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Ebola Virus I

Catherine Howard
Regina Mundi, Cork

One of the greatest threats to mankind these days is a lethal virus. Some, like HIV, which causes AIDS, have affected the human race greatly. The full effects of AIDS on the earth's population is not yet known, it can only be estimated. However, none are as terrifying as the sisters Ebola and Marburg are. They are members of a family of RNA viruses known as filoviruses. When magnified with an electron microscope (see photograph below), the virus particles have the appearance of thin pieces of thread and are thus referred to as thread viruses or "worms". The most lethal ones are the three sisters: Ebola Zaire, Ebola Sudan and Maburg. These viruses have no vaccine and no known cure.

Marburg, although not the most widespread of the three, is perhaps the most deadly. It has the infectious capability of the common cold and kills nine out of every ten people it infects. Marburg emerged in 1967, when it killed seven people in the town of Marburg, Germany. It broke out in a vaccine factory where they were using the cells of monkeys from Uganda. In all, 31 people caught the virus before it burnt itself out. It is much like radiation sickness in that there is substantial hair loss and massive internal bleeding. It would later emerge in Belgrade, Yugoslavia.

Virologists made Marburg a Level 4 virus. Virus containment (or biocontainment) is divided into four biosafety levels, based on infectious capability and potential for harm. Biosafety level 1 is of minimal hazard - Salmonella, E.Coli, etc. Level 2 is moderate biohazard and includes Hepatitis and Influenza. Level 3 is of a high biohazard and multiple vaccinations are required to work within it. Level 3 includes Anthrax, Typhus and HIV. Level 4 means extreme biohazard. Level 4 laboratories maintain maximum security. The infectious agents - Ebola and Maburg, Lassa Fever and Hanta, are all highly virulent and there exists no vaccines or cures.

When working in a level 4 laboratory, you have to wear special clothing for protection. These are known as "space suits", because they resemble the suits astronauts have to wear. Oxygen is pumped directly into the suit, never coming in contact with the contaminated air in the lab. In theory, they completely protect the person inside the suit from what lives in the air around them.

There are two types of suits - Chemturion and Racal. Chemturion suits are blue in colour and are for working in laboratories. When working in a lab, an air hose is plugged into the suit. Air circulates around the suit by way of the "blowers". The blowers make a lot of noise and technicians often have to wear earplugs. Then there is the yellow or orange Racal suit. These have a battery-operated air supply incorporated into the suit and are disposable. They are for fieldwork only.

A Level 4 laboratory is kept under constant negative air pressure. This means that if there is a leak, or something else goes wrong, the contaminated air would be sucked back into the laboratory instead of to the outside world. To get into a Level 4 lab, you have to go through an airlock and a decon (decontamination) shower on the way back out. It is policy for all work to be done in pairs so that they can each check each other's suits regularly.
All of the above measures are needed to contain and work safely with Level 4 viruses such as Marburg.

Then, in 1976, came Ebola.

It first emerged in both Sudan and Zaire simultaneously. In a mission hospital run by Flemish nuns in Yambuku, Zaire, a local schoolteacher came to the dispensary with what he thought was treatable malaria. The nurses gave him anti-malaria drugs and sent him home to his wife and young baby. Three or four days later his fever and muscle pains had progressed into severe bleeding and excruciating pain. They put him in a bed at the hospital and hooked him up to an IV. The hospital was understaffed and did not have adequate medical supplies. They were re-using syringes after only rinsing them with water. They had no choice but to do so. Therefore the same needle that was used to treat the sick schoolteacher was used to treat many other patients at the hospital.

When a person infected with a lethal haemorrhagic fever reaches the final stages of the disease they haemorrhage and die. Military experts have a term for this - they say the victim "crashed and bled out". The schoolteacher crashed and bled out ten days after he first visited the mission hospital.

Within weeks, the new and uncontrollable disease had devastated the tiny village of Yambuku. The symptoms and effects of Ebola on humans are terrifying.

For the first six days, the victim experiences back pain and headaches. They develop a fever and a sore throat. Some mistakenly believe that they are getting the 'flu'. Clots form in the blood stream, slowing the flow of blood to the major organs. Some experience what is called "third spacing" - when the blood fills the space between the skin and the flesh. As a result of this, red and white blisters appear on the surface of the skin. From the seventh day onward, the mouth, gums and salivary glands bleed. The lining of the tongue, throat and trachea either slips into the lungs or are expelled while the victim is vomiting violently. The liver dies. The kidneys fail and the blood becomes toxic with urine. On or after the tenth day, the eyeballs haemorrhage and turn red with blood. The heart softens and then bleeds into its own chambers. The lining of the gut is lost. In the last moments of the victim's life, they are sent into a fit, limbs thrashing wildly, spraying infected blood everywhere. It is at this time that the virus is trying to find a new host.

Viruses work by first latching themselves onto the wall of a cell, causing the wall to close around the virus particle and engulf it. Once inside, the virus particle sheds its outer layer of protein. The core (made of either DNA or RNA - Ebola is made of RNA) then attacks the cell, reproduces and then moves onto another cell. In the body, this takes about 25 minutes.
As the people of Yambuku were unaware of the dangers of the virus and how it was transmitted, many of them stayed with the sick and dying members of their families, and then went on to prepare the bodies for burial, as is the custom in that part of the world. Many were infected because of this.

Virtually unknown to the people of Yambuku, across the river in Nzara, a similar epidemic was occurring there also.

Several weeks into the crisis, one of the nuns at the Yambuku mission hospital fell ill. This was a great shock to the nuns - she was the first white person to become infected with the strange disease. Until then, it had only posed a threat to the natives of the village. (Unfortunately, it took the death of a white foreigner to reach for outside help, but even so it drew attention and help to these hot zones). Very worried, they put the nurse in one of the few motorised vehicles they had and sent her on her way to Maridi, where they believed there was a hospital. At that stage, no one who had become infected had survived.

But Maridi was in the midst of an epidemic also.

It was time to get outside help.

Ebola Virus II

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