There’s been a lot of attention in the media recently regarding the ebola outbreak in Central Africa, so I thought it would be useful to learn the basics of this disease which has already killed more than 1000 people, and then move on to the drastic measures that have been taken to fight it.
Ebola, being a virus, works by entering the host’s cells, and manipulating them so it produces proteins to make more viruses rather than proteins to make new cells. It acts specifically on endothelial cells, those that cover our skin, line our blood vessels and other tubes in our bodies. To protect itself from being attacked by the immune system, the ebola virus makes cells produce a special glycoprotein which affects the mechanism with which white blood cells detect intruders, so it goes by undetected and can reproduce inside the cells.
The effects this has on the sufferer are diverse but horrible. They range from fever and headaches to severe internal bleeding. So far, there is no treatment, much less a cure or a vaccine, although there is a lot of work towards it. However, when a patient comes into a hospital with those symptoms, and eventually gives positive for ebola, there are ways to prevent the lethal effects of the virus, which can be mortal in 70% of the cases. Usually, he is given plenty of water to prevent dehydration, and can be prescribed procoagulants (drugs that stimulate blood clotting) in the later stages of the infection to stop large internal bleeding.
Since the start of the pandemic last December, it has become the largest ebola outbreak in recorded history, and although governments worldwide are fighting its spread and the WHO (World Health Organisation) has declared it a global public health emergency, the virus is still working its way through the population. At the moment, there are about 1700 infected people, all living in Africa, and all from only 4 countries, but without measures could expand to others. Fortunately, ebola is not airborne, and the only way to pass it on to someone else is by fluid exchange, for example by blood.
Due to the high incidence of the virus, there have been outstanding exceptions to the usual drug control. For example, it hit the news last week that the American government had approved the use of experimental drug ZMapp to treat two infected civilians in the USA, which then expanded to treating priest Miguel Pajares in Spain. After his death on the 12th, the WHO announced it was now legal to treat infected people in Africa with unlicensed drugs. However, ZMapp, the most popular one, is running out, so other countries like Canada are now donating other drugs which although are on the experimental phases, are thought to help treat ebola.
This situation is unheard of, and of course many people think it is unethical to treat humans with drugs whose efficacy and side effects are not completely known. But WHO says that the situation calls for extreme measures, so any chance of helping the diseased should be used. Even better, the people who are given those drugs will be closely monitored, and they will be treated as part of a clinical trial. This could eventually help identify effective drugs against ebola and at some point stop this catastrophe.