Friday, June 20, 2014

The Hot Zone


        The book The Hot Zone by Richard Preston was centered on the Ebola Virus and the different strains found throughout the world. Preston was able to visit the few places where the disease is most prominent in Africa and in the Reston, VA area. The book is split up into four main sections: The Shadow of Mount Elgon, The Monkey House, Smashdown and Kitum Cave. The Shadow of Mount Elgon starts off the book by giving the basic history of filoviruses and talks about someone named Charles Monet who became sick after visiting Kitum Cave, which is located in Kenya. It follows his progression through the disease with all the signs and symptoms that he had and eventually led to his death. Also, it shows possibly the first human-to-human transmission of the disease when the doctor that is treating Monet contracts it as well. This also goes through all the basic hazards and procedures one must go through while treating Ebola. He interviewed and told the story of Dr. Nancy Jaax, who had the pleasure of working with Ebola Virus in a Biosafety Level 4 area.  She had a scare and was almost exposed to blood that contained the virus, but she escaped luckily with no type of infection. By the time that I was finished reading this first part I already had chills simply due to the fact of how gruesome ones death is when contracting this disease. Also, that anybody is susceptible to contracting Ebola at anytime, it was a frightening thought. The Monkey House was centered on the Reston Ebola Virus strain and had to do with a research facility in Reston, VA. This facility received a shipment of monkeys from the Philippines, where this particular strain was started, and saw almost all of their monkey’s die of conditions similar to the Ebola Virus. This went through all the preventative measures taken by the US Army and the Centers for Disease Control to prevent and completely eradicate this deadly disease form the area. This led into the section Smashdown; this went through how the Reston strain was not an epidemic, but an epizootic. This meant that it was only fatal and harmful to animals and not humans. The last section was Kitum Cave, where Preston actually was able to visit and go inside of the cave, completely covered from head to toe though. Preston talked about how Kitum Cave was the start of the Ebola virus and the natural host animal that harbors this deadly virus lives within the cave. Overall, this is one of the best books I have ever read in my life and it was really struck my interest in the biological field of study. I was actually forced to read this book for my AP Biology class my senior year of high school and fell in love with it. This was what interested in the sciences and is the reason I am planning on eventually obtaining my PhD in Infectious Disease Epidemiology. It was an incredible account of what has happened with this disease and really made you feel like you were there as it was happening.
    Bibliography:
    Preston, Richard. The hot zone. New York: Random House, 1994. Print.

Zaire Ebola Virus Disease Outbreak in Guinea


       An outbreak of Ebola occurred in Guinea earlier this year and was later found to be the Zaire Ebola strain. It was reported to have the same type of symptoms as Ebola and it had a high case-fatality rate. It was identified as the Zaire strain after analyzing some blood samples from infected individuals. There were seven different methods when going through this investigation of this disease. The first method was that they had to obtain blood samples from about 20 patients that showed the symptoms of the disease. The second method was to perform diagnostic assays, which investigated the viral ribonucleic acid to see whether or not filoviruses were detected. The third method was to perform viral sequencing, which was to sequence the genomes of the Ebola Virus by using polymerase-chain-reaction, or PCR. This helps to analyze the viral RNA more closely to basically just sequence the virus. The fourth method was viral isolation, which was to isolate the growth of the virus in the different cells and to use antibodies specific to a certain Ebola strain to see if there was going to be an increase in viral levels in the culture of the cell. This was measured by using PCR again, but this time it was in real-time so it is called RT-PCR. The fifth method was to use electron microscopy to use a negative stain on the organism to test and better see if the virus looked to have similar qualities of Ebola. The sixth method was to use phylogenetic analysis and compared the new Ebola Virus sequences that were obtained with 48 filovirus genome sequences that were obtained from GenBank. This information was separated into different phylogenetic trees that helped display the information properly and show what specific strain of Ebola it may be, as seen below. 
(Figure 3, Emergence of Zaire Ebola Virus Disease in Guinea)

The seventh and last method called for the use of epidemiologic investigations that looked through other possible transmissions, going through hospital records and interviewed many people that could possibly have had exposure to the Ebola Virus. The results show that an Ebola Virus strain was identified but it seemed to be different than the other five and seemed to surface from the Democratic Republic of Congo and Gabon. This outbreak occurred in March of 2014 and the first transmission of the disease seemed to appear in December of the previous year. This eventually spread to this village in Guinea and caused this severe outbreak of the disease. The main reason they were able to diagnose this as Ebola Virus was the clinical symptoms that were being shown by the patients. An epidemiologic curve was also created by graphing the number of cases of Ebola against the time frame of the disease, as seen below. 



(Figure 4, Emergence of Zaire Ebola Virus Disease in Guinea)

They discussed where they were thinking of taking their research next and I completely agree. That would be to find the animal that caused this outbreak, or simply the causative agent, and help to eradicate that possibility from ever happening again.                              
      Bibliography:                                                                                                                                             "Emergence of Zaire Ebola Virus Disease in Guinea - Preliminary Report — NEJM." New England Journal of Medicine. N.p., n.d. Web. 20 June 2014. http://www.nejm.org/doi/full/10.1056/NEJMoa1404505#t=article

Thursday, June 19, 2014

Ebola Virus Disease Transmission and Treatment/Prevention


       This disease is spread when people come in contact with blood or bodily fluids of infected animals and/or people (WHO, 2014). In reality everybody is equally susceptible to developing the Ebola virus. This is one of the main things that make this disease so dangerous because it can attack anywhere and anyone at anytime. The disease is most prevalent in developing countries, almost completely in Africa and the Reston strain being acquired in the Philippines. After one individual contracts the Ebola virus, it starts to spread from human to human throughout whatever community it has surfaced in, and leads to an outbreak in the population (WHO, 2014). There are really no defined treatments or vaccines to help combat the Ebola virus. There are some new therapies that are being developed to try and help with the treatment, but the patients mainly just require intensive supportive care (WHO, 2014). The patients just need constant fluids due to dehydration from constant vomiting, bleeding or other general loss of bodily fluids. People working to prevent the Ebola virus are going about it in two ways. One way is to reduce the risk of Ebola infection in people and the other way is to control the infection in health-care settings (WHO, 2014). These both seem to be pretty effective means of preventing this disease. When reducing the risk of Ebola infection in people, the announcement of the certain risk factors to the people in the involved areas is crucial. As shown below, a healthcare worker is working with an Ebola patient and is covered from head to toe to ensure that there will be no direct transmission between them and the ill individual. 
This is to reduce the risk of transmission from animals-to-human and human-to-human, and to also contain this outbreak by properly taking care of the deceased individuals. This is done by practicing proper burial techniques and allowing no direct contact between the severely ill individuals and the general public and the doctors helping them. When controlling the infection in health care setting, it is important to take proper measures by wearing long sleeved gowns, avoiding exposure to contaminated body fluids, face protection and use of gloves (WHO, 2014). Everybody that is involved whether they are an innocent bystander, helping treat the sick individual or are the sick individual is at a high risk of contracting the disease, so extreme caution is a necessity. I believe that this is probably the best preventative/treatment measure that is available right now. Since there is no direct treatment or vaccine available, the most effective treatment would be to just contain the outbreak and reduce the amount of transmission as much as possible. I personally think that they should just somehow create robots to conduct the nourishment of the patients with fluids and such so nobody has to come in direct contact with these individuals. The sick individuals should be quarantined until they either pass away or the disease subsides. This is to protect absolutely everybody from the disease and to ensure that there is no transmission of the disease from the sick individual.
     Bibliography:
            "Ebola virus disease." WHO. N.p., n.d. Web. 20 June 2014.    http://www.who.int/mediacentre/factsheets/fs103/en/

Ebola Virus Disease History/Statistics, Etiology, and Symptoms


          The Ebola virus disease was first discovered in Africa around 1976 in the countries of Sudan and the Democratic Republic of Congo. The disease received its name from the Ebola River that is located in the Democratic Republic of Congo. The most startling statistic regarding the Ebola virus would definitely be that the disease has a case fatality rate as high as 90% (WHO, 2014). The disease was first known as Ebola hemorrhagic fever because of the how the infected individuals would die once this disease was contracted. The Ebola virus is a filovirus, which means it is a member of the Filoviridae family, and has five different species of it (WHO, 2014). These filoviruses have a loop in them, as seen below, and this is one of the main factors that doctors will look for when analyzing the virus.
     These five different strains or species are: Bundibugyo, Zaire, Sudan, Reston and Taï Forest ebolaviruses. Every strain is harmful and deadly in humans except for the Reston strain, which has had no deaths reported after the outbreak in Reston, VA in the 1990’s. Although, more studies need to be conducted with this particular strain of Ebola because they only have one group for data, adult men. This disease appears to have developed from fruit bats, but mainly just from developing countries in remote areas that may not have the proper medical care or a clean area of living. These seem to occur in outbreaks in these developing countries, mainly occurring in Africa. Ebola virus has an incubation period of 2 to 21 days (WHO, 2014). The main symptoms of this disease are pretty clear and doctors can normally tell what is occurring quite quickly. They will start off as a headache, sore throat and just pain all over the body that is followed by more sever symptoms such as vomiting, internal and external hemorrhaging and impaired function of some vital organs (WHO, 2014). These symptoms could possibly show the doctors that you have different diseases, but Ebola can be easily identified through laboratory tests. Overall, if this disease is contracted, there is a very high chance that the infected individual could die due to the intense severity of the disease.
      Bibliography:
            "Ebola virus disease." WHO. N.p., n.d. Web. 20 June 2014.    http://www.who.int/mediacentre/factsheets/fs103/en/