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How did Thomas Duncan get infected, what he was told? (malaria)

The Ebola virus that infected Thomas Eric Duncan, the Liberian man who fell ill in Texas, has sickened at least six others in the sandy neighborhood near the Liberian capital where he lived in a rented room with a plain wooden door.

A chain of confusion and denial links the Dallas apartment complex to which he moved to a dark green house about 30 yards from Duncan's door in Liberia, where the desperate family of a dying pregnant woman treated her illness as malaria, not the highly infectious virus that has killed more than 3,300 people.

Now two members of the Williams family, Duncan's neighbors and landlords, are dead, three other people are sick and Duncan has become the first person to develop symptoms of the disease in the United States.

If not for the Williams family's insistence, perhaps based on wishful thinking, that 19-year-old Marthalene Williams didn't have Ebola, the disease might never have reached U.S. soil...(much more, please read it at the link)
Posted by uppityperson | Mon Oct 6, 2014, 07:24 PM (6 replies)

Your organs do NOT liquify, contrary to popular literature. Why do you get sick, die? Details here..

No photos or visuals are provided, but if you are squeamish about what happens in a non-graphic cellular and system way, you are warned. I am more bothered by "liquify, bleeding from every orifice" language than technical medical jargon, but if you are bothered by technical medical jargon, that is what follows.

Contrary to popular literature, organs do not liquify from ebola leading you to dying by bleeding from every orifice. There are 2 basic things that happen, leading all to often to death. An immune system over reaction leading to cytokine storm, and DIC causing lots of little blood clots, tissue death, then bleeding.

Your immune system over reacts, releasing chemicals that damage blood vessels, letting fluid, blood and plasma leak out. Your blood pressure drops, you die.

DIC is a combination of excessive blood clotting and then the inability of blood to clot since all the clotting factors are used up. The body makes lots of little blood clots that plug up capillaries leading to no blood flow to parts of organs. This kills those parts of the organs. Liver, kidneys, brain, digestive tract, etc.

Because the body has made so many blood clots in inappropriate places and because the blood vessels are damaged and leaky, you then can bleed easily. The blood vessels leading into those parts have open ends and can bleed. Anywhere you bump gets bruised, and the bruised grow quickly on your skin. And inside your body.

Parts of the lining of your digestive tract can slough off when it is dead. But it is not liquified. It is dead.

At the end stage of the disease, you have small leaks in blood vessels," says Thomas Geisbert, an immunologist at the University of Texas Medical Branch at Galveston. "You end up with essentially no blood pressure. Your body temperature drops and you go into shock."

But when you look at the nitty-gritty details of an Ebola infection, a surprising fact surfaces: The virus isn't what ends up killing you. It's your own immune system.

"The normal job of the immune system is to eliminate infections," says virologist Christopher Basler, at the Mount Sinai Hospital in New York City. "But when it's activated at extreme levels or it's out of control, it becomes damaging to the host."

The most extreme immune attack is the "cytokine storm." Although many viruses, like bird flu and SARS, can trigger this shock and awe assault, Ebola is probably the best at it. And at the end of an Ebola infection, it's the cytokine storm that kills you, Basler says....(more)

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.”...

Posted by Tom Wilson Grade level: M.D./PhD, Pathology, Div. of Molecular Oncology, Washington University Medical School
Question 1: Ebola does NOT cause the body to liquefy! I wish I knew
where this description of the disease comes from. Ebola does cause a large degree of tissue destruction in many parts of the body. We call this tissue destruction "inflammation". But it is fundamentally no different than the kind of destruction that occurs in, say, the common cold. This is exactly how your body fights the infection. Unfortunately, the inflammation can sometimes hurt you as much as it helps fight the infection. Part of inflammation is that tissues become leaky to fluid (why your nose runs), and this is compounded in Ebola infection since the virus is infecting (and killing) the cells of the blood vessels (see below), and so there is an even greater leakiness that results in frank bleeding. This results in the very powerful image of an infected person, since they have a bloody drainage at the eyes, nose, mouth, etc., and leads to the name for this disease, which is "hemorrhagic (i.e. bleeding) fever". But this idea that the internal organs turn to liquid is absurd. They are merely having the same kind of inflammation occurring, which does cause fluid
accumulation and severe tissue destruction, but again, it is nothing asfanciful what you have been led to believe.

As for the clotting, part of the bodies normal response to a damaged blood vessel is to form a clot there, to stop the bleeding. A clot is a
solidification of the the liquid components of blood, and is thus a fundamentally different process from the inflammation that is causing the fluid leakiness.

Question 2: Ebola virus does NOT infect every cell in the body! Again, I wish I knew where this idea came from. Ebola infects almost exclusively the cells that line the insides of your blood vessels - we call them "endothelial cells". Since all parts of your body have blood vessels, of course, all *parts* of the body (skin, organs, brain, etc.) can get infected. This is certainly part of why Ebola infection is so severe - by infecting only one cell type, the whole body can be damaged. It is also part of why Ebola can spread about the body so quickly - as soon as virus gets released from a dying cell, it finds itself in the bloodstream where it can now be pumped all over the body very fast.

In humans and monkeys, the hallmark of filoviral disease is unchecked viral growth that coincides with a relatively wide range of possible disease manifestations including fever, malaise, diarrhoea and vomiting, severe liver damage and various coagulation deficits that cause filoviruses to be categorized among the viral haemorrhagic fevers. The worst of the symptoms, including haemorrhage in a few individuals3, 91, seem to flow from a 'cytokine storm', a profuse release of pro-inflammatory cytokines52 (Fig. 1). In addition to cytokine effects on vascular permeability, causes of excessive bleeding can include plummets in platelet numbers, severe liver damage and the activation of tissue factor in monocytes and macrophages92. The time from infection to death is generally 1–2 weeks, with some variability depending on the virus and host species, as well as on initial dose93. For survivors, recovery is a lengthy process.

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