My name is Rachel and I am a senior at Rutland High School. I am working on a STEM and Global Studies project about the effect Ebola has on the body and the economy.
With the recent outbreak, Ebola is getting a lot of attention, but when you get down to it what really is Ebola? Can Ebola mutate to become airborne? How is it transmitted? How does it impact your body? What impact does the virus have on the economies of West Africa and the United States? How does preparation differ from hospital to hospital? What can we do to prevent the spread of Ebola? How is Ebola treated?
What is Ebola?
Ebola is a hemorrhagic fever that causes internal and external bleeding. Within the Ebola virus there are historically five distinct strains; Ebola Zaire, Ebola-Ivory Coast, Ebola Bundibugyo, Ebola Sudan, and Ebola Reston. The Ebola Zaire strain is the most lethal, and is the strain present in this outbreak. The Ebola Sudan and Ebola Bundibugyo strains have also been associated with large outbreaks among humans and a high death rate. The Ebola Reston strain caused an outbreak in cynomolgus monkeys that were in a quarantined in a facility in Reston, Virginia. Some of those who working with the monkeys became ill with the virus, but did not get sick. Upon further testing of the infected workers it was discovered that they contained the antibodies to the virus.
The Ebola virus is an encapsulated, helical viron with a long loop at one end that could be branched, circular, or “u” shaped. The inner nucleocapsid is single stranded RNA that is wrapped around the proteins NP, VP30, VP35, and L in a helical arrangement. There are two other proteins, VP24 and VP40, which have roles as structural proteins, mediators for host immune response, and viral replication and assembly. These proteins are located inside the viral envelope, which covers the viruses protective protein capsid, that is created by the host’s protons. The VP24 protein has been linked to the lethalness of Ebola. This protein binds to the host’s protein that is responsible for signaling molecules in and out of the host’s nucleus. The VP24 protein takes aways the host protein’s ability to send important signals to the nucleus and activate the immune system’s antiviral defences. This means that your body has no way to defend itself from the virus.
Can Ebola become airborne?
Some common illnesses such as the flu or rabies are RNA viruses. Most RNA viruses have a high mutation rate because they do not have a method of proofreading a genome like DNA viruses do. This being true, Ebola had already mutated over 250 times since it was first identified in 1976, as of August 28th, 2014 (nrp, 14 August 2014). Researchers found that the virus is mutating twice as fast in humans as it does in animals such as fruit bats. It is very rare that an RNA virus will mutate and become airborne because they do not have the means of completely changing their transmissibility. Even though this is true we cannot rule out the chance that it could become airborne, but there is a very high chance it will not become airborne.
How is Ebola transmitted?
The Ebola outbreak started when one human came in contact with an infected animal and then spread the virus to other people after they became symptomatic. Ebola is transmitted through all bodily fluids. Once a patient is extremely infected they could spread the virus when they cough, if they produce any mucus or bodily fluid and it comes in contact with someone else. Typically after a person has contracted the virus they will begin to show symptoms between 2-21 days. This is because of the way the symptoms progress from flu like symptoms to internal bleeding. If someone has been in contact with the virus, but is not showing symptoms after 21 days then it is very likely that they did not contract the virus.
Doctors and nurses who are treating Ebola patients are at an increased risk of contracting the virus. Some hospitals are still developing protocol for handling the virus and others did not have any protocol until they had an Ebola patient. If doctors or nurses do not put on the protective suits in the correct way or take them off properly, then they are at risk for contracting the virus. One problem with these suits is that they can be a one-size-fits-all, and in some cases any employee could be too big or too small for the suit causing it not to fully protect them. Hospitals routinely practice donning and doffing based on evidence based practice, to not only allow for their staff to be more comfortable with the process, but also analyze the efficacy of their personal protective equipment (PPE).
In West Africa the burial teams are also at risk of contracting the virus because even after death, a body is still infected, meaning that it can still spread the virus. These teams decrease their chances of contracting the virus by spraying the bodies down with bleach, wearing protective suits, and using tarps as a way to carry the bodies to the burial sites (BBC, 1 December 2014).
How does Ebola impact your body?
Once the virus is initially contracted it moves through the bloodstream hijacking the host’s healthy cells so that it can start to rapidly produce more of its own cells. The Ebola virus infects the host’s endothelial cells, which then leads to internal bleeding. Endothelium is a thin layer of cells that line the inner surface of blood and lymphatic vessels. Endothelial cells that are in direct contact with lymph are called lymphatic endothelial cells, but if they are in direct contact with blood they are called vascular cells. Both of these kinds of endothelial cells have specific functions, but the general function of these cells is to help form new blood vessels, repair damaged or diseased organs, and control blood clotting. Once this function is inhibited hypovolemic shock occurs. Hypovolemic shock is when severe blood and fluid loss make the heart unable to pump blood to many vital systems, which then causes organs to stop working.
In addition to hindering the body’s ability to repair organs, the virus attacks the liver and kidneys and can lead to death. It is known that the virus attacks the liver because upon lab test amongst Ebola patients, there have been heightened AST and ALT levels. ALT stands for alanine aminotransferase found in the liver, but there are small amounts in the kidneys, heart, muscles, and pancreas. ALT is used as a way to detect if the liver is damaged. AST stands for aspartate aminotransferase and is released into the bloodstream when the liver, heart, or other organs that are damaged. Alanine aminotransferase detects a problem in within the liver, which then causes aspartate aminotransferase to be released into the bloodstream.
Blood tests prove that the liver is not the only body part that is impacted; many aspects pertaining to blood are greatly affected. Lab results show that there is a reduction in the number of red blood cells, a deficiency of platelets in blood, and high concentration of blood protein,which causes bleeding in the tissue, bruising, and slow clotting.
After the symptoms have progressed to their final state of internal bleeding and body systems shutting down, death will soon follow.
Economic impact in West Africa
Although many West African countries have had their economies affected by this deadly virus, Sierra Leone, Guinea, and Liberia have greatly suffered from it. When the Ebola outbreak became increasingly worse, fear and panic impacted many farmers. This then caused the food security of the West African countries to be threatened. In the worst affected areas in Sierra Leone 40% of farmers have abandoned their fields, leaving their crops to rot (BBC, 15 October 2014). These farmers left in fear that they were going to contract the virus not their crops. Ebola is not spread through food, except for bushmeat of infected animals. Since there is a lack of food in these countries, their food storage centers are losing stock. This is leaving many West African families with another problem to face; hunger (BBC, 15 October 2014).
Economic impact in the U. S.
Due to few cases of Ebola in the United States, we have not spent too much money treating the virus in our country. We have given Ghana’s government 1.7 million dollars. This is not the only impact the U.S. has seen, we have also had a decrease in tourism due to the outbreak. This is because many people are afraid to fly or leave their homes due to the outbreak.
Some parents in Houston, Texas did not want their children going to school when there was an Ebola case there. From some families this meant that one parent would not go to work, which then causes them to decrease their income. Even though this does not immediately affect the U.S. economy it can in the future. When families are making less money, they spend less money causing big and small businesses to suffer in their profits.
How does preparation for Ebola differ from hospital to hospital?
I recently went to the Rutland Regional Medical Center and met with a member of the Rutland Ebola team, Mr. Bastian Fagginger-Auer. When I asked him how the hospital prepared for the virus, he told me that they took inventory of what they already had and then they order other materials that they needed. He told me that some hospitals have spent hundreds of thousands of dollars preparing for the virus, but Rutland Regional Medical Center has only spent between five or six thousand dollars. RRMC exceeds the CDC’s recommendations for the Ebola preparation and protocol.
What can we do to prevent the spread of Ebola?
Preventing the spread of this lethal virus is extremely important. It is vital that if someone has been in West Africa and/or treating Ebola patients that they are monitored for a minimum of 21 days. This will allow for them to be carefully screened for any signs or symptoms of the disease. If indicated Quarantining these individuals will allow for the virus to be in one confined area if they did happen to contract the virus while treating others.
Another way to prevent the spread of this virus, or any virus for this matter, is by raising awareness. By informing people about the disease, its symptoms, the transmissibility rate, and how to respond if you or someone you know has the virus a few things will happen. The first thing that will happen is that many people will not be as scared by the virus because they know important facts about it. Another thing that will happen by informing people on how to react upon finding they are symptomatic is that they will know not to come in contact with others, which will decrease the likelihood of their friends and family contracting the virus.
It is also important to wash your hands often and to stay up to date on your immunizations. Getting a flu shot can make a big difference if you were to come in contact with the virus. Since you have the flu antibodies in your system from getting the flu shot, your body will only have to worry about fighting off one virus.
How is Ebola treated?
As of right now there is not a vaccine that is ready to be used on humans, but there are ways to care for someone with Ebola. If someone is showing symptoms of Ebola and it is determined that they do have to virus then they will be given fluids and blood when needed. This dramatically increases the survival chances because the patients is being treated as the virus progresses.