I keep getting questions about Ebola, especially what one can do to lower the likelihood of getting infected with it, etc. So today, I am going to answer the questions, and provide additional research based information to help quell your concerns and fears.
I totally understand, and if I didn’t know what I do as a physician, I would be very afraid about this virus.
What I do know is that it is difficult to gauge how much information to provide the public with, and how to do it in a way that doesn’t engender panic. This has been a daily story for several weeks, and it’s hard to ignore it, so in many regards it is very over reported.
A few days ago, I had a conversation with another physician, who said to me, “The world is going to come to an end in one of 3 ways: a. a pandemic, b. a large meteor, c. thermonuclear warfare.”
Being the person of faith and optimism I am, I respectfully disagreed. I do not believe the world is coming to an end, anytime soon, nor do I believe a pandemic is going to wipe out a significant portion of humanity. We know more today than ever about not only the epidemiology of infections (how they spread in populations), we know how to contain them, and how to treat them. We also know, even though this is rarely discussed, the key role nutrition plays in susceptibility to all infections.
So again, I ask you to take a deep breath, take care of yourself—i.e., do the right things to keep your enhance your health (especially your immune system), and know that continuous fear can actually make you more susceptible to a wide swath of illnesses, and infections.
I am also going to share links to information to you about the efforts to contain this infection in Africa (for example how Nigeria reduced the death rate to 40%) and other articles about hemorrhagic viral infections.
Stay tuned and stay strong!
1. What is Ebola?
Ebola is a virus infection. According to the Centers for Disease Control: Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).
Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified Ebola virus species, four of which are known to cause disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.
Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.
The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa.
2. Why is it so deadly?
Most people aren’t aware that it’s not the virus that causes death, but what it (like other infections) can trigger--Ebola virus stimulates a what’s known as a cytokine storm. After an individual is infected, the Ebola virus attacks the immune system and begins destroying T-lymphocyte cells, which are the same cells that HIV attacks. Ebola, however, is far more aggressive in destroying these cells, which are essential for maintaining the immune response. Soon, the infected body will begin to ache all over; they will begin vomiting and experiencing diarrhea.
The ‘Cytokine Storm’
The last phase of Ebola is the “cytokine storm,” which occurs when the immune system begins attacking every organ in the body, bursting blood vessels and making the infected person bleed both internally and externally, through the eyes, vomit, and diarrhea. It also causes leaks in the blood vessel (thus the bleeding part of the hemorrhagic fever), which causes the blood pressure and temperature to drop and leads to shock.
But when you look at the nitty-gritty details of an Ebola infection, a surprising fact surfaces: The virus isn't what ends up killing you. It's your own immune system. Our immune system plays a significant protective role, but when it is over stimulated, as it is during a cytokine storm, it damages the very organs, it was designed to protect.
The most extreme immune attack is the "cytokine storm." Although many viruses, like bird flu and SARS, can trigger this shock and awe assault, Ebola is probably the best at it.
What Are Cytokines?
Immune cells use cytokines to communicate with each other. Cytokines are small molecules released by cells into the blood. And they can trigger a variety of biochemical responses. activities. Cytokines can stimulate various white blood cells to the site of infection, gobble up sick cells and even sneak through blood vessel walls. They also stimulate inflammation, which when uncontrolled, causes damaged tissue to swell, heat up and die.
In essence, a cytokine storm is an SOS signal that causes the immune system to launch its entire arsenal of weapons all at once. This last-ditch, kamikaze attack hurts the virus. But it leaves behind tons of collateral damage. Blood vessels take the brunt of it.
3. How do I protect myself against Ebola?
If you must travel to an area affected by the 2014 Ebola outbreak, protect yourself by doing the following:
- Wash hands frequently or use an alcohol-based hand sanitizer.
- Avoid contact with blood and body fluids of any person, particularly someone who is sick.
- Do not handle items that may have come in contact with an infected person’s blood or body fluids.
- Do not touch the body of someone who has died from Ebola.
- Do not touch bats and nonhuman primates or their blood and fluids and do not touch or eat raw meat prepared from these animals.
- Avoid hospitals in West Africa where Ebola patients are being treated. The U.S. Embassy or consulate is often able to provide advice on medical facilities.
- Seek medical care immediately if you develop fever (temperature of 101.5°F/ 38.6°C) and any of the other following symptoms: headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained bruising or bleeding.
- Limit your contact with other people until and when you go to the doctor. Do not travel anywhere else besides a healthcare facility.
4. What is my risk of getting infected with the Ebola virus?
All cases of human illness or death from Ebola have occurred in Africa (with the exception of several laboratory contamination cases: one in England and two in Russia). One travel-associated case was diagnosed in the United States on September 30, 2014. On October 12, 2014, a healthcare worker at Texas Presbyterian Hospital who provided care for the index patient has tested positive for Ebola. CDC confirms that the healthcare worker is positive for Ebola.
Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with the blood or body fluids of sick patients. People also can become sick with Ebola after coming in contact with infected wildlife. For example, in Africa, Ebola may spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. The virus also can be spread through contact with objects (like clothes, bedding, needles, syringes/sharps or medical equipment) that have been contaminated with the virus or with infected animals.
5. What treatments are available?
No FDA-approved vaccine or medicine (e.g., antiviral drug) is available for Ebola.
Symptoms of Ebola are treated as they appear. The following basic interventions, when used early, can significantly improve the chances of survival:
- Providing intravenous fluids (IV)and balancing electrolytes (body salts)
- Maintaining oxygen status and blood pressure
- Treating other infections if they occur
Experimental vaccines and treatments for Ebola are under development, but they have not yet been fully tested for safety or effectiveness.
Recovery from Ebola depends on good supportive care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years, possibly longer. It isn't known if people who recover are immune for life or if they can become infected with a different species of Ebola. Some people who have recovered from Ebola have developed long-term complications, such as joint and vision problems.
6. What do you know about natural treatments?
Thus far, there’s been no known research specifically, that I have located on the recent outbreak. However, there is significant research on viral infections in general, as well as other hemorrhagic fevers related to nutritional supplementation/treatment.
In particular, selenium deficiency, beyond general malnourishment (in African populations) may play a role in the cytokine storm. See link to Dr. Sircus’ article with detailed research studies on nutritional aspects of viral infections.
http://orthomolecular.org/library/jom/1995/articles/1995-v10n0304-p131.shtml (Selenium and Ebola article)