Understanding Ebola

gets your earlobes. But we did want to discuss it because it has picked up obviously so much traction in the last couple of weeks here. Yeah, I mean, just the word ebola on its own, especially right now, is enough to just summon all these feelings of fear, these feelings of personal body horror, uh, and even xenophobia. I mean you see that popping up, especially all over social media, where it's suddenly these attitudes of keep it over there, keep people away from me, I'm gonna lock myself with

my home and no strangers allowed kind of mentality. Um, But you don't have to give into the full on fear, the full and paranoia, uh, certainly Ebola is a very dangerous virus, and we're going to discuss why it's dangerous and and and why it is UH pivotal that we

that we focus on it. UH. But in this episode, we want to we want to lay out the science of ebola, the science of the of a Bola virus disease and UH and discuss what it is, how we're fighting it and UH and and hopefully you'll leave this podcast with a lot more information about what's going on in the world right now with it. Yeah, because it can be overwhelming to hear the statistics and to hear

how it spreads. And I have to say, I think that's some news meeting outlets don't necessarily give it the context that it needs. So you have all these sort of free floating facts out there that can really inspire UM a lot of fear in people. And here's here's a good example. This is, you know, the worst outbreak of evil of this virus and history UM happening right now in West Africa, is claimed more than seven lives and this is according to the latest count from the

World Health Organization. And we have deaths occurring in Sierra Leone, Liberia, Guinea and Nigeria. So I'm sure you guys have all heard about this and that it is spreading. In fact um, Margaret Chan, who is the chief of the World Health Organization, said that this outbreak is moving faster than efforts to

control it. All of that sounds a little a bit chilling, But we'll discuss more about why this is and give it a better context so that we don't react to it in a way that's fear based, and hopefully we can come to this conversation with with more thoughts on how it's actually working and why it's spreading quickly. Yeah, and I mean on top of that, of course, the other side of the equation here is that that we have two American AID workers from blind Berria that are UH.

They are currently in Atlanta right here where we record the show UH to receive treatment from Emory and the CDC Special Treatment facilities, and people have responded to that with varying levels of fear and paranoid like I have you Have you even seen it on the the stuff to Blow your Mind Facebook message board where we have we have a lot of followers now, so that's different

demographics are are represented there. But I've seen comments like, you know, of course, keep them away, don't bring it here, or or what if the plane crashes, or and and a lot of this is it's you know, there there

are several different forces at work here. I mean, part of it is, you know, people are tuning into UM even in just in their peripheries, into a into a twenty four hour cable news cycle that has to really ride stories like this until the horse collapses, uh and get as much as much juice out of it, as much fear as possible. You're you're also dealing with people who have with the people who have depended on movies for a lot of their understanding of of what what

the pandemics and epidemics that consists of. I mean, even right now, one of the more immediate examples that comes to mind is there's just a show on effects called The Strain with a vampire pathogen and granted nobody's looking at that would I would imagine and and seeing anything other than fiction there, But there's enough uh reality in the coloring of that show that that it ends up informing your perception of what it means to bring UM

a pathogen into the country. But you know, particularly when you consider, too, that bats are peripherally involved with this virus, which we'll talk about in a moment. Um. This is from Time magazine writer Scott z Burns. He says, the people who are infected with ebola developed a screenwriter's list of symptoms, bleeding from the mouth, nail beds, and eyes, as their capillaries disintegrate inside them, their brains awash in the blood of hemorrhagic fever, become deranged, and there is

no vaccine, there is no cure approved for use. So again, to your point, this has a filmic quality to it, and you can't help sort of run with some of that now, and you would be so silly, I must said, too, can be completely you know, unfazed by that description. I mean, that is a fearful reality that we're talking about there. It is also a sensationalized version of this too, and we'll get into that when we talk about symptoms. But

let's just tether this to to some other information. UM. I'm sure everybody knows this, but I think it's it's helpful to just repeat it. Um, we're talking about human to human transmission are occurring as a result of close contact with blood secretions or tissues from patients where the virus can travel to a new victim through mucostal surfaces or breaks in the skin. So this is not something

that you can catch in the air. Um. Again, that's just I feel like that must be grounded in our imaginations here, because otherwise we can kind of run well with this. And I think hence your point about the message board and oh what if the train of the plane goes down, and what if it spreads from person to person? Yeah, yeah, we we do not see that in the in the in the variations of abola that

we're talking about here. Um, it's not the kind of thing that is that a healthy looking stranger on a train is going to cough in your general vicinity and then you're gonna catch it. No, but it would in the film. It would in the film, of course, because that's uh, that's the kind of fearful pathogen that you want to base a movie around. All right, let's get down to brass tacks and talk about this virus. Yes, so yeah, it is important to just start at the

very basics. We are talking about a virus, and a virus is a small infectious agent that replicates only inside the living cells of other organisms. Biological viral infections are spread by the virus, which is essentially a small shell containing a genetic material, and it injects its content into a far larger organism cell and so then that cell is infected and eventually transformed into a biological factory producing

replicants of the virus. So you know, it's it's the basic genetic mission of any organism at a very simple level. It just gets in there, it makes more copies of itself and pumps those out. Um. But of course it's a it's an invader, and there are uh, with any virus, they're gonna be there's there's the potential for for varying ill effects and uh, and that's the problem, right. Uh. And so the Ebola virus that we're talking about here is a is a philovirus belonging to the virus family

Philo variety. So far, we've only identified two members of this family, the Marburg virus and the Ebola virus, and of a Bola viruses we've identified five species. Uh. There's the Thai forest formerly known as the Ivory Coast ebola. There's Sudanese Ebola, there's Zaire Ebola, there's rest in Bola Ebola, and Bunda bug Yo. Yeah, and the one that is taking hold right now in Western Africa is the Zaire strain. Yeah. Um,

the rest of his strain is an interesting one. If you guys want to find out more about that, check out the how stuff works article how Ebola works, because that kind of goes into that strain which is not dead lady humans. It is among other animals, but not to us. And that one originally in the Philippines apparently that did, but it has made its way into the US. And I don't want to spend a long time on

that one because it really truly isn't deadly to humans. Uh. But the article has a great treatment of it and great information about it. So if you look at this at the philovirus virons of iron being the individual virus um, it may appear in various shapes, including long or branched filaments as well as a shorter filaments that may look like a six or a U or a circle. By now, I feel like every article you found on find online about ebola is kind of using the same image of

the viron. So just think of a colorful shoe lace, and you kind of have the idea of what you're looking at. Yeah, it's that blue shoelace among the red tissue. And this is a small crater. We're talking filaments to measure up to fourteen tho nanometers in length. They have a uniform diameter about eighty nanometers and they're enveloped by a fatty membrane. And each viron contains one molecule of single strand negative sense RNA. So it's it's a very

simple little creature. This is I mean to even call it a virus, a creature. You get into a lot of uh contested space there, but it's a it's a very simple element in the body that causes this. But it begins replicating and that's where the problem. Yeah, and scientists don't have all the details about how evil it works in the body, but they do have a handful of facts. Um, you just mentioned a couple. The Ebola virus is most closely related to the viruses that cause

measles and monks. And one of the proteins, and it is suspected to be the superpower of the ebola is called glycoprotein, and it binds to host cells, so that the virus can enter and then replicate, and the other version is then released from the infected cell and may play a role in suppressing the immune system. And then the virus is pretty much impartial and will infect a wide range of cells in our bodies, but early on

typically it goes after those associated with the immune system. So, just to give a little history on an ebola here, this is not one of those illnesses that we have, you know, ancient records of. If we go back to the ninety seven that's when lab workers in Germany and Yugoslavia were handling tissues from green monkeys and they developed hemorrhagic fever and we ended up identifying the Marburg virus um.

There were thirty one cases seven deaths so associated with this particular outbreak, and the virus was named after Marbor, Germany because that was the side of one of the outbreaks. Now, fortunately we haven't seen that many outbreaks of Marburg virus over the years. The worst of these was two thousand four, two thousand five outbreak angola, and that claimed two fifty lives with death rate. But but so far that's been the worst of Marburg. Now, as far as I Bola

virus goes. We first identified that in seventy six when two outbreaks occurred in northern Zaire and in southern Sudan, and these both occurred in the in the area of

the Ebola River. Thus the name in Bola virus. Yeah, and I wanted to just get into a little bit of detail of one of those cases, the one and then in the then country Zaire Um that was in as you say, and that wasn't a man named Mabolo, and he had some symptoms of a really high fever and they thought, okay, malaria, right, and they used the drug Quinnona on him. It was administered to and with

a needle. And because medical supplies were in in really short supply, a needle in high demand, they use that needle over and over again, and that just infected scores of other hospital patients. Now, a month later, Maballo died and his family performed the ritual burial of removing all food and waste from his body with their bare hands. So this is you've probably seen this in the media

before that this is part of the burial ritual. Weeks later, eighteen of the family members participating in the ritual died, and since then ebola has reserve for something like twenty times, spreading farther and farther out, perhaps because of bats and and changing conditions due to climate change. And we'll talk more about that in a moment um. But I think that that example kind of sets the stage for what

we're seeing today. Yeah, key there, especially the handling of dead bodies and close contact with sick individuals during the depths of their sickness. Yeah. And of course now we have disposal methods in place for a new needles that's known, but that was sort of the first vector there. Yea. Now, so you mentioned the bats, and currently sciences scientists believe that bats are likely the reservoir host for a bola. Now, reservoir host can harbor a pathogen indefinitely with no ill effects.

But we've also seen ebola spread through guerrillas, chimps, and uh a duker, which is a type of antelope. Uh. And in these cases, uh, they're often deadly results uh. Though some also think that non human primates are just more or less an accidental host, much like human beings. Now you mentioned uh only mentioned Scott z Burns earlier that pizza. He wrote for Time magazine opinion piece titled Contagion,

screenwriter Ebola isn't the pandemic fear is. He has just a little bit at the beginning where he mentioned the bat. I just wanted to read that because I thought it was so concisely put. He says, there is an animal somewhere in Africa, most likely a bat, that has worked out an arrangement with a microscopic agent. The deal is this, the agent won't kill the bat if the bat will transport it to other warm blooded animals and give it

a chance to do its gruesome work. All the bat had to do to enter this arrangement was built up resistance to the agent over generations and become a good hiding place and then continue about its business of being a bat. I like that because that really gets to the heart of again, what is a bola from from a biological standpoint? How does it fit into the environment.

Because it's easy to just think of these diseases it's just an absolute sort of evil, awful thing that rises up and destroys and without remembering that, it is, like everything else, just fulfilling a genetic mission. It is a classic zoo nootic disease meaning that occurs naturally in animals but can be transmitted to humans. And it does look like bats are their best chance. As you say, they

have built up an immunity. And according to the World Health Organization, pig farms in Africa can play a role in the amplification of infection because of the pres sense of fruit bats on these farms. And if you think about these pigs being infected and then being slaughtered, and if the practices aren't really very clearly done to specifications that UH would not allow a person to get infected in under their nails or you know, in their saliva

on accident, then there you go. You've got transmission of the disease. Moreover, the areas in which fruit bats are dwellings seem to get further and further out in Africa, and this is thought because of the changing conditions due to global warming. So again you see this spread happening. This is these are these are all these sort of

component parts of why the virus is spreading quickly. So there we see the jump from animals to humans because it may happen because of close contact with these with these pigs we've been in contact with the bats. It may occur from eating bush meat. You're eating ape, you're eating uh uh, you know, chump, you're eating bad and

and and and and catching it that way. And then once it's in humans, then there's of course more potential to spread through burial practices, through caring for sick individuals coming into contact with their with their diarrhea, with their vomit, with their blood. Um. Furthermore, men who have recovered from the disease can stial transmit the virus through their semen

throughout the seven weeks following the illness. So, I mean, that's one of the things about a bow in one of the facts that you here repeated again again that I Bola remains active for for an extended period of time here. Yeah. Now, compounding that, of course, is just you know, a distrust of government officials, a distrust of

UM medical facilities and medical workers and UM. Imagine too, someone trying to quarantine your family member and how upsetting that would be to you, or how upsetting it would be to you if there was a certain burial tradition that you were family UM in your community had always

engaged in. And then we're told to stop because as we know, these are the sort of traditions are are deeply ingrained in us and part of the healing process, and to be told that you can't do that probably feels, you know, it's probably fueling some of that distrust towards people in official positions to try to put a stop to the spread. Now, the other thing to consider is that these parts of the world, these some of these countries have been hard hit over the decades with war,

with many other different types of strife. So it's kind of like, you know, one thing after another, and you have a community of people who they're only sort of way of dealing with life day to day is each other in the sort of bomb that they have, so trying to you know, these outside organizations coming in and trying to give them these directions probably feels very sort of alien to them and um and sort of disruptive of the ways that they have survived in the past.

All Right, we're gonna take a quick break, and when we come back, we're gonna get into these symptoms that occur as this virus spreads through a human host. All Right, we're back, and uh, as we continue to talk about ebola here and now, it's the point where we need to get into how the infection spreads in through the

body and the various symptoms that they occur. Now, this is this is likely some of the material that you've you've definitely uh encountered already just through media consumption of the ongoing crisis. But if you remember, we talked about the virus in the cell and and how the virus needs to invade the cell and turn the cell into

a virus producing factory. And what happens then is the virons burst out of the cells and begin producing the protein ebola virus glycoprotein and attaches to the cells on the inside of the blood vessels. So this is where things start getting um interesting because this increases the permeability of the blood vessels and blood leaks out of the vessels, and it also affects the body's ability to coagulate and thicken the blood. Yeah, because all of those things are

triggering these chemical responses that we begin to see as symptoms. Now, when ebola enters a human being, it kind of hangs out seemingly harmless for about two to twenty one days, typically more four to ten, and then you get to see those symptoms come first. You see fever, chill, headache, muscle and joint aches, and tiredness, and then it begins to get uh much more intense. Yeah, and when the immune system fights back, the ebola actually works to elude it.

It blocks the signaling to cells called neutrophils, and these are white blood cells that are in charge of sounding the alarm basically and uh so. And then on top of that, ebola will actually infect immune cells and hitchhike to organs such as the liver, the kidney, displein, and the brain. Yeah, we thought about the ability of virus to do that with the neutrophiles. It's kind of fascinating

that they can game the immune system like that. Alright, So, as you mentioned, we're looking at an incubation period about four to nine days after exposure, but it may last up to twenty one and then that's where the course of the illness really gets going. Um usually last between six and ten days. Uh. Days one through three, Uh, you're looking at flu like symptoms and just a general

feeling of bodily weakness. Days four through seven. Uh. Patients may also get vomiting, diarrhea, nausea, low blood pressure, headaches and anemia. Yeah, and some of them will develop a rash on their trunk and their shoulders. Right. And then days seven through ten, this is where things can get far worse. Uh. This is towards the end of the illness where you may encounter just fury and feelings of confusion,

bleeding both internally, uh and externally. And this can also progress towards coma shock and death, but not in all cases. And that's one thing to keep in mind here at all times. Um, you'll you'll often see that nine mortality rate thrown out with ebola, but that that is just it's more correct to say that the mortality rate can be up to with ebola, and it's gonna reach its high highest levels in areas where it is not treated

or not treated effectively. You see that that mortality rate, Um, it's still high, but you'll see it go down ten and twenty thirty points or thirty points are more in cases where the patients are are are actually going to be cared for in in a more u sustainable way. Yeah. And with this zy ear strain that is currently under way, in the past has been but I think they've got it down to about sixt right now, that's where I've

seen it hanging out. Yeah, and you probably already mentioned this, but I did want to say that the blood does start to cot al throughout the body. That's that's it causes sort of this breakdown of the organs and the failure of organs, and when it's clotting throughout the body,

that exhaust the supply of proteins that handle clots. So that means that when tissue damage occurs in the other personal body, those proteins aren't available to do their clotting work, and that's where it all begins to break down internally. And generally death is not a result of the hemorrhaging, but from multi organs failure or shock. Yeah. Now, of course not everyone dies from ebola, and when people survive ebola. There are a few different factors that that that that

play a role here. I mean, one, of course, is just the overall immune system health of an individual. Is this a young person with you know, that's that's that's in the prime of their life that have encountered the virus, or is this uh an older individual is to someone with an already compromised immune system, etcetera. The other factor here that that that scientists are still trying to understand exactly how it plays plays into this. But how many

virons does want and up taking into their system? How big is the initial viral invasion of your body? Is it a small number, is it a larger number? Obviously that is thought to play a role as well. Yeah, and that might depend on whether the animal or the human you are infected from where they were in that illness. So as you say, how many virons are present in the bloodstreamer, saliva or whatever it was that was the infecting um element, So the way that it's transmitted can

also Uh, it can also influence the mortality rate. For instance, needles have a greater mortality rate than say saliva. So you're probably wondering at this point, Um, how does one treat a bola? How does one treat a bola under more or less ideal circumstances in the field in Africa? Well, currently no licensed vaccine for ebola is available. That several vaccines are being tested, but none are available for clinical use.

So if you're a severely ill patient with a bola, uh, what's generally going to happen is gonna be dehydrated, so you're going to require oral hydration with solutions containing electrolytes or intravenous fluid, so sailing the infusions and electrolytes to keep you hydrated. And beyond that, there's not a lot that can be done in the field. However, there are some some additional experimental treatments they're making the news and

in which there is a lot of hope. Yeah, and before we get to that, I wanted to say that studying is kind of I would say difficult as well, because there exists these things called biological safety levels that correlate to different types of lab studying different viruses, and b LS one is the least life threatening, while BSL four is the most. An ebola requires a b s L four lab protocol, so scientists have to work in space suits with respirators and get decontaminated before entering and

leaving these labs. And only about a dozen of these labs current only exists in the United States. And furthermore, because the number of victims has been low relative to other diseases right. Malaria is a good example, and the outbreaks tend to happen in remote parts of the world. A k outside of the United States UM. Because we're so American centric um where it's difficult to administer vaccines, there hasn't been a lot of industrial support for creating one.

But given that this outbreak has happened and people are now engaged, people are are definitely more interested in finding a seroreum that could work. And as you say, there have been some reports in the media. I think some media outlets have called it a secret theorem, which is really problematic. It's not secret. Again, I feel like this is this the word serum is so loaded from a news sense you can you almost can't help it adds secret, secret theorem from a laban. And the fact of the

matter is is that there's a treatment. There's a drug that has been in development and has been used only in animals so far, but you could say that about nearly any other disease or virus out there. There is a drug that is being worked on UM. But as we say, the conditions for it going to market haven't

exactly been like, hey, let's accelerate this until now. So the yeah, the the particular treatment in question here, the serum is is known as z MAP and uh this is uh, this has been developed by a San Diego based company, map Bio Biopharmaceutical and it's one of a class of new drugs known as monoclonal antibodies, and these use uniquely manufactured proteins to prevent in theory, the ebola virus from infecting new cells. Um they've also been used in the treatment of some cancer, so it's not just

completely an ebola centric treatment strategy. And so with z MAP, we're talking about a three antibody cocktail. Again, not a vaccine, but just a way of artificially boosting immune response against sugar tag proteins on the outside of the ebola virus. And interestingly enough, tobacco plays a role in it. Yeah, but particularly an Australian strain of of the tobacco plant is involved in this. And there's actually a division of R. J. Reynolds to tobacco that's tied up in the drug trials

for this. But anyway, in this circumstance, this secret serum, if you will, is being administered to the two Americans here in Atlanta with it, or has been administered Dr Kent Brantley and Missionary Nancy right Ball, that's right, and only three doses had ever been created, so two of those were used on them, and of course we'll see what the results are. Yeah. I think everyone's pretty hopeful about it and and also ultimately hopeful about the potential

here to create a better treatment regime for use in Africa. Yeah. I mean, because again, this is this virus just it ravages the body, and here we have this opportunity to perhaps um lesson suffering and do something about it. Um. I did want to share a letter from a listener, Jessica, because I think it helps to give a little more

context to this um. Yeah, because ultimately we are we we are not in direct contact with you know, we're seeing this from Afar, and she has has been there and and say she wanted to share some of her thoughts. She said, in two thousand and eight, I traveled to Sierra Leone for six week immersion with a large group of early twentysomethings. We visited schools and clinics. She put quotation marks on this, partly to expand our mindsets, but also to provide what little help we could to a

recovering community. Siriel Leone experienced a horrifically brutal civil war from the late ninety nineties to the early two thousands and is still attempting to heal. The people of the country are truly the friendliest, most open and loving people I've ever met in my life changed dramatically in US a few weeks I was there. I write because of the Ebola happenings, and I've attached photos of what consists of available medical care in Freetown, the capital city, which

is home to nearly one point one million people. Many Americans have allowed their fear to get the better of them with the recent transport of an infect American doctor back to the United States for advanced treatment. What many people don't realize is that the standard of care and underdeveloped countries doesn't even come close to what we have

available in the United States. The hospital in Freetown, which was still under construction in two thousand and eight, consists of a three level, multi room mud brick building with running water. However, running water, the luxury that it is, isn't sourced from a public water treatment facility like it is in the US. It may come from a tap, but it's not potable due to ramp at equally and

lack of proper sanitization. And then she goes on to say, when it comes to disease fatality, you cannot consider the disease itself in isolation. You must consider the accompanying conditions under which has been fatal. Even common diseases such as the flu, kills dozens of infants in the US every year, consider the social and medical factors in tandem. These are cultures that are based on physical contact and closeness. Even people you've never met before will greet you with a

full body embrace. Physical contact for the living and the dead provides the basic foundation of many African societies. And as for the medical factor, many of these quote treatment facilities are little more than four walls and what may or may not amount to a solid roof. Thatching and tarps are common because they're simply nothing else available, especially

outside of the quote unquote city. And then she goes on in a little bit more detail, and she says, top that off with a social fear of modern medicine, and you've got the worst conditions possibly for a highly communicable disease. Moving and infected US citizen back to high level medical care is not only best for him, but it's truly in the best interests of research for finding effective treatment and a cure, not only now but for

future outbreaks. I left a large piece of my heart in Sierra Leone, and I wish so much to relieve their continued suffering. Anything that we can do, we should. It's the human thing to do. Thanks so much, Jessica, indeed, thank you for writing in then in providing that a personal account that that deals with today's topic. So there

you go, there's ebola in a nutshell. Look at the virus, a look at the symptoms, I look at some of the treatments available to us, and and overall, you know, hopefully this helps to distill some of the fear, uh that is that's out there. Yeah, and I hope that that you know, it's it's looked at in a different context. And when you hear than knowing that in the past the ZI year strain has been mortality, but it's not

it's now. Or if you hear that it's spreading rapidly, then it's more understood in the ways that it's being um spread. It's not spread in the air. It's spread because of these other actors, the extenuating factors, and certainly in in a place like the United States, we don't even begin to have those factors at play. So for people to fear that it could somehow incubate here and infect us all and become this pandemic is like highly highly unlikely. So yeah, this is not the strain, This

is not Stephen King's the stand. Uh, this is real life. And hopefully we've provided you a little information to go on here, and if you want to learn more, do check out that article how Ebola works on how stuff works dot com, and of course, uh, the CDC and the World Health Organization both have excellent resources about this as well. Indeed, I mean, really there's a phenomenal amount of of information out there on the web right now

to douse the fires of paranoia with. But the thing is you have to you sort of you have to open your eyes, your ears and in your mind and actually engage with that information. And know, I do want to underline the the urge to to to just give into the fear is understandable. I mean it's when you when you're when you're faced with some sort of uh, you know, deadly virus, you want to run away from it.

I mean, that's part of our our program. But yeah, it well, but we should remember that we've been here before and on more intimate terms with the virus and I'm talking about H one and one bird flu or stars, so um. You know. Again, it's just it's important to review the facts and and to try to see what sort of cultural lenses on top of this, is there a little of the stranger factor of the fear of of foreigners going on. I don't know. They're all things

happening under the cover of unconscious. If you would like more information on our show, go to stuff Toble your mind dot com. That is where you will find all of our blog post all of our podcast episodes are videos links out to our various social media accounts. I'll be sure to check out our YouTube page Mind Stuff Show. We you're constantly updating that with new shows and new show ideas and new content. And no doubt you have

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