Everything you’ll ever need to know about EBOLA in 5 paragraphs

                                                                          

Ebola is once again in the news. Though we've had 14 outbreaks due to the Ebola virus in the 21st century, the current outbreak has captured the public's attention like none have since the 1995 epidemic in the Democratic Republic of Congo, which was set against the backdrop of The Coming Plague, The Hot Zone and Outbreak.

It's understandable. The ongoing outbreak spans multiple countries (Liberia, Guinea, Sierra Leone and Nigeria) and is the largest Ebola outbreak in history, with more than 1,600 cases reported and more expected. The virus has infected two American workers and killed a U.S. citizen. It shows no signs of abating. 

Along with interest, unfortunately, has come hysteria. Suddenly everyone is an expert on Ebola. Donald Trump called on the United States to close its borders to the infected workers and let them "suffer the consequences."  Sites have sprung up suggesting that Ebola can be prevented or treated with essential oils and conspiracy sites are raving about how the government will use Ebola for profit and force the Ebola vaccine on the population. Suffice it to say, there's a lot of misinformation out there. Here's the scoop on a few of the myths circulating about this viral disease. 

1. Ebola has killed a lot of people.

Ebola has a high fatality rate, killing many people who are infected with the virus, but there still haven't been very many deaths from Ebola overall. It's caused approximately 4000 infections and 2400 deaths since the first outbreak was recorded in 1976. That's an average of 64 people per year over 38 years. In contrast, malaria kills more than 600,000 people every year, or about 68 people per hour. Ebola is exotic, frightening and headline-worthy when the virus surfaces in humans, but it's not even a blip on the list of the world's most important killers. If you want to worry about a cause of death, look to car accidents, influenza or even lightning strikes — all are bigger worldwide killers than Ebola.

2. Ebola is always deadly.

There are five different known strains of Ebola virus: Zaire ebolavirus, the most deadly and the one causing the current outbreak in west Africa; Sudan ebolavirus, the next-worst both in fatality and in number of outbreaks; Bundibugyo ebolavirus, a strain only discovered in 2007; Taï Forest ebolavirus, which has caused only a single known human case; and Reston ebolavirus. For those of you playing along at home, you may have seen that one of those things doesn't sound quite like the other. The first four are all African in origin, and fatality rates range from about 25% for the Bundibugyo virus up to almost 90% in some Zaire ebolavirus outbreaks.

The Reston virus, however, is unique. It appears to come from the Philippines and was imported into the United States via shipments of monkeys to Reston, Va., for research purposes. The monkeys ended up getting sick, and an outbreak investigation ensued. The new Reston ebolavirus was identified there in 1989, and oddly, the monkey's caretakers were also found to have antibodies to the Reston virus, meaning they had been exposed. However, none of them had any overt symptoms. Since then, the Reston virus has been found in more humans — and pigs! — in the Philippines, but like the original outbreak, no humans got sick. So even though at least 13 people have been infected with the Reston virus, not a single one has shown noticeable symptoms of disease and none have died.

3. Everyone who dies of Ebola “bleeds out” horribly.

I blame this one on The Hot Zone, which provided graphic descriptions of what could happen with an Ebola infection, including bleeding from every body orifice and "liquefying" internally. However, that's not what usually does happen. More commonly, patients look weak and are very ill. There may be blood in their vomit or diarrhea, or occasionally from their gums or nose. Dehydration is a big problem, and in some cases getting intravenous fluids may be the difference between life and death. But blood does not typically "pour" from a person as their skin tears off at the touch, as The Hot Zone suggested.

4. Ebola comes from monkeys.

The movie Outbreak, in which a capuchin monkey serves as an adorable vector of death and destruction, can be blamed for this one.

There have indeed been cases in which contact with a monkey or an ape appears to have sparked an epidemic in humans, and consuming "bushmeat" — any kind of wild, hunted game — is a risk factor for acquiring Ebola and other viral infections. But primate species are not where Ebola really originates. In fact, even the Reston ebolavirus can make monkeys ill, and the more severe African strains of the virus have decimated populations of chimpanzees and gorillas in central Africa. Our primate cousins are suffering from Ebola to a greater extent than humans are.

Instead, bats appear to be the primary reservoir for Ebola, and studies are ongoing to determine if there are infected bats currently circulating in the affected West African countries. People get Ebola then from eating bats, coming into contact with surfaces that bats may have contaminated or through an animal intermediate that was first infected by a bat, such as the unfortunate chimpanzees and gorillas.

5. Ebola has never previously entered the United States.

Even Donald Trump is getting into the game by shouting on Twitter about closing the borders and keeping Ebola out of the United States. Many newspaper articles suggest the return of infected American patients Dr. Kent Brantly and missionary Nancy Writebol is the first time Ebola has been in the United States. Wrong.

If you read myth two, you already know there is a type of Ebola named after a U.S. city, but there was Ebola present in the country far before the 1989 Reston outbreak. Additionally, the Centers for Disease Control and Prevention and USAMRIID in Fort Detrick, Md., have both had active Ebola research programs for many decades, as do a number of other academic laboratories in the United States. The current infected patients are not even the first patients who have brought an Ebola-like virus into the country. A woman sick with Marburg virus (an Ebola "cousin") returned home to Colorado after a trip to Uganda in 2008. Despite exposing 260 people and not receiving the Marburg diagnosis until 7 months after she recovered, no one else got sick. 

Ebola is an undeniably scary infection, but it's not one that needs to be feared in the United States. The outbreak in West Africa will eventually burn out, and the virus will retreat once again into the forest, moving silently among its bat hosts until the next unfortunate soul accidentally steps into its path. 

Tara Smith

Tara C. Smith is an Associate Professor of Epidemiology at Kent State University. Her research focuses on zoonotic infections (infections which move between animals and people) and she writes for various outlets. 

Latest on Ebola:

 U.S. health authorities have eased safety restrictions on an experimental drug to treat Ebola, a move that could clear the way for its use in patients infected with the deadly virus.

Canadian drugmaker Tekmira Pharmaceuticals Corp. said the U.S. Food and Drug Administration modified a hold recently placed on the company's drug after safety issues emerged in human testing.

The company has a $140 million contract with the U.S. government to develop its drug, TKM-Ebola, which targets the genetic material of Ebola. But last month the FDA halted a small study of the injection in adults to request additional safety information.

Tekmira said Thursday the agency "verbally confirmed" changes to the hold that may allow the company to make the drug available, although it has yet to be proven as safe and effective.

Two Americans diagnosed with Ebola recently received a different experimental drug called ZMapp, made by Mapp Biopharmaceutical Inc. of San Diego. It is aimed at boosting the immune system's efforts to fight off Ebola and is made from antibodies produced by lab animals exposed to parts of the virus.

The U.S. aid workers were first treated in Liberia. And while the FDA must grant permission to use experimental treatments in the United States, it does not have authority over the use of such a drugs in other countries.

The FDA's move Thursday comes amid an Ebola outbreak in West Africa that health officials warn could sicken more people than all previous outbreaks of the disease combined. More than 1,700 people have been sickened in the current outbreak, which began in March. Nearly 1,000 have died, according to the World Health Organization.

Currently, there are no licensed drugs or vaccines for the deadly disease. Several are in various stages of development, but none have been rigorously tested in humans.

The FDA in March granted Tekmira "fast track" status for its Ebola drug, a designation designed to speed up approval of high-priority drugs by granting companies extra meetings with FDA scientists. Early studies of TKM-Ebola in monkeys suggested it could block high doses of the Ebola virus. But on July 21, the company based in Vancouver, British Columbia, announced the FDA had halted a small dosing study of the drug in 28 healthy adults. The company said regulators had questions about a type of drug reaction that can cause nausea, chills, low blood pressure and shortness of breath.

Tekmira's CEO Mark Murray praised the FDA for modifying the restriction on Thursday.

"We have been closely watching the Ebola virus outbreak and its consequences, and we are willing to assist with any responsible use of TKM-Ebola," Murray said. "The foresight shown by the FDA removes one potential roadblock to doing so."