Ebola and Marburg Viruses
I have few real friends, but I have a large number of “acquaintances.” Some are from ~30 years of working in the Educational Media (and we can all laugh at that some other time), some are from my days as a college student, some from my interest in Anthropology, and some from Engineering background.
Due to my medical conditions, an odd blood disorder, learning disabilities, asthma, I am perhaps more interested in the world of medicine then the ‘average’ person. Through some of my “acquaintances” I had lunch with some professional epidemiologists. These are the medical types who study diseases and how they spread. I was interested in Ebola and Marburg virus and the possibility of either becoming an epidemic. The consensus was neither has a realistic chance of becoming a global threat. Now if some a$$hole idiot decides to do some DNA slicing and dicing, then all bets are off. There is a very slim chance of Ebola, or Marburg, infecting a pig that is infected with flu and some natural “DNA slicing and dicing” >could< occur. Not likely, but once would be enough. And pigs are common in Africa…and flu is pandemic world wide…But it hasn’t happened yet and >probably< won’t happen.
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Ebola and Marburg are very similar viruses. They ‘digest’ the bodies of mammals that become infected and convert a large percentage of the ‘meat’ into virus particles. Both are a horrible way to die. Both have very high death rates, and while Marburg is slightly less lethal then Ebola, no sane person wants anything to do with either. From a practical perspective they can be considered the same. The primary difference being one strain of Ebola (Ebola Reston) burns through monkeys like a wildfire, but produces a sub-clinical infection (an infection that is not noticed) in humans. Both known strains of Marburg ‘eat’ people as easily as monkeys.
Much of the popular press/media would lead you to believe the current outbreak of Ebola Zaire in Africa is the end of the world. But the facts suggest otherwise.
Marburg virus entered the world’s consciousness in 1967 when it appeared in a research facility in the West German town of Marburg. Viruses are commonly named after the place where they are first identified. While ‘native’ peoples in Africa had almost certainly been getting ill and dieing for a very long time, people in the ones and twos dieing of odd diseases in Africa were of interest only to their family and friends. This isn’t to minimize the loss of any life, but in an area where several forms of Malaria killed thousands, the few deaths were simply lost in the noise.
The lab in Marburg used monkey kidneys to grow vaccines. The monkeys where imported from Africa and carried the Marburg virus with them. Human animal care technicians contracted Marburg from the monkeys. A total of 23 people became ill and 7 died, for a lethality rate of about 23%. Over the intervening years Marburg has popped up in around the world, but only in the wild in Africa. There were two accidents in the USSR (biowarfare?) research labs that infected people in ones and twos. In Africa in the 1998~2000 time frame at least 154 people became infected and 128 died for a lethality rate of about 83%. In 2004~2005 252 people were infected with Marburg in Angola, 252 died. Marbarg appears to kill between 23% and 90% and this is on a par with Ebola.
From the limited information available from the initial outbreak in West Germany it is apparent it took the medical community a while to realize something bad was happening. Somehow I would have thought people getting sick, bleeding out every opening in the body, and turning to goo, would have been a clue… But in spite of the initial confusion, only two people who didn’t work at the lab became ill. A worker recovered from Marburg and engaged in sexual relations with his wife. His seminal fluid was loaded with Marburg virus and the wife became ill. And morgue attendant who became infected handling infected corpses.
The important ‘take away’ is that even when confronted with a brand new illness that scared the crap out of the medical community, the disease did not run “rampant” in the larger community. It was contained in the lab with only two breaches, the wife and the morgue worker. It did not become an epidemic. Other then the two, no one outside the lab became ill. West Germany and central Europe were not depopulated. Marburg was contained, even though the medical community didn’t fully understand what they were dealing with. Standard medical procedures, quarantine, and barriers, stopped Marburg from spreading.
It is very important to understand that standard medical practices and procedures stopped an unknown pathogen without knowing the specifics of the disease.
Marburg and Ebola are a serious concern in impoverished African nations. It is probably fair to say Ebola and Marburg are >only< a concern because of the extreme poverty.
Major Ebola outbreaks, mini-epidemics, have so far occurred because disposable, one use, hypodermic needles are being reused. If one person comes in with Ebola, or Marburg, and receives an injection, then the needle is reused, everyone who receives an injection after the infected person stands a very good chance of contracting Ebola (or Marburg).
The funeral practices of Africa also are an important factor. I am not trying to be gross, but Ebola (and Marburg) both cause the human body to rapidly decay. Monkeys that died from Ebola Reston were pre-decayed, or looked like they had been dead for several days as soon as they died. Bodies break down into a highly infectious “goo”, the “goo” is literally loaded (as in a significant percentage of the “goo” is virus particles) with viruses. When the body of someone who died of Ebola (or Marburg) is handled by people who are not wearing biological protective gear, the handlers stand an excellent chance of contracting Ebola.
Most of us have microscopic breaks in the skin covering our hands. We use our hands for most human activity and they get damaged. Breaks in the skin happen with regularity. Most of the time this isn’t a big deal. Our skin rapidly heals, our blood clots and maintains our natural barrier and our immune system wipes out most intruders. But a select few pathogens (germs, viruses and fungi) take advantage of those breaks and enter our body. Most pathogens are fairly benign. Even Smallpox and plague (Yersinia pestis) require reasonably high numbers of “germs,” (300 to 400) Marburg and Ebola may only require as few as 4 or 5 virus particles!!!!! Even Aids is thought to require several hundred virus particles. Ebola and Marburg are unbelievably infectious.
Anyone who deals with any infected person, or animal, without proper barriers is playing Russian Roulette with all 6 chambers loaded, or using a semiautomatic with a round in the chamber and the safety off. But with the use of proper medical barrier techniques, and if you don’t inject Ebola into your arm (or butt), the risks are >probably< minimal. But if you don’t have gloves, (new intact gloves are mandatory!) and you handle a sick person or corpses, you stand a very good chance of contracting Ebola (or Marburg). It should be noted that “very good chance” is not “certainty”.
One of the hottest, most contagious and most lethal strains of Ebola Zaire comes from a young nurse who died from the disease. This strain is so special it has it’s own name, Ebola Zaire Mayinga. This strain is used for a lot of research. (Really? Why in the name of God do people mess with this stuff?)
It is considered the most lethal Ebola strain in existence. And it is likely the most lethal (natural) infectious agent in existence.
But…..
Nurse Mayinga wondered around Kinshassa after working with a nun who died of Ebola. She was symptomatic, that is was running a fever and had a headache and is presumed to have been a walking bioreactor. She interacted with at least 37 people and shared a soft drink with one person and none of them became infected. The physician who was treating Nurse Mayinga initially wore a gasmask, but realized she (doctor) was wading in a sea of virus and decided she wasn’t going to survive anyway. After the nurse died the doctor cleaned up the room where the nurse died and the two rooms where other patients had died of Ebola. In spite of working in a sea of virus, the doctor did not become ill.
If Ebola is as deadly as we know it to be, and if it spreads as easily as we know it to spread, how did this doctor not contract Ebola?
Ebola and Marburg are full of these paradoxes. A brother became ill with Marburg and the sister did not. The family was on vacation and the siblings were inseparable. The medical types can’t explain how one child became infected and died and the other didn’t.
One early explanation was perhaps some people simply fought off the virus. But from ~1993 on it became possible to measure antigens, defense products, in people who had been infected and recovered. In most cases where Ebola, or Marburg, didn’t spread, those around the infected person showed no antibodies, which means they simply didn’t become infected.
A related issue is the lack of education. “Germ” theory is poorly understood. Traditional beliefs predominate. The belief in ghosts, evil spirits, curses, hexes and similar supernatural agents is a hindrance in getting the general population to use proper techniques.
Of course even with the proper education, the lack of medical barrier equipment, (gloves, masks) the lack of effective disinfectants (carbolic acid, strong chlorine bleach, etc) pose serious challenges.
Several epidemics have been stopped only when the ‘medical’ workers panicked and abandoned their hospitals and people stopped coming. Hospitals in Africa have been the centers of infection in most serious outbreaks. I am not trying to be gross of flippant, but one classmate who was in Zaire during an outbreak compared the affected (infected) hospital to a “roach motel”, “They check in but don’t check out.” (I would have chosen Hotel California “You can check in anytime you want, but you can never leave) But even at the height of the outbreak, when the general public was panicking (and the medical community had already really freaked out), common street crime and malaria were a much bigger threat. My classmate considered herself lucky to have only been mugged and not raped….
Somehow I suspect that as bad as the current Ebola outbreak is, and 200 to 400 people turning into goo and dieing is bad, it isn’t something to obsess over.
Consider that with the west’s first meeting with Marburg, the virus only managed to kill about
A related problem in Sub-Sahara (Africa south of the Sahara Desert) is western medical technology has lead to dramatically increased populations. More people means more land is needed for farming. While tropical vegetation is lush, the soil isn’t nearly as rich was one would could expect. The frequent heavy rains washes nutrients from the soil. Soil rapidly becomes depleted and must be abandoned. Which means ever more forest is cleared. As the forest is cleared the local population interacts with more “critters”. Increased interaction gives more chance for Ebola, or Marburg, to jump to humans.
Currently most experts believe Ebola is present in an animal reservoir, and Fruit Bats are the current favorite. One disease vector model suggests that Fruit Bats pick up fruit, eat a little, and drop the half eaten fruit where it is picked up and consumed by ‘primates’. Primates includes humans, gorillias, chimpanzees, baboons and monkeys.
A popular food is Fruit Bat. These are consumed in a wide range of ways, stews, fried, baked, raw (Hum, do I really want to eat something that may well harbor Ebola?)…
Then there is Bush Meat. Humans like to eat. Most humans like meat. Africa is impoverished. Meat is expensive. So the locals eat Fruit Bats, and Bush Meat.
Bush Meat is a euphemism for “Primates”. This could be lower monkeys or “Higher Primates”, Chimps, Baboons, Gorillas. And in the process of butchering these primates, the butchers are exposed to ‘bodily fluids’.
I am surprised that Ebola isn’t more of a problem, like a constant low-level epidemic.
200~400 dead since perhaps October of 2013….not that big of a deal.
As to the whole “But Ebola is now airborne” hysteria….sorry it just ain’t so. IF, please note the >IF< Ebola had really made the jump to effective airborne spread, we wouldn’t have <400 infected, we would have 40,000 or 400,000.
Ebola will make it to Europe. Too many poor people in Africa desperate for a “better life” have little to lose. Stay home and starve, die of malaria, or risk sneaking into Europe, “The Land of Milk and Honey.”
Hum…what would you do if you were poor, poor that makes Mexico looks rich, and those greedy bastards to the north have more then they need and won’t share…wouldn’t you try for the brass ring.
And please folks, I am not defending people who try to sneak in, AKA >INVADE<, other countries. But reality is reality, as long as desperately poor people see (or seek) a better life, they will take insane risks to get to that life. And they will bring their diseases with them. Ebola, Marburg, Rift Valley Fever, Lassa Fever….and some of those diseases will take root, Aids, drug resistant TB and these will become (have became) a problem.
Aids was probably a local problem in Africa for decades, if not generations. As highways were built, the sex trade popped up along those highways. Morality aside, hunger is a strong aphrodisiac. In the early 1990s it was estimated that at least 80% of the prostitutes along those highways were HIV positive.
Anyone really want to guess how many of those illegal immigrants will have HIV/AIDS? And how many poor women/girls/men/boys will become, lets be euphemistic here, workers in the “sex trade”?
If you insist on having something to really worry about, consider what would happen if Aids becomes airborne….
HIV/AIDS is here already. Most of us pass people infected with HIV every day.
Of course I was somewhat dismayed to find out the US government has contingency plans to extract US citizens from Africa in the event Ebola, or Marburg, does manage to become something more then an idle threat. Really? It is somehow a good idea to bring people out of an epidemic zone? If I were the one doing the planning, I would be thinking about air exclusion zones, AKA ‘No Fly Zones”. Keep aircraft out of the area; let no aircraft in the area fly out. Apply a blockade to enforce quarantine. Contain and let it burn out. Yea, I guess I am a rather unpleasant person. But consider there is no effective treatment and no vaccine. Is it really unreasonable to consider enforcing a quarantine.
In “The Andromeda Strain” one plan to deal with a ‘wildfire’ was the use of a thermonuclear device to “cauterize” the infection. Dramatic? Overkill? I don't know. As bad as it would be, it might be better then the alternative.
Terry
I have few real friends, but I have a large number of “acquaintances.” Some are from ~30 years of working in the Educational Media (and we can all laugh at that some other time), some are from my days as a college student, some from my interest in Anthropology, and some from Engineering background.
Due to my medical conditions, an odd blood disorder, learning disabilities, asthma, I am perhaps more interested in the world of medicine then the ‘average’ person. Through some of my “acquaintances” I had lunch with some professional epidemiologists. These are the medical types who study diseases and how they spread. I was interested in Ebola and Marburg virus and the possibility of either becoming an epidemic. The consensus was neither has a realistic chance of becoming a global threat. Now if some a$$hole idiot decides to do some DNA slicing and dicing, then all bets are off. There is a very slim chance of Ebola, or Marburg, infecting a pig that is infected with flu and some natural “DNA slicing and dicing” >could< occur. Not likely, but once would be enough. And pigs are common in Africa…and flu is pandemic world wide…But it hasn’t happened yet and >probably< won’t happen.
- - - - - - - - - - -
Ebola and Marburg are very similar viruses. They ‘digest’ the bodies of mammals that become infected and convert a large percentage of the ‘meat’ into virus particles. Both are a horrible way to die. Both have very high death rates, and while Marburg is slightly less lethal then Ebola, no sane person wants anything to do with either. From a practical perspective they can be considered the same. The primary difference being one strain of Ebola (Ebola Reston) burns through monkeys like a wildfire, but produces a sub-clinical infection (an infection that is not noticed) in humans. Both known strains of Marburg ‘eat’ people as easily as monkeys.
Much of the popular press/media would lead you to believe the current outbreak of Ebola Zaire in Africa is the end of the world. But the facts suggest otherwise.
Marburg virus entered the world’s consciousness in 1967 when it appeared in a research facility in the West German town of Marburg. Viruses are commonly named after the place where they are first identified. While ‘native’ peoples in Africa had almost certainly been getting ill and dieing for a very long time, people in the ones and twos dieing of odd diseases in Africa were of interest only to their family and friends. This isn’t to minimize the loss of any life, but in an area where several forms of Malaria killed thousands, the few deaths were simply lost in the noise.
The lab in Marburg used monkey kidneys to grow vaccines. The monkeys where imported from Africa and carried the Marburg virus with them. Human animal care technicians contracted Marburg from the monkeys. A total of 23 people became ill and 7 died, for a lethality rate of about 23%. Over the intervening years Marburg has popped up in around the world, but only in the wild in Africa. There were two accidents in the USSR (biowarfare?) research labs that infected people in ones and twos. In Africa in the 1998~2000 time frame at least 154 people became infected and 128 died for a lethality rate of about 83%. In 2004~2005 252 people were infected with Marburg in Angola, 252 died. Marbarg appears to kill between 23% and 90% and this is on a par with Ebola.
From the limited information available from the initial outbreak in West Germany it is apparent it took the medical community a while to realize something bad was happening. Somehow I would have thought people getting sick, bleeding out every opening in the body, and turning to goo, would have been a clue… But in spite of the initial confusion, only two people who didn’t work at the lab became ill. A worker recovered from Marburg and engaged in sexual relations with his wife. His seminal fluid was loaded with Marburg virus and the wife became ill. And morgue attendant who became infected handling infected corpses.
The important ‘take away’ is that even when confronted with a brand new illness that scared the crap out of the medical community, the disease did not run “rampant” in the larger community. It was contained in the lab with only two breaches, the wife and the morgue worker. It did not become an epidemic. Other then the two, no one outside the lab became ill. West Germany and central Europe were not depopulated. Marburg was contained, even though the medical community didn’t fully understand what they were dealing with. Standard medical procedures, quarantine, and barriers, stopped Marburg from spreading.
It is very important to understand that standard medical practices and procedures stopped an unknown pathogen without knowing the specifics of the disease.
Marburg and Ebola are a serious concern in impoverished African nations. It is probably fair to say Ebola and Marburg are >only< a concern because of the extreme poverty.
Major Ebola outbreaks, mini-epidemics, have so far occurred because disposable, one use, hypodermic needles are being reused. If one person comes in with Ebola, or Marburg, and receives an injection, then the needle is reused, everyone who receives an injection after the infected person stands a very good chance of contracting Ebola (or Marburg).
The funeral practices of Africa also are an important factor. I am not trying to be gross, but Ebola (and Marburg) both cause the human body to rapidly decay. Monkeys that died from Ebola Reston were pre-decayed, or looked like they had been dead for several days as soon as they died. Bodies break down into a highly infectious “goo”, the “goo” is literally loaded (as in a significant percentage of the “goo” is virus particles) with viruses. When the body of someone who died of Ebola (or Marburg) is handled by people who are not wearing biological protective gear, the handlers stand an excellent chance of contracting Ebola.
Most of us have microscopic breaks in the skin covering our hands. We use our hands for most human activity and they get damaged. Breaks in the skin happen with regularity. Most of the time this isn’t a big deal. Our skin rapidly heals, our blood clots and maintains our natural barrier and our immune system wipes out most intruders. But a select few pathogens (germs, viruses and fungi) take advantage of those breaks and enter our body. Most pathogens are fairly benign. Even Smallpox and plague (Yersinia pestis) require reasonably high numbers of “germs,” (300 to 400) Marburg and Ebola may only require as few as 4 or 5 virus particles!!!!! Even Aids is thought to require several hundred virus particles. Ebola and Marburg are unbelievably infectious.
Anyone who deals with any infected person, or animal, without proper barriers is playing Russian Roulette with all 6 chambers loaded, or using a semiautomatic with a round in the chamber and the safety off. But with the use of proper medical barrier techniques, and if you don’t inject Ebola into your arm (or butt), the risks are >probably< minimal. But if you don’t have gloves, (new intact gloves are mandatory!) and you handle a sick person or corpses, you stand a very good chance of contracting Ebola (or Marburg). It should be noted that “very good chance” is not “certainty”.
One of the hottest, most contagious and most lethal strains of Ebola Zaire comes from a young nurse who died from the disease. This strain is so special it has it’s own name, Ebola Zaire Mayinga. This strain is used for a lot of research. (Really? Why in the name of God do people mess with this stuff?)
It is considered the most lethal Ebola strain in existence. And it is likely the most lethal (natural) infectious agent in existence.
But…..
Nurse Mayinga wondered around Kinshassa after working with a nun who died of Ebola. She was symptomatic, that is was running a fever and had a headache and is presumed to have been a walking bioreactor. She interacted with at least 37 people and shared a soft drink with one person and none of them became infected. The physician who was treating Nurse Mayinga initially wore a gasmask, but realized she (doctor) was wading in a sea of virus and decided she wasn’t going to survive anyway. After the nurse died the doctor cleaned up the room where the nurse died and the two rooms where other patients had died of Ebola. In spite of working in a sea of virus, the doctor did not become ill.
If Ebola is as deadly as we know it to be, and if it spreads as easily as we know it to spread, how did this doctor not contract Ebola?
Ebola and Marburg are full of these paradoxes. A brother became ill with Marburg and the sister did not. The family was on vacation and the siblings were inseparable. The medical types can’t explain how one child became infected and died and the other didn’t.
One early explanation was perhaps some people simply fought off the virus. But from ~1993 on it became possible to measure antigens, defense products, in people who had been infected and recovered. In most cases where Ebola, or Marburg, didn’t spread, those around the infected person showed no antibodies, which means they simply didn’t become infected.
A related issue is the lack of education. “Germ” theory is poorly understood. Traditional beliefs predominate. The belief in ghosts, evil spirits, curses, hexes and similar supernatural agents is a hindrance in getting the general population to use proper techniques.
Of course even with the proper education, the lack of medical barrier equipment, (gloves, masks) the lack of effective disinfectants (carbolic acid, strong chlorine bleach, etc) pose serious challenges.
Several epidemics have been stopped only when the ‘medical’ workers panicked and abandoned their hospitals and people stopped coming. Hospitals in Africa have been the centers of infection in most serious outbreaks. I am not trying to be gross of flippant, but one classmate who was in Zaire during an outbreak compared the affected (infected) hospital to a “roach motel”, “They check in but don’t check out.” (I would have chosen Hotel California “You can check in anytime you want, but you can never leave) But even at the height of the outbreak, when the general public was panicking (and the medical community had already really freaked out), common street crime and malaria were a much bigger threat. My classmate considered herself lucky to have only been mugged and not raped….
Somehow I suspect that as bad as the current Ebola outbreak is, and 200 to 400 people turning into goo and dieing is bad, it isn’t something to obsess over.
Consider that with the west’s first meeting with Marburg, the virus only managed to kill about
A related problem in Sub-Sahara (Africa south of the Sahara Desert) is western medical technology has lead to dramatically increased populations. More people means more land is needed for farming. While tropical vegetation is lush, the soil isn’t nearly as rich was one would could expect. The frequent heavy rains washes nutrients from the soil. Soil rapidly becomes depleted and must be abandoned. Which means ever more forest is cleared. As the forest is cleared the local population interacts with more “critters”. Increased interaction gives more chance for Ebola, or Marburg, to jump to humans.
Currently most experts believe Ebola is present in an animal reservoir, and Fruit Bats are the current favorite. One disease vector model suggests that Fruit Bats pick up fruit, eat a little, and drop the half eaten fruit where it is picked up and consumed by ‘primates’. Primates includes humans, gorillias, chimpanzees, baboons and monkeys.
A popular food is Fruit Bat. These are consumed in a wide range of ways, stews, fried, baked, raw (Hum, do I really want to eat something that may well harbor Ebola?)…
Then there is Bush Meat. Humans like to eat. Most humans like meat. Africa is impoverished. Meat is expensive. So the locals eat Fruit Bats, and Bush Meat.
Bush Meat is a euphemism for “Primates”. This could be lower monkeys or “Higher Primates”, Chimps, Baboons, Gorillas. And in the process of butchering these primates, the butchers are exposed to ‘bodily fluids’.
I am surprised that Ebola isn’t more of a problem, like a constant low-level epidemic.
200~400 dead since perhaps October of 2013….not that big of a deal.
As to the whole “But Ebola is now airborne” hysteria….sorry it just ain’t so. IF, please note the >IF< Ebola had really made the jump to effective airborne spread, we wouldn’t have <400 infected, we would have 40,000 or 400,000.
Ebola will make it to Europe. Too many poor people in Africa desperate for a “better life” have little to lose. Stay home and starve, die of malaria, or risk sneaking into Europe, “The Land of Milk and Honey.”
Hum…what would you do if you were poor, poor that makes Mexico looks rich, and those greedy bastards to the north have more then they need and won’t share…wouldn’t you try for the brass ring.
And please folks, I am not defending people who try to sneak in, AKA >INVADE<, other countries. But reality is reality, as long as desperately poor people see (or seek) a better life, they will take insane risks to get to that life. And they will bring their diseases with them. Ebola, Marburg, Rift Valley Fever, Lassa Fever….and some of those diseases will take root, Aids, drug resistant TB and these will become (have became) a problem.
Aids was probably a local problem in Africa for decades, if not generations. As highways were built, the sex trade popped up along those highways. Morality aside, hunger is a strong aphrodisiac. In the early 1990s it was estimated that at least 80% of the prostitutes along those highways were HIV positive.
Anyone really want to guess how many of those illegal immigrants will have HIV/AIDS? And how many poor women/girls/men/boys will become, lets be euphemistic here, workers in the “sex trade”?
If you insist on having something to really worry about, consider what would happen if Aids becomes airborne….
HIV/AIDS is here already. Most of us pass people infected with HIV every day.
Of course I was somewhat dismayed to find out the US government has contingency plans to extract US citizens from Africa in the event Ebola, or Marburg, does manage to become something more then an idle threat. Really? It is somehow a good idea to bring people out of an epidemic zone? If I were the one doing the planning, I would be thinking about air exclusion zones, AKA ‘No Fly Zones”. Keep aircraft out of the area; let no aircraft in the area fly out. Apply a blockade to enforce quarantine. Contain and let it burn out. Yea, I guess I am a rather unpleasant person. But consider there is no effective treatment and no vaccine. Is it really unreasonable to consider enforcing a quarantine.
In “The Andromeda Strain” one plan to deal with a ‘wildfire’ was the use of a thermonuclear device to “cauterize” the infection. Dramatic? Overkill? I don't know. As bad as it would be, it might be better then the alternative.
Terry
