Ebola - Should we be concerned in Scotland?

The short answer is Yes. I had never intended on beginning this blog on such a morbid note but I felt with the current situation regarding Ebola spreading to western countries, I believe it is pretty relevant and hope that I can provide a better understanding of the dynamics of the disease.

I have a fascination with diseases. By detaching from the harm and suffering they cause, the way in which they interact to immune systems and pharmaceuticals captivates me. I had always believed that when we feel feverish due to illness, that was the bug causing us to feel unwell, but it is in fact our body raising its own temperature to make it a less hospitable host to the infection. Basically, we make ourselves ill. Now, at some stage I would like to write short entries on other diseases and how they interact with the body but as it is topical I will overview Ebola.

Ebola is a zoonotic virus meaning it reservoirs non-pathogenic within a host before being passed to another susceptible host for the virus to take effect. Ebola, amongst other viruses, are carried by bats however, there has been little evidence as to why they are not affected by the disease itself. Some hypothesis suggest that the rapid and significant body temperature and metabolism increase bats incur during flight is adjuvant to an effective immune response. Frighteningly, humans and primates do not possess the ability to fend off the infection. A study in 2006 revealed that as Ebola spread across central Africa, 90% of Gorilla populations were wiped out. At the time it was also noted that the mortality rate in humans was 80% and unfortunately, that figure has not changed.

The typical symptoms of Ebola after infection. As you can see it takes rapid effect and can be catastrophic.

The disease targets endothelial cells (lining of blood vessels), mononuclear phagocytes and hepatocytes. Upon infection, the Ebola virus glycoprotein is synthesised and replication overwhelms protein synthesis of infected cells and the host immune system. The glycoprotein also interferes with neutrophil signalling further helping it evade the immune system. The result is haemorrhagic fever with subsequent organ damage, leading to organ failure and death.

There is currently no vaccine or treatment available against the virus. This is not reason to panic as there are many labs all over the world currently working to find one. Certain procedures can help patients such as fluid and electrolyte balance to counter dehydration and the administration of anticoagulants early in the infection to control intravascular coagulation although these treatments still do not guarantee survival by any means. The best chance of fighting it is isolation and quarantine. The disease typically spreads via fluid transmission, ie and infected bat’s saliva contacting a hosts blood, introducing the virus (there has been instances of bats dropping part-eaten flats and passing the disease to mammalian hosts that way). At this stage there is very little evidence to suggest it can be transmitted through the air which is in some ways comforting as airborne transmission is a much more effective method of disease progression.

I hope the intent of this post is not misconstrued. I am opposed to media derived scaremongering with little evidence backing up their weekly “civilisation ending” catastrophe, be it war, disease, famine or something more nonsensical. I merely want to provide a bit more insight into the disease itself. I believe that if the disease is controlled properly then we will not face any danger as a civilisation and as individuals in the western wealthy world we should be relatively safe from contracting it (unless you visit central Africa or get particularly cosy with bats). So to go back on my initial answer to the question: in Scotland, we probably shouldn’t worry about Ebola. 

My only concern is failure to properly quarantine the disease. Aid and healthcare workers who have been flown back to america for better treatment could prove problematic if there is a breach in patient isolation. The recent story of 2 American humanitarians who have been released from hospital after receiving treatment with experimental drugs (http://www.theguardian.com/society/2014/aug/21/ebola-americans-released-hopsital-recovery-doctors) is also a bit dodgy. Releasing patients at this stage without knowing the long term effects could result in relapses of the virus.

Next time I plan on writing about more positive and cheery scientific stories however I cannot guarantee the odd disease cropping up that I find interesting.