Ebola virus: From symptoms of common cold to bleeding out the ears and eyes

That the Ebola virus has killed close to 700 people across mostly three countries  since a new outbreak in February this year is no longer news. There has been over 1200 cases in this particular outbreak which has been described as the largest outbreak of Ebola ever recorded.

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Not only has the virus spread from the primarily remote villages in  Central and West Africa tropical rainforests where it was, before now, prevalent, this virus which is one of the deadliest viruses ever known to man, has stealthily crept across  West African countries of Guinea, Liberia, Sierra Leone and has been  reported to have killed one in Lagos.
With members of the public succumbing to the blow from the virus, health workers, in spite of precautionary steps, are usually the worst hit. Besides local health practitioners who have, over the years, contracted the virus, foreign health workers providing charity services have also been affected.
Just recently, two doctors leading the fight against the disease in Africa – Dr. Samuel Brisbane, a top Liberian health official, and Sheik Umar Khan, a leading Sierra Leone doctor – have both died after contracting Ebola.
In the past week, there have been reports that health workers working at a charity centre for the Ebola virus in Liberia have been hit by the ravaging virus.
The health workers, both of whom are Americans, worked for the humanitarian organisation, Samaritan’s Purse, which has an Ebola care centre at the  outskirts of Monrovia, Liberia.
Dr. Ken Brantly, the 33-year-old Medical  Director for the care centre, was previously confirmed as infected with the  virus and just last week, Nancy Writebol, a Christian missionary who had been working as a  hygienist decontaminating those entering and leaving the Ebola care area at  the hospital, was showing full symptoms of the virus.
Though both Americans have been isolated and are under intensive treatment, Ken  Isaacs, the Christian relief group’s Vice President of Program and  Government Relations, said the fact that health care workers have been  infected underscores the severity of the West Africa outbreak that has  killed hundreds in Liberia, Sierra Leone and Guinea.
“It’s been a shock to everyone on our team to have two of our players get  pounded with the disease,” said Isaacs, adding that health ministries in those  poor nations are challenged to respond. “Our team is frankly getting  tired,” he stated.
Cambridge University’s Dr Peter Walsh, a lecturer in archaeology and  anthropology and an Ebola expert, said: “This strain of Ebola is probably the  second most deadly virus in the world after canine rabies. If you get  canine rabies, you’re going to die, but we have vaccines for that.” Ebola  virus, on the hand, currently has no vaccine or cure.
Though Ebola is introduced into the human population through close contact  with the blood, secretions, organs or other bodily fluids of infected  animals especially fruit bats and spreads in the community through human-to-human transmission,  with infection resulting from direct contact (through broken skin or mucous  membranes) with the blood, secretions, organs or other bodily fluids of  infected people, and indirect contact with environments contaminated with such fluid,
there are silent fears that the virus might have mutated and can now  be spread by airborne means and not just only through body secretions. One theory that fuels this suspicion is the fact that the two US Doctors, who  have now contracted Ebola in Liberia, did so despite adequate protection.
Additionally, one study carried out by Canadian researchers in 2012 showed  how monkeys can catch the deadly disease from infected pigs without coming  into direct contact, thus raising concerns about the previously thought idea that the untreatable virus, which causes massive internal  bleeding and multiple organ failure, could only be transmitted through  contact with infected bodily fluids.
The researchers at the University of Manitoba in Winnipeg deliberately infected six piglets with the Ebola virus and put them in pens where macaque monkeys were housed in wire cages.
Within eight days all four monkeys caught the virus through indirect contact, according to the 2012 study entitled “Transmission of Ebola virus from pigs to non-human primate” published in the journal Scientific Reports. Dr Gary Kobinger,  Head, Special Pathogens at the National Microbiology Laboratory of the Public Health Agency of Canada took part in the study.
He told BBC News that they suspect that large droplets of moisture containing the virus were being exhaled with the piglets’ breath.
“They (the virus) can stay in the air, but not long; they don’t go far,” he told the press men. “But they can be absorbed in the airway and this is how the infection starts, and this is what we think, because we saw a lot of evidence in the lungs of the non-human primates that the virus got in that way,” he disclosed.

Further work is needed but the findings are worrying as macaques are close genetic relatives to humans, said the researchers.
According to the World Health Organisation (WHO), Ebola has a death rate of between 50 and 90 per cent and  there are no specific treatments for the disease— treatment is primarily  supportive and includes balancing fluids and electrolytes to counter  dehydration.
Perhaps, what makes the virus more petrifying is the fact that the initial  signs of infection imitate other diseases, like common cold, malaria or typhoid. According to the United States Centers for Disease Control and Prevention, the incubation period for Ebola  ranges from two to 21 days. The onset of illness is abrupt and is characterised by fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhoea, vomiting, and stomach pain. A rash, red eyes and hiccups may also be seen. The virus pierces veins and capillaries, forcing the blood vessels to bleed into the surrounding tissue, resulting in internal bleeding in mostly  the gastrointestinal tract and other internal organs. The virus  aggressively wipes out the building blocks of the body’s immune system and tiny blood vessels burst, causing patients to spontaneously bleed from their eyes, mouths, ears, and other orifices.
Researchers do not understand why some people are able to recover from Ebola and others are not. However, it is known that patients who die usually have not developed a significant immune response to the virus at the time of death.
For those infected who survive, recovery could be quick and total, or prolonged with long-term problems including joint pain, muscle pain, skin peeling and hair loss.
In spite of the grim realities of this disease, researchers have been working round the clock to provide a vaccine, if not a cure to combat it.
Dr Kobinger, who recently returned from the front lines of the outbreak in West Africa, said that he believes this is the last time the world would have to combat the virus without specific treatments or protective vaccines. He added that the outbreak is the most challenging of the six Ebola responses he has been on, but he believes the containment efforts are making progress.
He suggested this outbreak will speed efforts to get emergency use approvals to employ some of the experimental vaccines and therapies in future Ebola epidemics.
“My really, really deepest wish — and I don’t want to call this a dream, because it’s not a dream — is that there won’t be another outbreak like this. This is the last one. Next time, we’ll be ready,” Kobinger said in an interview with the Canadian Press.
But Kobinger agreed with others in his field who have argued that it would be unwise to use untested tools this time, saying the Ebola vaccines and drugs must go through Phase 1 clinical trials in people before they could be used in an outbreak setting. Phase 1 trials involve giving a drug or vaccine to a small number of healthy adult volunteers to ensure that it is safe for human use.
“These are all experimental drugs that have not met the requirements, even for a Phase 1 (trial) right now in humans. So, they have to pass all the toxicity (tests), and the safety trials,” he said.
The WHO Regional Director for the Africa Region, Dr Luis Sambo, in a fact-finding mission to the three currently most affected countries, underscored the seriousness of the outbreak while reiterating that it can be contained using known infection prevention and control measures. He observed that the outbreak is beyond each national health sector alone and urged the governments of the affected countries to mobilise and involve all sectors, including civil society and communities, in the response.
Currently, the only way of combating infection is by prevention. If a person is in an area affected by the outbreak, or has been in contact with a person known or suspected to have Ebola, they should seek medical help immediately. This is not the time to visit spiritual houses or hide the victim. According to the United States Centers for Disease Control and Prevention, preventive measures include the following:
Practice careful hygiene. Avoid contact with blood and body fluids of severely ill people. Do not handle items that may have come in contact with an infected person’s blood or body fluids.
Avoid funeral or burial rituals that require handling the body of someone who has died from Ebola.
Avoid contact with animals or with raw meat.
Avoid hospitals where Ebola patients are being treated.
Seek medical care if you develop fever, headache, achiness, sore throat, diarrhea, vomiting, stomach pain, rash, or red eyes.
For health workers, who may be exposed to people with the disease, the following steps can be taken:
Wear protective clothing, including masks, gloves, gowns, and eye protection.
Practice proper infection control and sterilization measures.
Isolate Ebola patients from unprotected people.
Avoid direct contact with the bodies of people who died from Ebola.
Notify health officials if you have been exposed to someone with Ebola.