Just When You Though Ebola Was Behind Us

 

Ebola, Mutation and a Lack of Preparation

Under a microscope an Ebola virus reminds me of a sailor’s double half hitch.  It is a virus of African origin, a hemorrhagic fever, meaning it causes intense bleeding, frequently from every orifice of the body, in the later stages of the disease.  Ebola virus disease (EVD) typically emerges periodically in small villages of Central and West Africa, near tropical rainforests.  

Ebola’s natural host is probably the fruit bats of the tropics.  When the disease moves to larger animals, principally primates (humans are primates) it becomes fatal.  When the people of these remote villages find the ill or dead primates and use them for food, Ebola enters the human population where is kills and spreads—always through contact with infected bodily fluids.  The disease first appeared in 1976 simultaneously in two countries, the Sudan and the Democratic Republic of the Congo.  At that time, it had a 90% mortality rate and was relatively self-contained.  Ebola outruns its supply lines by killing off its hosts so fast that they have no time to infect other people—thus limiting the life span of the disease.  

            Now, however, the roads are better, we have routine air travel between Africa and the rest of the world.  It takes from 2 to 21 days for humans to begin showing infection from Ebola and during that entire time any contact with human bodily fluids spreads the disease.  The infection can enter the body through pores in the skin, eye membranes, nasal passages (though it is not airborne) cuts in the skin, the mouth or reproductive passages.  Even a man who has survived Ebola can transmit the virus in his semen for up to seven weeks.  In a small, isolated village this is devastating.  In a large, dense, mobile, city environment, it can be apocalyptic.

In the modern world Ebola infected people are going to get to America.  We owe it to these people to do what we can to help them survive a disease that traditionally has a 90% mortality rate (60% now due to either better help or a fortuitous mutation).  But Ebola has never existed in this hemisphere.  If let loose it would be in a virgin territory--like smallpox among our Native Americans.  We had best hope that both the technology and the protocols work in this case. 

Unfortunately, that virus will now enter  a United States where science is treated like the enemy, where funding for research and medical advancement has been slashed past the bone, and where the people in charge have no medical training and no intellectual vigor.  We even have a Secretary of State that says he is too busy with Cuba to worry about something in Africa.  That statement is as unhinged from reality as is the Secretary’s boss. 

In all of this, of course, we must remember nature’s wild card:  evolutionary mutation.  Ebola came from something.  It has not always existed, at least not in its present form.  It became the killer it is by changing, slowly, to a form that allows it to exist to its advantage.  Like all evolutionary changes, this is not a conscious effort on the virus’ part.  It is random and accidental, the result of some mistake in genetic formation.  Most mutations are detrimental to the organism and result in death, with no chance for the change to be passed on.  Occasionally, a change is beneficial.  Some changes (like an ability to thrive in the body temperature of a chimp, as well as a bat) allow that organism to live longer, live better, and have lots of other little baby Ebolas that look and act just like their parent.  That is a successful mutation, and simple, constant evolution.

This disease is back in America.  And it would be best to remember that when it comes to viruses, that which does not kill you mutates and tries again.  

Face reality and keep the faith.

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