THE EBOLA VIRUS

• What is the Ebola Virus? And where does it Originate from?
• Outbreaks, Past and Present. Containment and Prevention.
• Transmission
• Symptoms, Vaccination and Cures
• Important Cases of Ebola in Spain.

The Ebola Virus, or Ebola Haemorrhagic Fever, is a disease of humans and other primates caused by an Ebolavirus, from the the Virus family, Filoviridae. It is the most deadliest species out of all 5 in the Ebolavirus Genus. The EBOV Genome is a single stranded RNA approximately 19,000 nucleotides long. The Ebola Virus and its Genus were first described in Zaire and is closely related to the Marburg Virus. It was only named "Ebola Virus" in 2010 to avoid confusion. The Ebola Virus, due to its high mortality rate, is classified as a Risk Group 4 Pathogen.

Signs and symptoms of Ebola Virus Disease usually begin suddenly with an Influenza-like state characterised by fatigue, severe fever, headaches and pain in the joints, muscles and abdomen. Vomiting, diarrhoea, and loss of appetite are also common. Less common symptoms include: sore throat, chest pain, hiccups, shortness of breath and trouble swallowing. The average time between contracting the infection and start of the symptoms, or the incubation period, is 8 to 10 days, although it can vary between 2 to 21 days. Skin manifestations may include a maculopapular rash. In 50% of cases bleeding from puncture sites and mucous membranes has been reported.

In the bleeding phase, which typically occurs 5 to 7 days after experiencing the first symptoms, internal and subcutaneous bleeding may present itself in the form of reddened eyes or bloody vomit. Bleeding into the skin may create petechiae (Small purple dots around the surface of the skin), Purpura (Discolouration of the skin), ecchymoses (Large Pupura) and Hematomas (Collections of Blood outside the blood vessels). Heavy bleeding is rare and is usually confined to the gastrointestinal tract. In general, the development of bleeding symptoms often indicates a worse prognosis. All people infected show some signs of the circulatory system being involved. If the infected person does not recover, death due to multiple organ dysfunction syndrome occurs.

After extensive research, scientists have considered that Bats are the most likely natural reservoir of Ebola Virus, after 24 plant species and 19 vertebrates were experimentally inoculated with Ebola, only bats became infected. It is also because bats were known to reside in cotton factories during the first cases in 1976 and 1979 outbreaks and they have also been implicated in the Marburg virus infections in 1975 and 1980. After bats contract Ebola, they then come into contact with primates, and humans. The main reason Ebola is spreading so quickly, is that after bats transmit Ebola onto other species of animals, that act as hosts to the virus, are then consumed by native Africans. This form of food is called Bushmeat, and is very common in rural and tropical areas in Africa.

Where exactly did Ebola originate from? In 1976, Ebola first emerged in Sudan and Zaire, and is named after the river Ebola, located in Zaire. The first outbreak in Sudan infected over 284 people, with a mortality rate of 53%. The second Ebola virus emerged from Yambuku and Zaire, with the highest mortality rate of any of the Ebola viruses, that being 88%, infected 318 people, most of which died from the fatal illness. Despite years of research, Ebola's natural point of origin was never identified. The third strain of Ebola, was first identified in 1989 when infected monkeys were imported into Reston, Virginia, from Mindanao in the Philippines. The last strain was discovered in 1994, when an ethnologist performed a necropsy on a chimpanzee infected with Ebola.

In mMarch 2014 the WHO reported a major Ebola outbreak in Guinea. Researchers traced the outbreak to a two-year old child who died on December 28th, 2013. The disease then rapidly spread to the neighbouring countries of Liberia and Sierra Leone. It is the
largest outbreak of Ebola ever documented and the first recorded in the region. By the 10th of October, 8,376 suspected cases of Ebola have been reported and alongside the reports 4,024 dead. However, the WHO has said that these numbers may be vastly underestimated. The WHO reports more than 216 healthcare workers among the dead, partly due to lack of equipment and long hours.

Aside from the human cost, the outbreak has severely eroded the economies of the affected countries. A financial report suggested that the economic impact of the Outbreak could kill more people than the Virus itself. As of September 23, in the three hardest hit countries, Liberia, Guinea and Sierra Leone, there were only 893 treatment beds available while the current need was 2,122. In a 26 September statement, it was reported that The Ebola epidemic ravaging parts of West Africa is the most severe acute public health emergency seen in modern times. Never before in recorded history has a biosafety level 4 pathogen infected so many people so quickly, over such a broad geographical area, for so long.

A very recent and important case of Ebola,Is that of Teresa Romero. Teresa Romero, is the first person known to have contracted Ebola outside West Africa. She had treated 2 Spanish Missionaries who later died from Ebola. A WHO adviser has warned that more Ebola cases can be expected among medical staff, even in developed countries. She remains in quarantine in the Spanish Capital, along with her Husband and 3 other people. Currently, 50 people are under observation in Spain after reporting High Fever. The infected nurse was part of a team of 30 staff at the Carlos III hospital in Madrid, looking after the missionaries when they were repatriated from Africa. She contracted the disease while taking off her protective suit with her hands, and then touching her face

There are various methods of prevention of the Ebola Virus, some which include Isolation of Patients, Sterilisation of Equipment and Surfaces, Wearing protective clothing and avoiding contact with the Deceased. In order to reduce the spread, the WHO recommends raising community awareness of the risk factors for Ebola infection. Ebola viruses can be exterminated with heat, but, you must keep it at a temperature of 60 degrees Celsius for 20 to 30 minutes. Putting cities under Quarantine, or enforced isolation, is also another method of containment. Governments often Quarantine areas where the disease is occurring or individuals who may be infected.

A number of experimental treatments and medications are currently being studied, such as antivirals. Which include, Favipiravir, BCX4430, Brincidofovir and Lamivudine. Lack of available treatment options has spurred research into a number of other possible anti-virals targeted against Ebola. As of September 2014, no vaccine was approved for clinical use on humans, it is hoped one will be available for testing in November, 2014. The most promising candidates are DNA Vaccines, that produce an immunological response to the Foreign Organism.

In conclusion, the Virus has caused over 3,798 deaths and counting, an economical cost of $32 Bn, it has devastated Western Africa, costing thousands of lives and infected many people outside of Africa. It is one of the worst Viruses of our Century, and certainly the largest. Not only has it devastated the human population, but it's also diminishing the population of Gorillas, native to Africa. We can only hope for a Cure or Vaccine.

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