

COMBI toolkit for behavioral and social communication in outbreak response a 7-step approach, with tools, checklists and templates for designing behavioral and communication interventions http://www.who.int/entity/ihr/publications/combi_toolkit_outbreaks/en/index.html

Field workbook for COMBI planning steps in outbreak response – a handheld guide and notebook for applying the WHO COMBI methodology in 7-steps, during an outbreak http://www.who.int/entity/ihr/publications/combi_toolkit_fieldwkbk_outbreaks/en/index.html