Ebola Virus
 
The end occurs in a few days. Staggering, the victim collapses in a fever. With bright red eyes, he begins to vomit. In a
 few hours, he dies a torturous death with blood poring out of every body opening, including his eyes and ears. When 
pathologists perform an autopsy, they discover that the internal organs of the patient have dissolved into a 
unrecognizable heap of matter ("Combating" 491).  These phrases describe the death of a person infected with the Ebola 
virus. While Americans worry more about diseases such as heart disease and cancer, infectious diseases are the leading 
cause of death worldwide. In fact, nearly one-third of the 51 million deaths in 1993 were from such diseases. With 
expanding air travel, infectious diseases once confined to isolated regions now pose potential threats to nearly any 
part of the world. "Emerging infections," according to Stephen S. Morse, a virologist at the Rockefeller University in 
New York City, "[are] a way of describing [a virus] that comes out of nowhere and suddenly seems to be rapidly going 
everywhere" (491). One of these emerging pathogens is the Ebola virus. This virus is one of the most deadly in the world, killing eighty to ninety percent of its victims. There is no cure or vaccine for this lethal virus; in fact, since the very first outbreak of Ebola nineteen years ago, no research has been done to find a cure. An epidemic of this virus would certainly be catastrophic. For this reason, doctors and leaders need to know what should be done in case of an outbreak. More money needs to be used for research and experimentation to find methods of preventing outbreaks and to discover a cure for the Ebola virus.
The Ebola virus is a usually fatal filovirus which affects monkeys and humans. Among the filoviruses are Marburg, Ebola 
Sudan, Ebola Reston, and Ebola Zaire. Filoviruses are members of the filoviridae family. They are highly pathogenic and 
capable of epidemic transmission. Under a microscope, filoviruses are string shaped with little hooks or loops at one 
end. These types of viruses are transmitted through close contact with bodily fluids and infectious blood. Spread is 
facilitated by the lack of modern medical facilities and supplies that could protect those giving care to infected 
patients, especially in indigent countries. The genetic makeup of filoviruses is very stable, in fact, unusually stable, 
since the virus that caused the outbreaks at the extreme geographical ends of Zaire, separated by nineteen years, 
has changed little. Therefore, the virus may have changed to occupy special niches in the wild.
 
The Ebola virus is a biosafety level four virus. Biosafety levels in laboratories are numbered zero, two, three, and four
; four is the highest. There is no level one. As a safety precaution, levels two, three, and four are kept under negative
 air pressure so that if a leak develops, air will flow into the biosafety zones, rather than out into civilization. In 
order to be permitted into a biosafety level three laboratory, it is necessary to be vaccinated for many diseases 
including yellow fever, Q fever, Rift Valley fever, the VEE and WEE complex, tularemia, anthrax, and botulism. In order 
to be permitted to enter level four, however, no vaccinations are needed because there are none for level four hot agents
 (Preston 42). When dealing with these microorganisms, space suits must be worn: "All laboratory studies present an 
extreme biohazard and should be conducted only under high containment conditions" ("Ebola Hemorrhagic" 1). A level four 
hot agent is a lethal virus for which there is no vaccine and no cure. In fact, because this virus is so dangerous, there
 are only two laboratories in the country adequately equipped to store and study hot viruses, the Army facility and a 
laboratory run by the CDC in Atlanta (504). 
 
Ebola is a virus named for the Ebola River in Zaire, its first site of discovery. The Ebola River is located at the 
headstream of the Mongala River and is a tributary of the Congo, or Zaire River. The first known emergence of Ebola Zaire
, the most virulent strain, occurred in September 1976, where it erupted simultaneously in 55 villages near the 
headwaters of the Ebola River. The Ebola virus is a member of the filoviridae family. It is a severe viral illness that 
causes a hemorrhagic fever in monkeys and humans, jumping easily between them. The incubation period is from two to 
twenty-one days, meaning that this is how long it takes from the time of infection until when the symptoms appear 
(Troy 46). The onset is very sudden and death occurs in about ten days. Infections result in a death rate of eighty to 
ninety percent. All the hemorrhagic viruses have hosts, usually a rodent or an insect. The host carries the virus but 
does not itself become ill. The Ebola virus must have a host because of its stability and existence for over nineteen 
years, but it still has not been identified. All viruses are unable to survive on their own and remain inert until conditions become suitable. Viruses are only able to replicate and reproduce within the cells of hosts. So the host must continue living while infected with Ebola in order for the virus to spread. Otherwise, all the hosts will be dead and the virus will not have a place to reproduce and remain "alive." Scientists are not sure if viruses should be classified as living since they cannot reproduce on their own. The Ebola virus is a simple virus; it kills with swift efficiency and has a devastating range of effects. Ebola Zaire is a "slate wiper" in humans (Preston 27), killing almost every person contracting it. This virus is distantly related to measles, mumps, rabies, and certain pneumonia viruses, demonstrating the worst symptoms of all these viruses. Like measles, a rash develops over the entire body. Like rabies, psychosis and madness develop as the disease progresses. Other effects are similar to a bad cold and include headaches and backaches. The Ebola virus is composed of seven different proteins or large 
molecules. Three of these are vaguely understood by scientific researchers and four are completely unknown in structure 
and function. These proteins seem to attack the immune system, like HIV. Unlike HIV, however, the attack is explosive: 
"Ebola does in ten days what it takes AIDS ten years to accomplish" (46). In a blood sample, Ebola kills cells quickly 
and in vast numbers. It is simultaneously an invasive life form and a sophisticated organism. 
 
 
The Ebola virus attacks every organ and tissue in the body except for skeletal muscle and bone. A perfect parasite, it 
transforms every part of the body into "a digested slime of virus particles" (72). After exposure, the virus begins to 
multiply in its host's cells and destroys them. About seven days after exposure, relentless headaches and backaches 
appear. Three days later, the fever and dry heaves begin (10). Also at this time, the face becomes passive and 
expressionless. The eyeballs become fixed and turn bright red; they fill up with blood, causing blindness. The skin 
turns yellowish with red speckles, called petechiae. The victim's personality turns sullen and resentful as memory loss 
occurs. In a few more days, the victim begins to throw up black vomit endlessly. At the peak of infection, an eye dropper
 full of blood may have a hundred million particles of the virus, and it is only necessary to contract four or five 
particles to become infected with Ebola. This peak period is referred to as extreme amplification. During extreme 
amplification, the blood thickens and slows, and small blood clots appear in the blood stream. The clots drift through 
the bloodstream into capillaries where they eventually merge together. This closes off blood to various parts of the body
, causing dead spots to appear in the brain, liver, kidney, lungs, intestines, and all throughout the skin. Since no 
blood can reach the intestines, they die and go slack. The clots in the brain cause brain damage and erase the host's 
personality. As tiny spots in the brain liquefy, the victim becomes an automaton and is hostile. Ebola also attacks 
connective tissue and multiplies in collagen, the main protein that holds organs together. The collagen in the body 
becomes soft and the underlayers of the skin die and liquefy. The skin develops a macupapular rash, composed of tiny 
white blisters mixed with red spots. These red spots combine to become large bruises. The skin becomes so soft that any 
kind of pressure may tear it, and hemorrhagic blood pours from the rips. The area around the victim's teeth also bleeds; 
hemorrhages may occur from the salivary glands. Every opening in the body bleeds no matter how small (Troy 46). The 
surface of the tongue turns bright red and then is "sloughed off and is swallowed or spat out . . . or may be torn off 
while vomiting" (Preston 73). The back of the throat and lining of the windpipe may also disintegrate and then slide down
 the windpipe into the lungs to be coughed up with sputum. The heart muscle softens and hemorrhages into its chambers. 
Then, as the heart beats, the lungs and chest cavity are flooded with blood. The liver swells up, turns yellow, liquefies
 and cracks apart, dying completely and turning putrid. The kidneys are jammed with blood clots and dead cells; they 
cease functioning. The spleen turns into a single, huge hard blood clot, the size of a baseball. The brain is destroyed, 
and the victim goes into grand mal seizures, in which the entire body twitches and shakes. These convulsions give the 
virus a chance to spread to other hosts through the bodily fluids that exude from the victim. The Ebola virus multiplies 
so rapidly and powerfully that the body's infected cells become crystal-like blocks, called bricks, of packed virus. 
These crystals are ready to escape the cell. The bricks first appear near the center of the cell and then migrate toward 
the surface. As the brick reaches the cell wall, it disintegrates into hundreds of virus particles, which push through 
the cell wall and drift away in the bloodstream. These particles cling to the cells and enter them to continue 
multiplying. After death, the corpse rapidly deteriorates in a few days, leaking fluids that are saturated with Ebola 
(72-75).
 
The majority of cases of Ebola occur in hospitals in the developing world. The spread of disease results from the lack of
 adequate medical supplies and the reusal of needles and syringes. Outbreaks are quickly controlled, however, when 
appropriate medical supplies and quarantine procedures are used ("Ebola Virus" 1). The Ebola virus is spread through 
close personal contact with blood and bodily fluids of a person who has contracted the virus (Sanchez 2). In the Ebola 
Reston outbreak in Reston, Virginia, monkeys located at the opposite ends of a room became infected with the virus. The 
virus moved quickly and decisively across the room and most likely was inhaled by the monkeys into the lungs (Preston 65)
. This occurrence is disturbing because it previously has not been known that Ebola could be airborne. Scientists are 
still uncertain about whether the virus drifted across the room, or if somehow fluids from one monkey were thrown at the
 other monkeys. In order to curb the spread of Ebola, when an outbreak occurs, several procedures must be followed. 
First, all suspected patients must promptly be isolated. Second, strict barrier nursing techniques must be followed. 
This means that there should be a layer of protection between the patient and others, requiring the use of masks, gowns,
 and gloves. These should not be reused unless disinfected. In addition, all personnel should be informed about the 
nature of the disease and how it is transmitted. High risk nursing procedures such as intravenous lines, handling of 
blood and secretions, and catheters and suction should be carefully administered. Finally, proper disposal of waste and 
corpses is essential. All fatalities should be buried or cremated as soon as possible. Cases of Ebola are diagnosed by 
specialized blood tests that detect a specific antigen or antibody or by isolation of the virus. There are no 
commercially available tests. Perhaps this would aid in detecting the virus much more quickly.

The Ebola virus first emerged in Zaire in 1976. Out of the 300 people infected, 276 died. Outbreaks also occurred in 
neighboring Sudan in 1976 and in 1979. In 1989, the virus reemerged in the suburb of Reston, Virginia, among a shipment
 of laboratory monkeys. Then, on April 10, 1995, Ebola surfaced again in Kikwit, Zaire. No one knows for sure how the 
outbreaks began or where the virus initially came from. However, it is theorized that Ebola arose from previously uninhabited areas that were impacted by development. Morse, at the Rockefeller University, explains:
When you have a forest and you [do not] go into the forest, you may never come into 	contact with the denizens of that
 forest. . . . When you build your house in the forest, . . . 	then you are at risk for whatever denizens of that forest
 might carry. . . . When you clear 	the land for agriculture, you change the environment in a way that may suddenly 
allow a 	rodent species or some insect species . . . that may carry a previously [rare] disease to 	suddenly 
increase in number. (qtd. in "Combating" 497)				      This is very true in places worldwide in 
which expanding populations are forcing people into previously uninhabited territories. Infectious agents such as Lassa 
fever, HIV, and Ebola are suspected to have originated from conditions similar to these in central and west Africa (497).

 
In Reston, Virginia, the building where the monkeys had been housed had to be decontaminated. A SWAT team for biohazards
 was formed to "nuke" or sterilize, the facility: "If the hosts are people, you evacuate and isolate them. If the hosts 
are animals, you kill them and incinerate the carcasses, then drench the place with chemicals and fumes" (Preston 171). 
In the process of decontamination, the SWAT team repeatedly scrubs the place with bleach. Then, all exterior doors, 
windows, and vents are sealed with duct tape to make the building airtight. Next, patches of bacillus subtilis higes, 
spores which are harmless but hard to kill, are placed at various locations throughout the building. Hopefully, if the 
decontamination kills the spores, it will kill anything. Finally, electric frying pans with disinfecting crystals that
 release formaldehyde gas are placed on the floor and turned on. The facility is then left vacant for several days. 
Since the gas has nowhere to go, it remains inside and penetrates everything. Then, the SWAT team enters with space 
suits to see if the spores are dead. If the spores are indeed dead, the decontamination effort is dubbed successful. 
The object of the SWAT team is to "make the building a place where nothing lives" (250).
 
 
Even though no cure has been discovered, progress has been made. Scientists think they know how Ebola bypasses the immune
 system. They believe that the key is a molecule called glycoprotein, a protein attached to a carbohydrate. At an early 
stage of infection, large amounts of glycoproteins are detected in the blood. Soon after, the Ebola virus begins to 
replicate in large numbers. There are two types of glycoproteins: transmembrane and secreted. The secreted kind attaches
 itself to neutrophils, one of the white blood cells whose job is to destroy viruses. After the glycoprotein secures 
itself, more are made to accelerate the replication of the virus ("Ebola Developments" 1). Ebola also grows well in the 
endothelial cells that line blood vessels. This may explain how the capillaries are destroyed and the hemorrhaging is 
caused. Researchers suspect that if an efficient way could be found to stop the production of glycoproteins, then maybe 
this could help treat Ebola infections (2). There is also a new experimental vaccine created from the genes of the virus.
 Scientists injected the vaccine into the legs of guinea pigs. The viral proteins that the genetic material coded for 
was produced in the leg muscles. Then, when the protein showed up in the bloodstream of the animals, the immune system 
responded. Fifteen of the sixteen animals injected survived, and six of the six that were not injected died (3). 
Steroids offer another hope for developing a cure. The Gabonese doctor who brought the virus to South Africa was 
misdiagnosed and treated with steroids for another illness. He responded speedily to steroids and survived (4). Still
 another hope lies in the genetic makeup of the Ebola virus. All the known subtypes of Ebola were analyzed, and even 
though they were very different from each other, they were amazingly stable. Researcher Anthony Sanchez and his 
colleagues of the Special Pathogens Branch of the National Center for Infectious Diseases at the U.S. Centers for 
Disease Control wrote that the stability of each strain "bodes well for the development of effective immune or antiviral
 therapy or vaccination strategies" (4). The dissimilarity between the Ebola strains shows that the viruses are fairly 
old and could have evolved along with their natural hosts (5). This is a positive sign because the virus is much less 
likely to mutate before a cure can be discovered. But, in order to find a cure, research must take place, and research 
needs to be funded. Meanwhile, the ability to quickly detect an outbreak of infection is crucial. This ability is called
 surveillance. Most experts agree that this part of the public health system is the one that most needs improvement and 
what remains of the surveillance system is "inadequate to deal with emergent diseases like Ebola" ("Combating" 494). 
Morse at the Rockefeller University says, "We're all worried about the state of our surveillance system. We know what 
surveillance is, we know how to carry it out, we have much better tools than we did ten years ago, and yet our 
surveillance systems are not improving. If anything they are getting worse" (qtd. in "Combating" 504). The Center for 
Disease Control (CDC) has indicated four areas to improve surveillance: quicker detection and response to emerging and 
reemerging diseases, more research into diagnosis and prevention, better coordination of prevention efforts, and a 
stronger network for reporting more emerging diseases (506). A new system for fighting infectious diseases is needed. 
Morse points out that:
If we think of this as a new weapons system, which is really what it is, one that can 
protect us against an all-pervasive enemy that is always there to trouble us, it's a very 
cheap weapons system. The importance of this to our future has got to be as great as . . . 
any other defense program, and the cost is minuscule in comparison to what we would get 
out of it. (qtd. in "Combating" 506)
 
Budget constraints are seriously hindering necessary research. Inadequate funding for drug research has "worsened the 
plight of victims of emerging infections such as Ebola" (493). Brian Mahy, director of the CDC's Viral and Ricksettial 
Disease division, reflects that "[it is] a shame that we have absolutely nothing [to] offer- a serum or vaccine or a 
drug- for what everyone agrees is the most horrible infectious disease [known]" (qtd. in "Combating" 493). Experts agree
 that surveillance needs improvement, and research into prevention and treatment needs funding. Because of government 
cuts, the Army has stopped their antiviral research program. Mahy agrees that surveillance is the key; however, he also 
remarks that "At the end of the day, you also need some sort of treatment for diseases. But we are sadly lacking in 
research capacity. For the last nineteen years, since Ebola was first reported, when we might have been able to fund some
 research on developing a drug, . . . nothing has been done. There has been no money essentially to work on these 
viruses" (506). One example is the AIDS virus. Suppose the AIDS virus had been noticed before it spread. By the time it 
was discerned, however, it was too late for millions of people. The same mistake should not be made with Ebola. In 1996, 
the president's budget proposal requested $8.8 million for research; however, Republican lawmakers proposed $3.9 million 
for emerging infections (506). Many critics say that hot viruses like Ebola are "too deadly to have much of an impact on 
the growing population" (497). One reporter, Malcolm Gladwell, says, "Ebola kills its victims in two weeks, which doesn't
 give them much time to infect anyone else. Ebola kills too quickly to sustain a serious epidemic" (qtd. in "Combating" 
497). Although it may be true that the virus will "burn [itself] out" (506), however, "that logic may not hold true if . . . Ebola were to evolve into a vectorborne pathogen like malaria. If, like malaria, Ebola could live harmlessly in the body of a mosquito, it would not burn itself out and could spread throughout its carrier's range" (506). Most scientists predict this lethal microbe will appear in the future (507). When Ebola made its only documented appearance in the United States, fortunately, it did not strike humans. "In retrospect, it all worked out," says Henderson. "But the big issue is this: What do we do in an outbreak? We simply haven't worked this through" (507).
	








 
	Works Cited
"Combating Infectious Diseases."  CQ Researcher. 5(1995):489-512.
     "Ebola Developments: Treatment."  Electronic Telegraph.  31 December 1991              .
"Ebola Haemorrhagic Fever."  In Point of Fact No. 88.  May 1995.  1p.  3 Nov. 1998. .
"Ebola Virus Hemorrhagic Fever: General Information."  National Center for Infectious Diseases Centers for Disease Control and Prevention.  28 May 1998.  3pp.  3 November 1998. .
Preston, Richard.  The Hot Zone.  New York: Random House, 1994.
Rupp, Jennifer.  "Ebola Virus."  World Book Encyclopedia.  Chicago: World Book, Inc., 1998.  vol 6: 48.
Sanchez, Anthony., et al.  "Reemergence of Ebola Virus in Africa."  EID vol. 1 no. 3.  3pp.  National Center for Infectious Diseases Centers for Disease Control and Prevention.  19 January 1996.  3 November 1998. .
Troy, Kirk.  "The Plague That Wasn't."  Newsweek.  9 December 1996: 46.
Weil, John.  "Virus."  Grolier National Encyclopedia.  Connecticut: Grolier Incorporated, 1992.  Vol. 19: 613-16.
"Woman Dies from Ebola in South Africa."  CNN Interactive.  25 November 1996.  2pp.  David Clinch and The Associated Press.  3 November 1998 .