The WHO just released the latest statistics on what has turned into the largest ever outbreak of Ebola virus (EBOV) in Africa. The epidemic started in Guinea around December 2013.
CDC director has expressed confidence that health officials will be able to contain the spread of the virus in the U.S.
– Ref. ii
As of 7/27/2014, Guinea, Liberia, Nigeria, and Sierra Leone have reported a total of 1323 cases, with 729 fatalities [i]. Most patients are from Guinea and Sierra Leone. The 1 Nigerian case was an international traveller, a major concern as the epidemic unfolds and drastic containment measures are taken by the countries affected.
Since first posted here, things have worsened considerably. As of Sept. 28, 2014, there were 7157 cases and 3330 deaths from the epidemics. This is more than twice the count from only 1 month earlier (Aug 26, 2014) when a total of 3069 cases and 1552 deaths were reported.
As the first case has now been diagnosed in the US, we can observe first hand how successfull our hospital system is in managing Ebola, and how successful we are in tracing contacts. I wish our representatives from CDC and NIH were a little bit less self-assured when they proclaim on TV that we are not likely to see Ebola gaining a foothold in the US, that spread of the disease in the US is highly unlikely.
Why should we have a lot of respect for the ingenuity of the Filovirus family?
Reason #1: they have survived and outfoxed us a few times already;
Reason #2: our state of blissful ignorance: we just know so little about their survival strategies and virulence factors;
Reason #3: the early disease symptoms are fever and non-specific signs/symptoms. Hence, by the time we can suspect infection and quarantine a potential case, it’s already too late.
EBOV GP glycans direct the immune system to produce antibodies against highly variable or dispensable regions on the viral surface
Ref: J. Cook. PLoS
Below a table of major virologic and clinical facts relating to Ebola virus infection. Some therapeutic approaches are mentioned without any claim of completeness.
[table id=9 /]
References:
M Salvaggio. Other viral bioweapons: Ebola and Marburg hemorrhagic fever. Dermatol Clin 22 (2004) 291 – 302
Cote. Small molecule inhibitors reveal Niemann-Pick C1 is essential for Ebolavirus infection. Nature 2011; 477: 344
J. Cook. The Secret Life of Viral Entry Glycoproteins: Moonlighting in Immune Evasion. PLoS Pathog 9(5): e1003258. doi:10.1371/journal.ppat.1003258
[i] http://www.afro.who.int/en/clusters-a-programmes/dpc/epidemic-a-pandemic-alert-and-response/outbreak-news/4236-ebola-virus-disease-west-africa-29-july-2014.html
[ii] http://www.politico.com/story/2014/10/ebola-us-border-111581.html#ixzz3F72LYrCE
