Ebola is one of the filoviruses (Marburg is the other known filovirus). The filovirus family is small and remarkable because both known viruses typically cause a hemorrhagic fever that is fatal in many cases. Ebola has several heavily studied strains, typically named for the location where they are found (A case was made for a strain named Ebola Mayinga, which was isolated from a nurse who was treating a patient from Zaire. Her strain had a case fatality of 90%). Most of the strains are named for locations within Africa (where all, so far, of the human fatalities have occurred). Ebola is small. It gets into the body any number of ways. From there it attempts to get into a cell. Once there it grabs a hold of the cellular machinery and start churning out copies of itself. The cell literally begins to ooze out spaghetti threads of virus before ultimately falling apart, shedding thousands and thousands of viral particles to start the next infective cycle. This disease devastates tissue and moves incredibly fast. Organs are horribly damaged before you even realize there is a problem. Ebola circulates through the blood, therefore it has easy access to the walls of the vasculature (Arteries, veins, and capillaries). Its perfectly happy to jump into the epithelium lining these vessels, replicating within them and ultimately destroying the cells lining the vessels. As the vessels are damaged, the body responds by attempting to seal the leaks in the vessel walls by clotting. The body goes into a clotting overdrive trying to patch all of the damage that is happening throughout the vasculature. Very quickly, the body uses up all of its clotting capability. In a perverse turn, this hyperactive clotting attempt allows the body to bleed freely. From everywhere. Patients will cry blood colored tears, blood will ooze from under their fingernails, their gums will bleed around their teeth. This bleeding isnt limited to the outside world, either. Within their body, bleeding is happening within the gut as the GI tract lining is destroyed and shed. Some patients freely urinate blood. Early deaths may happen for patients who have bleeding in the brain. The central theme is that the bleeding starts to happen everywhere. However, the virus is pretty cagey. It doesnt (typically) devastate the lungs, heart, or brain. The patient is still going, surviving as their body is being destroyed by a runaway virus. This virus is hijacking almost every cellular process it can to make more copies of itself. Meanwhile, the virus is being shed in all of this blood. Happy to infect any cell it can gain access to. Because of the bleeding in the mouth (and from the GI tract), the patient is expelling virus with every breath. In many cases the patient will suffer from seizures (either due to brain damage from small bleeds or due to metabolic processes that have been deranged by the virus activity). These seizures will throw infective fluids far from the body, catching others unaware. Literally everything that comes out of the body is radiantly infective at this point. Cures... We dont really have any right now. Supportive care is possible, if you can safely care for a patient this infective, AND you have the infrastructure to pour resources into the patient (Africa is not known for its incredible medical infrastructure). Finding a cure is difficult. The disease is reported to be incredibly painful. For the patient, most of their epithelial linings will be damaged and probably slough off. Imagine the lining of your mouth, throat, stomach, intestines, urinary tract peeling off. Your epidermis tends to stay intact, but frequently horrible bruises mottle the skin as anything beyond the most trivial contact results in massive bruising under the skin. Finally, for many of these patients, theyre mostly conscious throughout the process, saving the occasional seizure (I think there was a study looking at survivability versus seizures in Ebola patients. The less seizures, the better outcome). That means theyre awake for all of this. ***The current epidemic in West Africa is noteworthy however because, for the first time in documented history, the ebola virus has reached major population centers. But thankfully this strain has a 60% mortality rate rather than the 90% seen in Zaire.
Posted on: Wed, 27 Aug 2014 11:50:45 +0000
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