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Spread of the deadly virus challenges researchers, employees of public health systems

West Africa 2014 Ebola epidemic shows what can happen when an infectious virus in the midst of a population is caused by a broken medical system where fuel and cultural practices, public fears and permeable borders the spread of the disease.

Outbreak exposed a lack of scientific understanding of the Ebola virus. By the time the World Health Organization and others mobilized to confront the crisis in the middle of the year, employees of public health systems had already begun in the field, fall far short Ebolas distribution. Scientists scrambled to determine how it worked once inside the body.

The researchers a crash course in the vaccine and drug testing for products in the field with only animal tests could continue to go quickly to fight a virus that has no cure. This unconventional approach rapidly gained consensus mounted as the death toll.

Although Ebola has been recognized as a dangerous pathogen since it first appeared in 1976 had in the past, caused mainly rural outbursts in the sand on their own. Not this time. Arise at the crossroads of Liberia, Sierra Leone and Guinea, breaking out of this remote region jumped by stray cases in Europe and North America appear to be. The arrival in Dallas a visitor of Liberia, Ebola was diagnosed and later died, underscores the global nature of infectious diseases today (SN Online: 9/30/14). In early December, the epidemic had 6,346 people dead and at least 17,834 patients - more than any previous Ebola outbreaks, combining more than 38 years. About 35 percent of infected people died.

Ebola is a fearsome hemorrhagic virus that spreads through contact with body fluids. The disease shows itself caused by leakage of blood vessels as fever, headache, vomiting, and weakness. Patients experience severe internal bleeding and can lose more than five liters of fluid per day.

The Dallas-case led to speculation whether Ebola air could go. But researchers had reported in July that monkeys do not Ebola each pass through the air, indicating that it is extremely unlikely that people (SN: 9/6/14, p. 7). Ebola's natural reservoir is unknown, but bats are suspected because they carry the virus (SN Online: 8/11/14).

By sequencing the genome of viruses isolated from 78 patients, researchers tracked the strains responsible for the current epidemic of an outbreak in 2004 by Ebola virus in Central Africa (SN: 9/20/14, p. 7). It is unclear how the virus crossed the continent, traveling without triggering an outbreak.

To get a handle on why some people survive the infection, scientists mice resistant to Ebola with which it susceptible to and discovered that a gene responsible for blood vessel leakiness severity of the disease may play a role (SN Online: 5/11/14). Another study, published in the mbio found that the Ebola virus can edit its genetic material, adding additional RNA building blocks. These changes can affect how the virus grows in humans (SN Online: 04/11/14).

Ebola is cunning, appear with outbreaks and then melt into the jungle since time immemorial. In West Africa, the officials found that warning helps. After the epidemic began, nearby countries were on alert, and a small outbreak in Nigeria by a sick traveler Liberia caused defeated in October thanks prompt isolation of sick persons and monitoring of hundreds who may be exposed.

Nigeria's actions can hope. "There is evidence that this disease can be stopped by using tested and proven infection control and public contact tracing methods," says Jeffrey Duchin, an epidemiologist at the University of Washington in Seattle. An independent outbreak in rural areas of the Democratic Republic of the Congo flared in August and November was deleted, with this approach. But it killed 49 people initially.

Transmission control was missing earlier in West Africa epidemic. Many sick people refused treatment, domestic and unknowingly infected their families to stay. Traditional funeral customs, including touching the body, the virus continued to live. Rumors surfaced that foreign workers, the disease was spread. Without drugs or vaccines to offer and with inadequate fluid replacement IV and disinfectant supplies health care workers were underequipped to handle overwhelming problems.

A sick person can shed the virus for weeks. The intense risk of liquid contact became clear when some healthcare workers wearing biohazard suits fell ill. The specific exposure route in such cases says rarely traceable to a needlestick or other obvious injury, Daniel Bausch, Tulane University doctor who worked with people who became infected despite taking precautions. "It is much more subtle than that," he says. "You touch something and scratch your eye or customize your mask." And that's it.

In response to these appalling conditions delivered, and other makeshift clinics, coveralls, car care, laboratory equipment and other supplies. It sanctions, untested drug use in some Ebola patients. In August But supplies quickly ran, and the results little about the future drug value decomposition. In December regulators were planning to deliver several new Ebola medicines to patients, while the connections finalize effectiveness. Antibodies from the blood of the survivors are used as a treatment option as well. And test vaccine in healthy people had the prerequisites for use in the field (SN Online: 11/26/14).

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