Ebola

A few months ago, the word “Ebola” wouldn’t have meant anything to most of us. But since the outbreak in West Africa started back in March and came to the attention of the media a few months later, it’s been all over the news! Having been taught about viruses in my clinical microbiology Masters, I’ve been following events with geeky interest and asking: what exactly is this virus that’s made the world so alarmed?

Instead of just re-stating the safety information and news updates that are out there on good websites like the World Health Organisation and Centers for Disease Control, I thought I’d write a bit about what the virus itself is like.

Ebolavirus (say it like a Yorkshireman: “eeeee-BOH-la”) is actually the genus name of the bug, like the Homo in Homo sapiens. The species that caused the outbreak in West Africa is called Zaire ebolavirus, and it was first discovered in 1976 near the Ebola river in the Democratic Republic of the Congo (used to be called Zaire).  Ebola is part of the Filoviridae family, so-called because viruses in this family look a bit like pieces of string – the Latin word filum that the name is taken from means “thread”. Marburg virus is also part of the same family.

Both Ebola and Marburg viruses cause something that’s called a “viral haemorrhagic fever”, or VHF. VHFs are caused by a number of viruses, and these viruses tend to be ones that have jumped from animals to humans. Normally, Ebola infects fruit bats. The theory is that these viruses are adapted to their animal hosts, so cause massive problems in humans because we’re not the same. This can be things like haemorrhaging (bleeding), hence the name of VHFs, but can also be vomiting, diarrhoea, and brain-related things like confusion and delirium, besides the standard “flu-like” symptoms of fever and muscle ache that you get with viral infections.

At the super-tiny level, the way things interact is all about shape. It’s a bit like those toys that babies have, with the holes that are different shapes and only the square block will fit in the square hole. Viruses have proteins on their outside that they use to stick to cells with proteins on their surface that are the corresponding shape. Then the virus can get into the cell and start reproducing. Ebolavirus infects cells called fibroblasts. These guys make collagen and are found in stuff called connective tissue – basically the bits of the body that stick other organs and bits of organs together. They also tend to be near to cells called endothelial cells, and epithelial cells, which can then get infected, too. Endothelial cells line the inside, and epithelial cells line the outside of things in your body, and that’s why Ebola can get transmitted through body fluids.

The reason that Ebola is scary isn’t just its horrible symptoms, but also its relatively high mortality rate (roughly 50% on average, but has ranged from 25-90% in the past) and the fact that it’s spread so much. From what I can tell, it seems like a big factor in this has been the state of the countries that it has broken out in. Sierra Leone and Liberia didn’t have strong healthcare systems to begin with, and the system has collapsed under the burden of this outbreak. They simply haven’t had the resources to contain the spread of the virus and treat people. And the worst of it is, with the proper control measures the virus wouldn’t spread because it isn’t all that contagious. If you look at the average number of people someone infected with Ebola infects, it’s less contagious than SARS, measles, Hepatitis C, and even HIV. If Ebola ever came to the UK, I reckon we wouldn’t have a full-scale epidemic on our hands here. We can quarantine people, we have beds for them, we have a health system with contingency plans for this kind of thing .

There’s no need for us in the UK to panic. But there is a huge need for us to pray for the situation in West Africa, for the people working hard to treat patients, for the patients and their families, for rich countries to help; and pray that God would use this to show His glory. No matter how bleak things look, it’s all in His sovereign plan that He works for good.

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