Ebola: Separating popular myth from medical realityBy JOY WANJA MURAYA | Monday, August 6  2012 at  18:35

It evokes macabre scenes from Old Testament plagues, especially the bit about bleeding from every orifice in your body.

Tales by people who claim to have seen victims of the highly contagious Ebola read like the script of the horror movie Outbreak.

Ebola, which struck Uganda last week and caused a scare in Eldoret where a patient has been admitted with Ebola-like symptoms, is a viral haemorrhagic (bleeding) fever rated as one of the most virulent viral diseases known to humankind.

However, a Ugandan epidemiologist, Dr William Mbabazi, says falsehoods about the disease complicate the spreading of awareness about it.

According to Dr Mbabazi, much of the representation of the Ebola virus in fiction and the media is exaggerated, if not mythical.

A common myth has it that everybody who contracts the disease bleeds from all body openings.

The expectation that all Ebola cases bleed to death is a lie as documented facts show that bleeding is not a major clinical sign for cases of the disease.

Haemorrhage

In December 2011, the talk in Nairobi was about a 29-year-old woman who had been rushed to Kenyatta National Hospital bleeding from the nose, ears, and mouth.

Although she died shortly after arrival at the referral hospital, panic gripped both health workers and the general public, with self-styled street experts swearing that it was Ebola.

However, Kenya’s public health director Shahnaz Sharif ruled out Ebola. It was established that the patient was bleeding from the stomach, perhaps because of an ulcer or a similar ailment.

According to Dr Mbabazi, not all haemorrhagic diseases should be directly associated with Ebola.

“The major clinical features are: fever in 100 per cent of cases, intense fatigue in more than 90 per cent of cases, while headache, abdominal pain, vomiting, and diarrhoea are also present in more than 80 per cent of the cases,” says Dr Mbabazi who is also the technical adviser for Management Sciences for Health in South Sudan.

According to a paper by scientists who studied the virus in 2007 and 2008, approximately half of infected people manifest haemorrhagic signs such as bleeding from the nasal cavity, passing of blood in urine, and/or gastrointestinal and vaginal bleeding

Another pervasive myth has it that the virus kills so fast that it has no time to spread.

Dr Mbabazi explains that symptoms usually appear abruptly after an incubation period of between four and 21-days. He says that although this can prevent the transmission of the virus to many people, it is still ample time for some people to contract Ebola.

Fruit-eating bats

The average incubation period from contact with an infected person to symptoms onset is seven days. Are monkeys responsible for the spread of Ebola?

According to scientific paper on the Ebola outbreak in August 2007 to February 2008 in Bundibugyo District, in western Uganda, attempts to link the outbreak to wildlife failed because none of the families investigated admitted to hunting as this is prohibited.

However, evidence shows that the Ebola virus seems to reside in the rain forests on the African continent and in the Western Pacific.

Dr Mbabazi says that although human infections are commonly traced back to non-human primates, it appears that humans are directly infected from the natural reservoir or through a chain of transmission from the reservoir.

“The only literature available seems to suggest that the fruit-eating bats commonly found in tropical rain forests are the natural reservoir for this virus because when these bats are (injected) with the Ebola virus in experiments, they have survived, indicating that they might be spreading it,” notes Dr Mbabazi.

So is Ebola a plague? According to Dr Mbabazi, it is and it can threaten human existence because all human beings are susceptible to Ebola infection. The virus spreads easily through body contact or contact with fluids such as saliva, semen, and blood.

The virus causes disease in 40 to 50 per cent of exposed people and kills 40 to 90 per cent of them, making it a plague.

“However literature shows that Ebola survivors develop immunity,” Dr Mbabazi told Kenya's Daily Nation newspaper.

Zombie-like

There have been claims that Ebola liquifies the body organs of infected people, but Dr Mbabazi disagrees. Instead, he says that Ebola interferes with the clotting and bleeding mechanisms of the body.

“The symptoms are initially non-specific, but liver function may be impaired, blood clotting functions (coagulation) are dysregulated, septic shock and multi-organ failure occurs in most cases that eventually die,” Dr Mbabazi says.

Handshakes have also been said to be a fertile ground for the spread of Ebola. Or aren’t they?Dr Mbabazi agrees because hands easily get contaminated when they get in contact with infected material like sweat, vomit, stool, urine, blood, or any other body fluid.

“Such materials can be picked by the hand in a hand shake directly or inadvertently from door handles, tables, and chairs.”

On whether victims wear zombie-like faces, infectious disease expert Dr Philippe Calain says:

“At the end of the disease the patient does not look, from the outside, as horrible as you can read in some books. They are not melting. They are not full of blood. They’re in shock, muscular shock. They are not unconscious, but you would say ‘obtunded’, dull, quiet, very tired.”

Ebola is classified as a Category ‘A’ biological terrorism agent by the US Centre for Disease Control as well as being considered a select agent that has the “potential to pose a severe threat to public health and safety.

As a terrorist weapon, Ebola has been considered by members of Japan’s Aum Shinrikyo cult, whose leader, Shoko Asahara led about 40 members to Zaire in 1992 under the guise of offering medical aid to Ebola victims in what was presumably an attempt to acquire a sample of the virus.