06 August 2012

Ebola Outbreak: The Good, 
                       The Bad, and                        The Ugly
- What’s good is that the Ebola episode is currently being controlled in the sense that all persons who have had contact with patients have been isolated. This is according to the WHO representative in Uganda, in effect halting the spread of the deadly disease. The “contact list” is short under 200 individuals. The CDC, WHO and the Doctors Without Borders have joined forces in helping Ugandan officials to control the spread of Ebola. 

-  Sadly, the first fatality was a three-month-old girl. As a matter of fact, over a dozen participants in the funeral were infected. The other bad and sad part is that at least 16 people have already succumbed to the disease. Since then, authorities have taken bold steps in disposing or burying of the bodies.The ugly part is that the doctors were initially unaware of what they were dealing with because the symptoms were atypical. They expected bloody sputum which is a hallmark sign of Ebola. The outbreak was confirmed on July 28, several days after villagers were dying in a remote corner of western Uganda. The disease spread to more villages deep in the western district of Kibaale because of the slow response in identifying the Ebola culprit. As of July 31, 2012, there have been at least 38 cases and 16 deaths.

- The highly infectious and lethal Ebola virus was first identified in 1976 in Congo and was named after a river in that area. This current outbreak appears to have started in June of this year. Then on July 28, the Uganda Virus Research Institute/CDC confirmed the outbreak. Because testing was able to be done in-country at the new UVRI/CDC lab, instead of the out-of-town rigmarole, the disease was identified and proper measures were taken. Better late than never, we could say. Remember, this is a case of the Ebola Sudan virus strain. The disease is native to African territories. It is spread by direct contact with body fluids and blood of a person infected with Ebola virus.  It is also spread by contact with a contaminated object or infected animal. Symptoms include fever, headache, joint and muscle aches, sore throat, and weakness, followed by diarrhea, vomiting, and stomach pain. Skin rash, red eyes, and internal and external bleeding may be seen in some patients. Endothelial cells, mononuclear phagocytes, and hepatocytes are the main targets of infection. After infection, in a secreted glycoprotein, the Ebola virus glycoprotein is synthesized. Ebola replication overwhelms protein synthesis of infected cells and host immune defenses. Infected white blood cells also serve as carriers to transport the virus throughout the entire body to places such as the lymph nodes, liver, lungs, and spleen.

- All epidemics of Ebola have occurred in sub-optimal hospital conditions, where practices of basic hygiene and sanitation are often either luxuries or unknown to caretakers and where disposable needles and sterilization equipment are unavailable or too expensive. In modern hospitals with complete facilities, from nursing barriers to high-alert procedures, there has not been any uncontrolled spread of this dreaded affliction. Researchers believe that the virus is normally maintained in an animal host (zoonotic) that is native to the African continent. The natural habitat, local conditions, and host animal is poorly understood. Fruit bats have been suspected as carriers. In 2005, researchers had found evidence of Ebola infection in three species of fruit bats. But other sources have been investigated, from plants, arthropods, to non-human primates.

      Biosafety level 4 hazmat suit: researcher is working with the Ebola virus.
    Date: 21 September 2011
    Author: United States Army Medical Research Institute of Infectious Disease

- Confirmed cases of Ebola virus infections have been reported in the Democratic Republic of the Congo, Gabon, Sudan, the Ivory Coast, and Uganda. So, travellers take heed and avoid contact. If you intend to help out in these areas, it would be best to consult the local health authorities first. Likewise, contact the WHO, CDC or Medicine Sans Frontiers, as well as the Uganda Virus Research Institute. If you have had contact with patients or infected material, report to the said authorities without delay.

- Fernando Yaakov Lalana, M.D.


  1. Thank you for your posts, Doc. It is informative and a good source of current medical information. Keep up the good work!

  2. Thank you for your posts. Interesting!