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Forefront Biological Sciences. How does the Ebola virus spread? Call Us At A New York Times article graphically described a scene , now distressingly common, in a West African clinic: "Nurses, some not wearing gloves and others in street clothes, clustered by the door as pools of the patients' bodily fluids spread to the threshold. In the next ward, a 4-year-old girl lay on the floor in urine, motionless, bleeding from her mouth, her eyes open. A corpse lay in the corner - a young woman, legs akimbo, who had died overnight.
A small child stood on a cot watching as the team took the body away, stepping around a little boy lying immobile next to black buckets of vomit. They sprayed the body, and the little girl on the floor, with chlorine as they left. What does the phrase bodily fluids really mean? How does the virus move from one person into another? Is it spread by coughing or sneezing? How long is the virus contagious? How quickly does it spread? It's a welcome change to hear good news about Ebola.
But how long does that take, for it to dry out or for sunlight to kill it? If somebody with Ebola throws up on the street, how long will it stay moist enough to cause disease?
Where does Ebola live in a patient? Is it partial to certain tissues? If it's so hard to get, why is it spreading so rapidly in West Africa? What does the word Ebola mean? It just sounds ominous. Where did that name come from? Should a patient turn up here, how would we handle them? How would we handle their bodily fluids and waste?
Priority one must be keeping the clinical staff safe. How foolproof is protective gear? After all this meticulous preparation, what do you worry about the most? How does Ebola compare to the other causes of death in Africa? Subscribe Now. Read more biological science articles. Contrary to expectations, study finds primate neurons have fewer synapses than mice in visual cortex. Study identifies potential target for treating systemic inflammation in obesity.
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New discoveries reveal how acute myeloid leukemia walks a fine line between growth and cell death. Maximizing health and wellness through microbiome research. UChicago researchers re-create sense of touch and motor control in paralyzed patient. I'd Like to. So, as the Centers for Disease Control and Prevention explained , "If a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person's eyes, nose or mouth, these fluids may transmit the disease.
The scenarios under which Ebola spreads are very specific. And Ebola doesn't spread quickly, either. A mathematical epidemiologist who studies Ebola wrote in the Washington Post, "The good news is that Ebola has a lower reproductive rate than measles in the pre-vaccination days or the Spanish flu. That means an Ebola victim usually only infects about one other person.
Compare that with measles, which creates 17 secondary cases. NPR has an excellent graphic to this effect:. If you do the math, a single case in the US could lead to one or two others. That's what happened in Dallas in one patient infected two nurses when he was very sick and therefore very contagious. Because we have robust public health measures here, the virus didn't spread farther than that.
Compare this situation with West Africa, which had to deal with more than 25, cases in a completely broken and underfunded health system. That's where experts say the worry about Ebola should be placed. Science is always evolving and never certain. And because Ebola is a rare disease, there are still many scientific avenues that need exploring. One of the enduring questions is where Ebola lives when it's not in humans.
Hunting for viruses is no easy task, and Richard Preston, author of the Ebola book The Hot Zone , summed up why this mystery has stumped virologists since Ebola was discovered:. It's just a weird conundrum. The scientists are all scratching their heads. It's an interesting problem. The guy who wrote the textbook on Ebola explained it to me: there is a gold standard proof that the Marburg virus an Ebola cousin lives in a particular species of bat. They've proved that. But that's Ebola, not Marburg.
They are both members of the filovirus family. With Ebola, there's a lot of speculation that it could be living in fruit bats. The fruit bat carries Marburg. Could Ebola be in fruit bats?
Living Ebola has never been found in a fruit bat. So maybe it could be in a tiny little tick or insect that lives on the body of a bat, and then it's infecting the bat and the bat infects a human. Those fruit bats are incredibly common in Africa. People eat them. They are supposed to be delicious. So there's all this contact between bats and humans. Shouldn't there be more Ebola?
But there isn't. Ebola could easily live in an arthropod. But go into a rainforest environment — ecologists haven't even given names to a lot of the insects there, and when it comes to mites and ticks, forget it. Even experts have real trouble distinguishing one species of insect from another.
All of a sudden, you have to test thousands of creatures for Ebola and you still might not have found Ebola because it might be in that insect you didn't test. There's something here we're not seeing. Scientists also aren't sure why some people get Ebola and others don't.
They don't know why some folks with Ebola never show symptoms and can't spread the disease to anyone, while others are "super-shedders" with very high viral loads — and are therefore very contagious. They are still learning about the long-term side effects of Ebola, and whether survivors have lifelong immunity to the virus meaning they can't get it more than once.
Some researchers are looking into whether Ebola today has mutated to become more contagious than it was previously, and how that will impact the reproductive rate of the disease. So far, it seems it evolved at a normal rate this time around.
Most scientists aren't concerned that the virus will mutate to become airborne , however, since a virus has never been known to change the way it's transmitted.
The unprecedented scale of the current outbreak is tragic, but it will hopefully help answer some of these questions. In fact, this epidemic has already served up new insights into the virus. First, the traditional approach to containing an Ebola outbreak — tracing the contacts of the infected person and isolating them — is extremely difficult to scale when thousands are involved.
The second lesson relates to how Ebola spread today versus how it spread when it was discovered in Because of the changing economic and social dynamics in Africa, people travel more than they did in the past, and many regions have urbanized. This means outbreaks are less likely to be relegated to rural and remote areas and can therefore get much larger. Which means, Michael Specter pointed out in the New Yorker , "in a world where almost any incubation period is longer than even the farthest plane ride, we are all only as safe as our most vulnerable nations.
When people get antibiotics quickly and have their fluids replaced, they tend to live. But, again, this is truer in strong health systems with good access to care than it is in impoverished countries like Guinea, Liberia and Sierra Leone.
To learn more about the latest science, the New England Journal 's Ebola outbreak page and Science 's special Ebola collection are great resources. Before , Ebola was a disease that was mostly confined to remote African villages. Health officials didn't worry about it reaching epidemic proportions. And then Ebola went global. Since then, there have been 20 other outbreaks , but they have usually occurred in isolated rural areas and died out quickly. The countries involved — DRC, Gabon, Sudan — have experience in stamping out the virus before it spreads.
This year has, in many ways, changed people's notions of how Ebola can move through populations. Specifically, researchers now contend that he might have played in a tree filled with fruit bats and contracted Ebola that way. By the time the Ebola outbreak was identified in March, it had already spread to all three countries along the border. And it kept spreading: in July, a Liberian American got on a plane bound for Nigeria, bringing the virus with him and spurring 20 cases and eight deaths in Africa's most populous country.
Soon, another case turned up in Senegal. In Spain , a nurse who had been caring for a repatriated priest got the virus in Madrid. Mali confirmed an Ebola case last October: a 2-year-old girl who had recently returned from neighboring Guinea who has since died, leading to the discovery of several other cases and deaths. In December , a health worker returning from Sierra Leone to Glasgow, Scotland , was diagnosed with the virus.
That's nine countries hit with Ebola in one year. There's never been an Ebola outbreak like this before. The usual methods for containing Ebola, like tracing patients' contacts, haven't scaled to outbreaks of this size By October , Senegal and Nigeria were declared virus-free, having stopped their small outbreaks.
By November, so was the DRC. Mali also has zero suspected cases. In Scotland and the US, the virus did not travel very far. On May 9, , Liberia was finally declared virus-free , but there are still cases in Guinea and Sierra Leone, "creating a high risk that infected people may cross into Liberia over the region's exceptionally porous borders," the WHO warned. The epidemic has dragged on in West Africa, in part because the usual methods for containing Ebola — like tracing patients' contacts — don't scaled to outbreaks of the size that Liberia, Guinea, and Sierra Leone had to battle.
In the past, public health officials had a playbook for stamping out Ebola. Because the disease isn't very contagious and spreads slowly, they just needed to find all those infected, quarantine them, and identify everyone they'd been in contact with.
This could be done in sparsely populated rural areas or places with only a few cases. But an epidemic is much harder to contain when suddenly many countries are dealing with hundreds or thousands of cases. Since West Africa had never seen Ebola, the virus had a three-month head start before health officials in the countries involved even realized they were harboring an outbreak. It didn't help that the international community was very slow to bring aid to the region, only declaring a public health emergency in August, five months after the first international spread.
For these and other reasons, the current Ebola epidemic in West Africa continues to burn. Nina Pham, the Dallas nurse who contracted Ebola.
This makes other approaches to understanding the course of disease important to try. We are now collaborating with people at other labs who are using animal models of the disease. When we compare this response to other viruses, it appears that the response to Ebola is much stronger than to other types of disease. Also, it appears that specific types of responses are associated with survival from the disease.
We are investigating whether this early immune response can be used to develop a diagnostic for early disease. Can we look very early, even before symptoms show up, and identify an immune system response to an Ebola infection? It also appears to be the type of responses that develop.
One of the things we see in animals that succumb to the disease is one type of immune cell—a type of neutrophil—accumulates, whereas in animals that survive, that immune cell is not as abundant.
There are no Food and Drug Administration —approved therapies. People are beginning to develop some therapies, and information from those studies says that the earlier an individual is treated, the better their survival. If we can find ways to diagnose infection early, that will directly help effective therapy. And with early diagnosis, if you identify one patient that is symptomatic, suggesting that their course of disease is far along, early tests like the one we are developing will allow rapid testing of contacts of that first patient and early treatment of those infected with the disease.
We are really trying to understand what this very overactive immune response is and how we can start damping it down.
Our lab is also developing antivirals that work against Ebola, and we are working on diagnostics that will be at the point of care. We have been focusing on developing a diagnostic for Ebola, Marburg, and Lassa, where point of care is a high priority. Tomorrow: Tracking the Ebola virus. Art Jahnke began his career at the Real Paper , a Boston area alternative weekly.
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Moderators are staffed during regular business hours EST and can only accept comments written in English. Statistics or facts must include a citation or a link to the citation. It can possibly infect a new victim via a cut or scratch on the skin, and can certainly do so through an injection with an unsterile needle.
It can also be spread sexually. A small number of people, although infected, do not develop serious disease. Most others, however, are susceptible to the virus and will fall ill. The incubation period is between four and 16 days. Once inside the body the virus multiplies and invades all the major organs.
There is a high fever, headache and joint pains, vomiting and diarrhoea. The characteristic haemorrhaging or bleeding is caused by a process called DIC - disseminated intravascular coagulation.
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