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Chapter 1: What is the Ebola virus and how does it relate to current outbreaks?
Welcome to a bonus episode of the Health Report, which is on Ebola virus, given the current outbreak in the Congo and Uganda. It's probably worth us just starting with Ebola virus. Yes. What we are discussing, because we're talking about a group of viruses, the Ebola virus family. A family of three, probably. Well, six but four are known to cause issues in humans.
Well, the Australian CDC says three. And a lot of the publicity. So it's a question of just how many variants there might be. But you're right. I think the problem is families of viruses have lots of relatives and some are disease causing and some are not. And coronavirus is a classic example of that.
And it's worth pointing out that when you've heard about Ebola virus outbreaks before in Congo and other places before, it's often been the strain called Zaire or Ebola virus strain. And this is not what is causing issues in the Democratic Republic of Congo at the moment. And that is part of the issue here. But it's a group of viruses... Very nonspecific symptoms, fevers, chills, yes.
People can have disruption of their coagulation or clotting pathways later and they can develop clotting and bleeding. But it is a group of viruses that has a high fatality rate. up to 50%. But you can save people's lives with supportive care. So it's not inevitable, even when you've got haemorrhagic disease, that you're going to die, but it does need intensive supportive care.
And one of the other problems with Ebola, which increases its infectivity, it's not a pandemic virus, but close contact and contact with body fluids and blood can spread the virus, is that the virus lingers in the body for a long time. So it goes into areas which are called immune privileged. So in other words, where the immune system doesn't get in.
So the fluid in your eye, the testes, and a couple of other areas of the body where the virus can live and potentially come out again and infect other people. And that's why contact with any bodily fluids, including breast milk, saliva, that can transmit the virus, but also contact with someone who's recently died from Ebola.
And this is why you might be hearing in the news about burial practices and why that might be playing... into the current outbreak. We should just talk about that a little bit in terms of the West African outbreak about 10 or so years ago, a bit more than that actually now, where at least 11,000 people died. Some people say it's much more than that.
Most of these estimates, by the way, are underestimates because this happens in the countryside, it happens with inadequate record keeping. And these viruses come out because of a conjunction of circumstances, social disruption, poor medical services available, in the case of the Congo, warfare, lack of trust in governments. And
One of the ways they got this under control in West Africa wasn't just public health measures. It was actually cultural interventions. It was going door to door to reassure people that it was safe to say that one of my members of my family has this or is sick in the back room so that health care professionals could come in.
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Chapter 2: How does Ebola spread and what are its symptoms?
So animals get sick and die, which is a bit like the Black Death, a bit like plague. So plague, when plague hit, the Black Death hit, and people got used to it. I mean, it lasted 300 years, that second pandemic of plague. People started to recognise when it was going to appear because animals started dying. That was the sign. That was the sign that animals started dying.
And of course, rats were the classic species because the fleas on the rats would jump. You'd get bitten by the flea. And then if you got pneumonic plague, it would spread through the respiratory route, which is why it became a pandemic. In this case, you can catch it from animals as well. So it's
It is pervasive and in that environment where you are moving around and housing may not be adequate either, you would potentially come in contact with these animals too. But again, it's the blood products and the body fluids of these animals which are the problem. When the people realised what a serious problem Ebola was, a lot of effort to develop vaccines. In 1970s, yeah?
That's when it was discovered? It was discovered, but more later on. So in response to the big Ebola outbreak, a lot of effort went into vaccine development for Ebola, and they did develop vaccines that were effective. And there is one in store that uses a virus called VSV to carry in the virus antigen to stimulate the immune system. And the question is, how similar...
The other viruses are... Like the Bundibugyo strain. Yeah, to the original one, and whether or not there's cross-reaction with the vaccines, and they simply don't know that. The research is not conclusive on that. At the moment, we just have to assume there's no treatment and no vaccine.
But the World Health Organisation has said it could take up to nine months to develop one for the Bundibugyo strain. So it may take time, and the prevention element to this is essential. So just to take us to where we're at now, at the moment there are 600 suspected cases. And by the time you're listening to this bonus episode, it might well be more and it's probably more already.
139 suspected deaths from Ebola. We think this originated in the Democratic Republic of Congo in a very densely populated area. It's now leaked into Uganda and possibly other neighboring countries as well. When they were initially testing and seeing that people were getting sick, including healthcare workers, they were looking and testing for the Zaire strain or the Ebola strain.
And it wasn't coming back positive. And so possibly there's been under detection. They eventually then went and tested for the Bundabugyo strain. And it's very likely that there has been a lot of silent spread, that this outbreak's numbers are much larger.
And a few years ago, this might well have been detected because USAID, the international aid organization, which is now defunct because it's been defunded in the United States, carried a lot of the burden of the monitoring and intervention in these areas. And it's disappeared. And ironically...
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