A reaction I’ve heard an absurd number of times regarding the covid pandemic goes something like “I’ll worry when Ebola hits the US.”
That happened. It really wasn’t much to worry about.
Today’s Moment of Science… the Ebola outbreak that wasn’t.
A nasty little filovirus, Ebola was first identified in a 1976 Zaire outbreak. Television dramatizations of it often depict a patient’s insides turning to mush, which is not quite accurate. Typically symptoms present about a week after exposure, but can take over three weeks to appear in some cases. It starts off with flu-like symptoms, and from there a patient can experience severe diarrhea, vomiting, muscle pain, and dehydration. Difficulty breathing and chest pain may occur within a week of symptoms starting.
Around the same time, due to the blood’s hindered ability to clot correctly, the patient experiences severe bleeding problems, internally and often at the mucus membranes. Though there are theories, the mechanism for how Ebola causes bleeding is not exactly clear. Suffice to say though, the terrifying visual we have of liquified organs is overblown. It’s called hemorrhagic fever, not “gooify your kidneys” fever. Still, hemorrhaging out your eyes and your ass simultaneously isn’t typically a sign of good health.
So in 1989, when some macaque monkeys in the Hazleton Lab in Reston, VA tested positive for Ebola, shit got a touch panicky.
Six people tested positive, including one animal handler who cut themselves while performing necroscopy on an infected specimen. A thorough investigation was undertaken to contain the virus, with precautionary measures treating this as an airborne virus, pathogenic to humans.
But then something even weirder happened than an Ebola outbreak in suburban Virginia: none of the humans got so much as a sniffle.
A strain of the virus now termed Reston Ebola (RESTV) was identified as the cause. It was pathogenic in the monkeys, but humans were unharmed, simply developing antibodies. It’s now known to spread between pigs, causing a sometimes fatal respiratory infection. Though it can also be passed from pigs to humans, it hasn’t mutated in any way that causes symptoms in humans. Yet.
Six ebola strains have been identified, four of which are confirmed to cause disease in humans. Though we often think of it as a disease that ravages everyone in its path, it’s more a disease that kills through poverty. It’s fatal up to 90% of the time in economically disadvantaged regions of the world. Get someone to a hospital with IV fluids, medications to manage the bleeding, and a monoclonal antibody cocktail? The chance of fatality drops to about 10%. Dr. Fauci has called some of the new monoclonal antibody treatments the “first drugs that, in a scientifically sound study, have clearly shown a significant diminution in mortality” for Ebola patients.
It’s fortunate to think these tools could provide a backbone to work from if Reston Ebola ever becomes pathogenic. It’s also disheartening to know that they’re not reaching the people in need now.
The tragedy of the disease being one of poverty is that it will go on much longer than it has to. The vaccine for Ebola is, incredibly, 97% effective. But where there’s Ebola, there are still far more annual fatalities from a disease with an affordable and widely available vaccine: measles.
This has been your daily Moment of Science, suggesting that poverty kills far more people than Ebola.
(Just because I know this will come up in the comments- yes, this was written about in The Hot Zone by Richard Preston which was made into a TV mini-series. Loved them both.)
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A little known fact, typically hidden deep in the underbrush or not mentioned at all, ever, is that there has long been a very effective vaccine for Ebola and another vaccine for Marburg virus, a filovirus closely related to Ebola virus. They were first developed in Winnipeg, Canada at the Canadian Science Center for Human and Animal Health, known locally as the “biolab,” in the early 2000’s, and they were found so effective in experimental challenges in macaques that the vaccinated animals were returned to the general animal population. When the Ebola hysteria of 2014 hit the news, the existence of a well proven vaccine was hardly ever mentioned, and post-recovery Ebola victims who donated immune plasma to infected individuals got all the publicity despite the dubious results of that approach. Relax, out there, an effective vaccine has been around for almost 20 years.
This article explicitly discusses the vaccine.