Chapter 8: Final Thoughts

                       The Ebola outbreak pose a severe health risks to individuals that live in Africa and also other countries that have come in contact with. One important aspects about Ebola that we should consider is that the disease have the ability to spread rapidly which is due to the countries weak healthcare system. Therefore, there is a high mortality rate in Africa than other countries such as the United States. The symptoms of Ebola is so frightening that many healthcare workers and/or physicians are withdrawing from the battlefield of fighting the Ebola in Africa. Quarantine are quite not that effective today, because many felt that they are deprived from their human rights, thus, they ignore the quarantine method and continue to interact with others and even transmitting the disease to other individuals. When will Ebola stop? No one knows..... One can say that Ebola can be listed on the top 10 lists of deadly killers along with guns, cancers, AIDS/HIV, and etc. What we need now is global collaboration on the discussions of infectious disease management, emergency preparedness, and training of any health care organization professionals to combat Ebola. What we know now is that virus tend to transmit through the contact of blood and bodily fluids. The natural host of Ebola is the native fruit bats of Africa, and can cause internal/external hemorrhaging. But still, the Ebola is a mysterious agent that requires more analysis and investigation. 

                 One final thought is that I would like thank everyone that have read my blog for the past few weeks, really appreciate your patience and comments. I hope everyone that have finish reading my blog would have a better understanding behind the Ebola outbreak and the virus itself. I also hope you will grasp this information as long as you lives because I'm definitely not going to forget this since I'm writing this blog. LOL!

Chapter 7: The Search for a Cure

                                                           Video courtesy of Youtube. BBC Horizon 2014 Ebola The Search for a Cure PDTV


                     Several weeks ago, I have discussed about the movie, "Outbreak," which is a fictional movie similar to the Ebola outbreak that is happening today. But for this blog, I would like to talk and critique about the documentary, BBC Horizon 2014 Ebola The Search for a Cure. The reasons why I chose this documentary is because I felt that this documentary show a better perspectives of what is going on today, the scientists and/or physicians approach to the Ebola outbreak and the search for a cure for this deadly disease. The documentary started with an introduction of the Ebola outbreak, where all the employees of  CDC: Center for Disease Control were having a meeting discussing the recent outbreak of Ebola and the numbers of death that are associated with it. In this documentary, not only does it gives a background of the history and/or origins of Ebola which was first found near the Ebola river in 1976. Scientists speculated that the virus was acquire from bushmeat, especially from fruit bats which I have also discusses about in the previous blog. One important aspects that was learned from watching this documentary is the major source of the reasons why a certain area in the West Africa, suddenly being struck with high numbers of death due to untrained nuns that was running the "sort of" hospital and by reusing needles and syringes, thus, many individuals were contracting the Ebola virus and dying from it. Another points that I want to discuss is the action of the medical field especially in finding a cure for Ebola. Currently today in the news, alot of pharmaceutical companies have been claiming that they have created a drugs and/or vaccine for Ebola but DO WE KNOW IF THE EXPERIMENTAL VACCINE AND/OR DRUGS ARE EFFECTIVE AGAINST EBOLA? Also, the pharmaceutical companies are not disclosing enough information on the vaccine and/or drugs so can we actually relied on the information that was given. In addition, many people around the world would not understand the situation in which the people in Africa are suffering from because they could only hear about Ebola but do they see what is actually happening in Africa right now? One positive aspects of the documentary is that the production crews were able to show us the situation of what is occurring in Africa. After viewing the scenes where the patients with Ebola being held is just a horrible sight. Other viewers would definitely agree with me that the environment of the so-called treatment facilities and/or hospitals should change. The bedsheets, mattresses, medical equipments and etc, should be changed and replaced with something nice such as what we have in the United States. 
             It is nice to see a scientific view of Ebola than the movie, "Outbreak" because the documentary was created by BBC, alot more reliable source than a fictional movie. Of course, the movie was pretty entertaining to watch but as the Ebola outbreak is slowly becoming a severe issue around the world, it is nice to watch something about Ebola that is created by a reliable sources. As the audience and a very concerning one, we should understand what is going on around the world especially in the case of Ebola. There are definitely more people contracting Ebola in the near future, so as concerning citizens, we should be alert, understand the background of Ebola, the prevention, what is the physicians and/or scientists trying to do to prevent Ebola and etc. Furthermore, this documentary made several key points on Ebola so I believe this is a very educated and interesting documentary to watch for the general public. 

Chapter 6: FAQ

FAQ on Ebola:

The WHO: World Health Organization and CDC: Centers for Disease Control and Prevention have reported nearly 8,000 people have been confirmed or suspected of having Ebola. Around the world, a lot of people are scared and petrify. And here are some several questions that people are curious and concerns about:


1) How is Ebola controlled?
- By quickly recognizing patients that are infected by Ebola and quarantine those that have Ebola. Proper prevention and protection is crucial in protecting an individual that are treating those that are infected should wear proper uniforms, gears, and instruments to prevent the spread of the disease. Strict rules must be imposed.

2) Can Ebola be spread by insects such as mosquitoes?
- There are no current evidences that mosquitoes can transmits the Ebola virus, but it has been found that fruit bats is the host of the Ebola virus and that the fruit bats transmits the disease the wild animals and than human. 


3)What are the treatments for Ebola?
- Currently, there are no treatments for Ebola, but there are intensive care such as IV, monitoring blood pressure, and others to be performed on  patients with Ebola.

4) Can someone survive the disease?
- Yes, there have been survivors of the Ebola.  

5) Should I get tested?
- If you are experiencing any symptoms that are indicated on the WHO: World Health Organization and the CDC: Centers for Disease Control and Prevention websites, then it is better to be tested. 

6) What is the life expectancy of the Ebola virus?
- According to researchers and scientists, they indicated that the Ebola virus can survive on the surfaces for hours versus other viruses that can survive for days. 

7) Who have the highest risks of getting infected?
- Generally speaking, usually people that have the most contact with patients with Ebola, tends to have the highest possibilities of getting Ebola. People such as physicians,  nurses, mourners, family members, and etc. 

8) How do you know if you have Ebola?
- If you suddenly have a fever that is over 95 degree Celsius, muscle pain, headache, intense weakness, and/or sore throat. Then you should have it check out. The later stages which includes vomiting, diarreha, rash, bleeding internally and externally, and impaired kidney and liver functions, which required full immediate attention. 

9) Is quarantine necessary?
- Yes, usually, patients are contagious when they begin to shows the signs and/or symptoms of Ebola. So, in order to prevent others from getting infected by Ebola, the patients must be isolated from others to prevent the further spread of the disease. 

10) What is the advice of traveling?
- It is best to avoid traveling, unless, due to business and/or personal issues than the travelers should be vigilant with their surroundings, the people around them, and their health. Any changes to their health should be reported and they must seek medical attention as soon as possible.


References:
http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/qa.html
http://www.who.int/csr/disease/ebola/faq-ebola/en/
http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/epr-highlights/3648-frequently-asked-questions-on-ebola-hemorrhagic-fever.html
http://www.rivm.nl/en/Topics/E/Ebola/Frequently_asked_questions_about_Ebola
http://www.health.state.mn.us/divs/idepc/diseases/vhf/basics.html

Chapter 5: Transmission and Prevention

            So far, we have understand the natural reservoir for the Ebola virus was fruit bats, which I have already discuss in Chapter 4. In addition,  there have been research and studies being conducted to find the "why and how" Ebola was transmitted from fruit bats to primates, primates to humans, and human to human. Accordingly to the World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC) websites, both institutes provided a decent and relevant information on the transmission processes and facts on how do we prevent the spread of Ebola. Both institutes emphasizes that fruit bats, the host of the Ebola virus would pass the strands of the Ebola virus to wild animals such as primates by eating fruits and these unfinished fruits including the saliva of the fruit bats would drop to the ground when the fruits becomes ripe. And these bitten fruits would be consume by wild animals. Thus, this wild animals would  be consume by humans by the process of wild hunting. A terminology that academic officials used is "bushmeat." According to FreeDictionary.com, the definition of "bushmeat" is meat taken from any animal native to African forests, including species that may be endangered or not usually eaten outside Africa. Therefore, by eating these meats that came in contact with fruit bats would pass on the Ebola virus to humans. Since the symptoms of the Ebola would not appear to 2-21 days, the humans are unaware of the disease/illness, thus, the human would tend to transmits the Ebola virus to other family members, friends, and strangers. Accordingly to the WHO and CDC's websites which includes several methods on how Ebola is transmitted. They indicated that Ebola is spread through direct contact of a patient who is sick with Ebola, in terms of broken skin or mucous membranes by:

• Body fluids (e.g. saliva, feces, urine, vomit, and semen)
• Blood
• Contaminated objects (e.g. needles and syringes)
• Infected animals (especially fruit bats)

 IMPORTANT FACTS: Ebola is not spread by airborne or water.

                  Usually, individuals like healthcare providers, people that are responsible in disposing the dead bodies of patients with Ebola would tend to have the highest risk of getting infected by the Ebola virus because they have the highest rates in coming in contact with patients with Ebola. Therefore, the WHO and CDC proposes a strict protocol of protection for healthcare providers and other individuals that also comes in contact with patients with Ebola. Prevention and protection includes: the healthcare providers must wear protective equipments such as the space suits, gowns, masks, gloves, and anything that literally covered your entire body. Healthcare providers are instructed to dispose any syringes, needles, or anything instruments that have been performed on a patients must be completely removed. Also the patients that are recovering from Ebola should abstain themselves from having sex because evidence shows that the Ebola virus has been found in semen for up to 3 months, thus, physicians proposes that these patients should avoid having sexual intercourse or use a condom for 3 months or more.  

                                          Photo courtesy of UNICEF. Shows the signs and symptoms of Ebola. Including transmission and prevention.




Reference:
http://www.thefreedictionary.com/bushmeat
https://pbs.twimg.com/media/Brd0BoVCIAE9QaJ.jpg
http://www.who.int/mediacentre/factsheets/fs103/en/
http://www.cdc.gov/vhf/ebola/transmission/index.html
http://www.cdc.gov/vhf/ebola/prevention/index.html

Chapter 4: Fruit bats as reservoirs of Ebola virus

              An interesting journal article that I read from nature.com is about a study being conducted to find the primary source of the recent Ebola outbreak in Africa. Between the years of 2001 and 2005, there were a high numbers of individuals being infected by the Ebola virus, and also been linked to the concurrent outbreaks that devastated the gorilla and chimpanzee populations. In order to identify the cause, scientists and researchers captured a total of 1,030 animals, including 679 bats, 222 birds and 129 small terrestrial vertebrates, and were tested for the presence of the Ebola virus and/or symptoms. According to the article, it have been found that among the 1,030 captured wild animals, immunoglobin G (IgG) that specific in detecting Ebola virus, were detected in serums from three different classes of bat species. The article imply, "(4 of 17 Hypsignathus monstrosus, 8 of 117 Epomopsfranqueti and 4 of 58 Myonycteris torquata)," (Leroy, 575). On the side notes, the two principle organs that are targeted by the Ebola virus are the liver and the spleen. Based on the article, which indicates, "Viral nucleotide sequences were detected in these organs in other bats from the same populations (4 of 21, 5 of 117 and 4 of 142, respectively). No viral RNA was detected in kidneys, heart or lung in these animals after amplification by polymerase chain reaction (PCR) and no viral nucleotide sequences were revealed in any of the other animal species tested," (Leroy, 575). Surprisingly, of the bat species that were captured, majority of the bats were PCR-positive and IgG-positive, but not in all of the captured animals.
          Another findings that the article emphasizes is the yearly seasons which can also contribute to the episodic Ebola outbreaks. According to the article, "Mortality among great apes from Ebola infection can increase during the dry seasons when fruit is scarce in the forest-conditions that foster contact between animals as they compete for food. Immune function in bats also changes during these periods, for example as a result of food scarcity or pregnancy, which would favour viral replication and-aided by aggressive interactions-increase infection among great apes," (Leroy, 575). Therefore, the article implies that these factors my contribute to the occasional Ebola outbreaks in Africa. Not only does it apply to animals, humans should consider this factors because native Africans consume these animals by hunting, in another terminology "bushmeats" which is how humans obtain the Ebola virus.
          In conclusion, the article states that based on the study that were conducted on the 1,030 captured wild animals, the findings supported the hypothesis of Fruit bats as the natural reservoirs (an organism in which a parasite that is pathogenic for some other species lives and multiplies usually without damaging its host) of the Ebola virus and also Marburg viruses. According to the article, "...and as reservoirs for the virus families  Paramyxoviridae and Rhabdoviridae which are genetically related to Ebola," (Leroy, 575).

Article: Fruit bats as reservoirs of Ebola virus
http://www.nature.com/nature/journal/v438/n7068/abs/438575a.html


Reference:
http://www.nature.com/nature/journal/v438/n7068/abs/438575a.html

Chapter 3: "What if"

                                                                                                                            Photo courtesy of Quentin X. Wikipedia


                The movie "Outbreak" is a 1995 American film which portray medical disasters, starring Dustin Hoffman, Morgan Freeman, Rene Russo, and co-stars Cuba Gooding, Jr., Kevin Spacey, Donald Sutherland, and Patrick Dempsey, and directed by Wolfgang Peterson.  The film focuses on the outbreak of a fictional virus called Motaba (very similar to Ebola virus), which causes deadly fever. One major difference is that the fictional-Ebola like virus, Motaba is infected by airborne whereas, Ebola is infected by human to human transmission.


 When:
       The fictional Ebola-like virus called Motaba was first discovered in the African jungle in 1967, but then twenty-eight years later, Motaba resurfaces in Zaire and it is infecting a huge amount of innocent individuals.

Where:
      The film takes place in two location: Zaire (Africa) and a small town in the United States. Which is the results from the transmission of one of the host animal, a white-headed capuchin monkey named Betsy. 

Who: 

•       Dustin Hoffman portrays a USAMRIID virologist named  Colonel Sam Daniels, who is sent to investigate the medical problem in Zaire. Came back to the United States to alert the people.

•       Patrick Dempsey starring a Biotest animal holding facility named James "Jimbo" Scott, illegally brought a white-headed capuchin monkey named Betsy from Zaire to the United States. Jimbo tries to sell Besty to Rudy, a pet store owner, who is also infected with Motaba. Later Jimbo started to show signs of infection while traveling to Boston, where he transmitted the disease to his girlfriend, Alice, by kissing her. He later died from Motaba.
•      Morgan Freeman portrays William Ford, who was a US Army officers in 1967, he and Donald McClintock, destroy the camp where the Motaba virus was found. After twenty-eight years later, currently a General, superior of Daniels.
•      Donald Sutherland portrays Donald McClintock, a US Army officers, he and William Ford, destroy the camp where the Motaba virus was found.
•      Kevin Spacey as Lieutenant Colonel Casey Schuler, who join the task of investigating the Motaba virus and later came back to the United States to alert the people. 
•      Cuba Gooding, Jr. starring Major Salt, a new recruit that joins the team to investigate the Motaba virus.
•      Daniel Chodos portrays Rudy Alvarez, a pet store owner, who later is infected with Motaba, before he releases Besty to the woods. He later died from Motaba. 
•       Alice, plays by Kellie Overbey, is the girlfriend of Rudy, who receive the virus by kissing. Later died from Motaba.
•       Rene Russo starring a CDC scientist and Daniel's ex-wife, Dr. Roberta Keough, who also investigates the infection and later establishes that no individuals in Boston was infected with the virus beside Jimbo and Alice.
•       Leland Hayward III as Henry, a technicians at a Cedar Creek hospital who was responsible in running tests on Rudy's blood, accidentally breaks a vial, splattering the contents, and infecting numerous Cedar Creek citizens with Motaba, and in addition, he died from the virus. 

What: 
       Basically, the movie depicts a somewhat similar scenario as what is currently happening today in real life. Except the bombing, monkey spitting at you, and a rocket scientist that was able to create a cure for the treatment at a short amount of time. Overall, the movie depiction of the sign and/or symptoms of the virus is quite similar to Ebola. So what is the movie about? Well, an idiot named Jimbo, let loose an illegally stolen monkey named Betsy from the Zaire where the Motaba virus was identified and is infecting and killing alot of cilivans in Zaire, Africa. Of course, Betsy is the reservoirs of the virus because throughout the movie, whoever comes in contact with Betsy tend to died and also expresses the sign and/or symptoms of the virus. Jimbo not only infected himself with the Motaba virus but also transmitted the disease to his girlfriend which later both of them died from the virus. Actually, Jimbo was not the only idiot in this movie, we also have Henry, the technician from Cedar Creek Hospital, which he was responsible for running blood tests on Rudy, yet he was so focus on horse racing, which he accidentally breaks a vial, causing the blood content to splatter on his face. Then he went to the movie with his girlfriend, and also coughing nonstop without covering his mouth. And therefore, the virus was transmitted to other people in Cedar Creek by airborne. (SERIOUSLY, don't he understand to cover his mouth when his job is related to health and medicine.) So the town was infected with Motaba, and they were quarantine, causing fears and panic for the government and among other citizens. Sam found out that the military has decided to bomb the town of Cedar Creek so he tries to prevent the military plan, and was able to capture Betsy and using Betsy's antibodies and with the E-1101 to create an anti-serum in time to save the town. 


How:
        Reinforcement from the "What," Sam found out that Ford, already knew Motaba and that the national security have kept a mysterious serum, called E-1101, however, the serum does not work of the citizens of Cedar Creek so he uses Betsy's antibodies and the serum together and were able to create a cure for Motaba and save the citizens of Cedar Creek.


          First of all, I like to discuss what I like about this movie. 1) The bleeding, and other physical symptoms demonstrated a great and accurate depiction of Ebola virus. 2) The transmission scene was really interesting and kind of scary. Now I really understand how important to cover our mouth or nose when we cough or sneeze. 3) Great actors and actresses, I really love the monkey, Betsy, the most. Hope that there were no animal abuse on sets. What astonishes me is that the government and the military would go beyond the extreme to launch a bomb on the town that were infected by Motaba. I really hope that this does not happen in reality. So is Ebola similar to the fictional Motaba? Well Ebola is NOT transmitted by airborne, or water. It is speculated that fruit bats is the reservoir of the Ebola virus. In contrast, with the movie, Betsy is known to be the host of the virus, Motaba and that she transmitted the virus to Jimbo by spitting at him and scratching Rudy. It seems that Motaba and and Ebola have similar symptoms (e.g. bleeding internally/externally, eyes, ears, nose, fever, gastrointestinal tract, etc). In conclusions, this movie makes a great references if anyone is interested in learning more about Ebola and the symptoms.
  

Chapter 2: Signs and Symptoms

       According to the WHO: World Health Organization, the signs and symptoms of Ebola virus includes:
  

First sign/stage of symptoms:

• Fever fatigue (greater than 38.6 or 101.5 degree Celsius)
• Severe headache
• Sore throat
• Muscle pain

Follow by second stage:

• Weakness
• Diarrhea
• Rash
• Vomiting
• Abdominal pain
• Symptoms of impaired kidney and liver function
• Unexplained hemorrhage (bruising or bleeding)
•  Bleeding includes internal/external (for ex: oozing from the gums, blood in stool, vagina, gastrointestinal tract, nose, eye, etc)
• Cough up/vomit blood 
• Red eyes 

Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.  First stage of symptoms are usually similar to malaria, topic fevers, and dengue fever. But eventually proceed to the bleeding phase which is in cases about 40-50%. Heavy bleeding is rare but can be dangerous because heavy loss of blood may lead to death.

                        Signs and Symptoms of Ebola. Photo courtesy of Mikael Haggstrom: Ebola Hemorrhagic Fever from Centers for Disease Control and Prevention.


Reference:
 http://www.who.int/mediacentre/factsheets/fs103/en/
 http://www.cdc.gov/vhf/ebola/symptoms/index.html