- [Voiceover] So, Ebola virus disease has been on the news
and today is September 16th
and I just want to mark that on the calendar
so we can keep track of
kind of where things are as they stand today.
And these Western African countries
are kind of where we're seeing the disease.
Nigeria and Liberia, Sierra Leone, Guinea
and also Senegal all combined
have more than 4,000 folks
that have been sick with Ebola
and actually over 2,000 people have died of Ebola.
And I just want to contrast that
with kind of geographically kind of where
we've seen past outbreaks that are big.
And when I say big, none of the past outbreaks
have even compared with the size of the current outbreak.
But also the geography is different.
You see, in the past it's been more Central Africa.
And so, these are kind of two interesting points
about the current outbreak.
And while we're talking about Central Africa
I thought it would be kind of worth noting
where the name of Ebola comes from.
Actually there's a river down here in Central Africa
back in 1976 there was the first outbreak that we tracked
and it was actually named after the Ebola River
because that's the region where this
was first noticed.
So, this current outbreak
to understand it in its magnitude
I think it's useful to kind of take
a little bit of a larger view
and understand how it transmits or how it spreads
in the natural environment,
and usually these guys that I'm kind of shading in green.
These guys are thought to be kind of
one of the animals out there
that may be kind of spreading the disease around.
So, fruit bats are one of the culprits that people suspect
and they also actually get sick with Ebola.
So this one I kind of sketched in green
and when they get sick
they can spread it to other bats in their bat community.
And this becomes then,
the community because a natural reservoir.
We call this natural reservoir of disease or of virus
and this is where it kind of circulates normally.
And so, we wouldn't even think about Ebola
if it was only affecting bats.
Probably wouldn't worry about it too much
but what happens that every once in a while
it affects a human.
And the way that this might happen is
let's say this person goes in their front yard
and they notice a dead bat or a sick bat
and they try to care for it
and they might get some blood or stool
from that bat on their hand,
and they can kind of go into a wound, maybe have a cut
or it can go kind of in their mouth
or if they rub their eyes or nose.
So all of a sudden the virus now has a way into the person
and so that's kind of how we think
that first person might get sick.
And that first person we actually have a special name
especially if there's an outbreak
and that name is an Index Case.
We say that this person is the very first person
who got sick with the disease here Ebola.
And now looking at our calendar,
if this person got sick on the 16th today
then their first symptoms are not gonna be today.
They're gonna happen in a couple of days
all the way through three weeks.
So really, kind of a long window
in terms of when their first symptoms might happen.
It could be this month,
it might even be all the way through next month
because the seventh of October would be three weeks.
And generally, we notice that symptoms happen
kind of in this window I'm gonna draw right here.
So seven to 10 days.
That's when their very first symptoms start to appear.
So they're not immediate
and the first symptoms are kind of vague.
There are things like,
you know they might feel a little feverish
or they might get like kind of a little headache,
maybe some muscle aches.
So, kind of just general symptoms, not feeling very well
and at this point people think,
"Well, you know, maybe it could be anything,
"some flu or something."
So they don't usually go
and try to get medical help.
But then what happens is that the virus
kind of spreads through the immune system
and starts getting into all sorts of different tissues
and it can cause problems in their stomach,
they might want to vomit or have diarrhea.
It can go to their lungs, I'm shading in their lungs.
They might you know, start coughing.
It can cause rashes, it can cause muscles aches,
it can cause redness of the eyes,
conjunctivitis we call that.
It can also cause inflammation around the brain itself.
Meningitis.
Or it can cause bleeding of the nose
or the mouth, the gums.
And in fact, that bleeding is really classic
because we think of the virus traveling in the blood
and so bleeding is a really important thing to notice
because it's very, very transmissible.
You know, people can get it from the blood
and the word for virus in the blood
is kind of viremic virus, virus.
In this case, it's the Ebola virus,
and emic means in the blood.
So when the virus is in the blood
we would say they're viremic
and at this point they might say,
"Well, you know, I want to go
"and get the help of a doctor."
And so, if they go to get medical help
the kinds of things that they usually would get
would be like IV fluids if they're dehydrated.
If they're having difficulty let's say breathing
they might get some oxygen.
If their blood pressure is low
they might get some medications
to help their blood pressure
kind of come back up to normal.
So these are the kind of things that people do
and you know, in Western Africa
they have all these support out there.
You know, they have medical tents setup
to kind of help people that have Ebola
and so all the care they're giving
is considered supportive care.
And there's no real specific anti-Ebola medication.
Again, we're here on September 16th
and people are researching it.
But at the moment there is really just supportive care
to help people that are sick
and nothing specific that targets the virus.
Now the worrisome thing, this is now just a...
I want you to just kind of wrap your head around this
is that with supportive care,
what we're seeing in this outbreak on average
is a 50% or so fatality rate.
Meaning, for two people with Ebola one will die.
I mean it's a flip of a coin which is frightening.
I mean, if you come down with the symptoms
and you're waiting to find out
if you have Ebola or not or if you just found out,
it's a really, really scary proposition
that half of the people with this diagnosis are gonna die.
And that's exactly the reason why
the world is kind of watching
and intervening and helping
to make sure that we get this under control.
So, in addition to the supportive care
the other big area that we kind of think about is
how do you avoid transmitting the virus
from one person to another.
So let me just sketch in a second person here.
So here I've drawn a second person
and the question becomes
how does Ebola get from the first person
to the second person?
How exactly does it move?
And the quick answer is that it moves
through bodily fluids.
So bodily fluids include everything from
blood to vomit and diarrhea or stool
and these are kind of the big ones especially blood.
Very, very infectious.
But also stool and vomit
because a lot of these patients are sick
and bodily fluids can also be things
like saliva and sweat.
But again, these first few that I've kind of written out
are the ones to really keep in mind,
and blood in fact is an interesting one.
There was a study that I think is pretty cool
and kind of illustrates the point
where they showed that one drop.
Just one drop of blood from a monkey
that had Ebola was enough
to carry with it a million little Ebola virus particles
and that was thought to be enough
to infect a million monkeys.
So kind of the idea that one single drop could be enough
to really decimate a population.
So it kind of drives on the point
that if there's a drop of blood, just a single drop
or another bodily fluid that really gets over,
let's say over into this person's hand
and they can kind of go from there
to if they touch their face.
They can get entry into their body
or through their nose or eyes or mouth
or let's say they have a little cut.
It could actually make its way
into the blood through that cut.
So, a few kind of interesting ways
that bodily fluid can travel
but really then it gets a ticket into the second person
and the second person can get sick.
And of course that could happen
with stool or vomit as well.
Now another question that I think a lot of people ask
is what about airborne?
You know, can you breathe this stuff in?
And that's a big question and the idea I think is
literally is it kind of floating in the air?
And the answer is no.
You know, it's not really like other viruses
like measles and some other ones
where it's airborne.
So let me just cross that out so it's very clear.
It is not airborne.
In fact, I think a lot of the confusion
comes when you think about things like sneezes.
So with a sneeze you can imagine
like kind of you know, we've all seen those sneezes
or had those sneezes
where kind of a big droplet of goo
or mucus kind of goes out,
and you get this kind of shower, right, of droplets
and this kind of right around where you're standing.
Just right in your immediate vicinity
and that's not gonna affect anyone
that's kind of standing away from you,
and you could imagine maybe
in kind of a strange scenario.
Let's say there's a person kind of hanging out right here
right next to somebody's shoulder
and they're just kind of sitting there.
They might get hit in the face with one of these droplets
and maybe then you could say,
"Well, you know, therefore they got hit
"and they're sick with Ebola."
But again, it's the droplet which is a bodily fluid
and not the fact they were just breathing
you know, air like someone that was standing away.
So that's not a typical scenario
and that's why we don't call this airborne.
One quick thing I should mention
is that you can get virus that kind of hits a surface
and if it hits a surface like a table or the floor,
it can actually survive on that surface
they think for days to weeks.
And so it is an important point
because then that means that
if someone's been in the room
you really have to decontaminate that area
and get rid of all those little dried up droplets
that are sitting on the surface
to make sure that that room
is actually really quite clean again.
So what it boils down to
is that the real way to kind of
prevent the spread of this disease
is to make sure that these folks are isolated
if they are sick with the illness
and over here all the caretakers
they should be wearing protective clothing.
They should be wearing gloves
you know, to make sure that they don't get
blood on their hands.
They should be wearing gowns
to cover up the rest of their body
so that they don't expose any kind of wounds
or cuts or anything like that.
They should be also protecting their mouth with a mask
and goggles as well.
And so, this is actually exactly in the nose.
So all these should be kind of covered up.
And so, even working in these conditions
can be really tough.
I mean, these full body suits can get very, very hot
and it can very, very difficult
to work on these conditions.
But this is really what you want to see
to isolate Ebola from one person not getting to another
and in addition to just hospital workers,
of course you also have to remember
the fact that it's gonna be
you know, funeral directors
that are working with dead bodies
which can actually again spread virus.
Believe it or not, a dead body can
actually spread for weeks after the person has died.
It can be lab workers that are dealing with specimens
or family members actually are huge.
So, all these different people at risk
and by doing this,
you basically prevent the virus from spreading
and hopefully end this scourge
that's happened in Western Africa.