Posted by: Chris Maloney | October 17, 2014

Why Is This Ebola Outbreak So Much More Deadly?

If you believe the CDC and the WHO, the Ebola virus is difficult to catch and requires basically cutting yourself open with an infected scalpel. Clearly, this is not the case in this outbreak. But where did they get that idea, and why hasn’t this outbreak fizzled out like every other one of the over thirty plus outbreaks we’ve documented?

First, the CDC and the WHO aren’t making up the “hard to get this virus” story. It’s based on the history of Ebola virus dating back to the 1970’s. If you read the CDC’s history of Ebola outbreaks, it’s one screw-up after another, but in the end the outbreaks burned themselves out. Often in the first and only clumsy lab worker who infected themselves with a dirty scalpel. (Here’s the CDC history).

If you look at that history, which reads like the beginning of several pandemic thrillers, workers who contracted Ebola virus often didn’t get sick. They’d test positive for antibodies, but never have any symptoms.

How is it possible that we’re now seeing people get this illness and die by the thousands? Hint: it’s not because of urban settings. And it’s not because of increased air travel. Back in 1994 a Swiss scientist contracted Ebola from a Chimp corpse. She visited a hospital in Africa and then was flown back to Switzerland for supportive treatment. The whole time she was never placed under strict containment measures. They even let her out by day fifteen, so she was walking around for four more weeks with symptoms and never infected another person. (From a Stanford student’s Honors Thesis on Ebola, here) If that was this virus, the Swiss would be quarantined.

So why is this Ebola outbreak different? It’s because it’s not the same virus. When we say “Ebola” we all think of the same disease. But like the influenza virus, there are different families or clades of Ebola virus. This particular virus is barely in the Zaire family, it’s a genetic outlier. (see this Ebola’s full family tree here) So like SARS, or Avian Flu, or any new influenza virus, this particular version of Ebola is a mutation. Now, that doesn’t mean it’s airborne, but evidently it means that this particular strain is far more contagious.

 

 

 

 

 

 

But wait, should we know more about this particular Ebola strain? Nope. The mapping for this strains genetics includes “158 Ebola strains and 2 Marburg strains.” That’s a lot of different options.

Does the variety of options explain a lot of the confusion the CDC is experiencing about Ebola? Yes. Back in 1995, they could trace an African Ebola outbreak in health workers almost entirely to the unsanitary reuse of needles that had been used first on an Ebola patient. (Stanford thesis). We had horrific outbreaks in monkeys with Ebola shipped all over the world in 1989, and not a single worker got ill even though they got antibodies. So they thought they knew the risks and they weren’t very high.

So the experts are not prepared for the virulence of this particular strain. It’s far more infectious and deadly than previous strains of the same virus. While their mistakes are understandable, it’s time to get serious about Ebola. Even though no one is talking about airborne, patients need to be treated “as if.”

And if anyone cares, these are the New York Times (CDC data) graphs of the outbreak in Liberia. Maybe it’s time to really have a shift before we lose a generation of Liberians.

What you’re looking at are best and worst case scenarios. The best case is losing 27,000 people. The worst case is losing half a million to one and a half million. The population of Liberia is around four million, and the lives lost in two recent civil wars was about 250 thousand.

 

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