Episode Details

This week we talk about the Democratic Republic of the Congo, malaria, and healthcare infrastructure.

We also discuss militants, Uganda, and the Bundibugyo virus.

Recommended Book: We Should Get Together by Kat Vellos

Transcript

Ebola, which is more formally called Ebola Virus Disease or Ebola Hemorrhagic Fever, is caused by an infection by a type of RNA virus called an orthoebolavirus.

There are six known species of orthoebolavirus, and four of them have at some point infected and caused illness in humans. Those four are the ebola virus, sometimes called the Zaire ebolavirus, which historically has been the strain responsible for the biggest, most devastating outbreaks of this disease, the Sudan virus, the Taï Forest virus, and the Bundibugyo virus, the latter three each causing a variant of the disease that carries the same name.

The other two orthoebolavirus species that we know of, the Reston virus and the Bombali virus, have been known to infect animals, but have not, at this point at least, been known to make the jump to human hosts.

Ebola symptoms vary a bit between specific viruses and between hosts and infection conditions, but in general those who are afflicted by ebola begin to experience symptoms between a few days and a few weeks after infection, and they’ll start by experiencing cold and flu-like symptoms, like fever, sore throat, headaches, and general muscle pain. Soon after that, though, they’ll start experiencing diarrhea and rashes, they’ll begin vomiting, and they’ll begin to experience liver and kidney dysfunction, and around that same time, they’ll start to bleed internally and externally.

Once infected, a person has between a 25 and 90% chance of dying, depending on the strain of ebola, and if they die, usually due to what’s called hypovolemic shock—a severe and sudden loss of bodily fluids, including blood—they usually die between 6 and 16 days after those first symptoms are reported.

What I’d like to talk about today is a new outbreak of ebola centered in the Democratic Republic of Congo, and why this one stands out from other recent outbreaks in the region.

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Ebola was first officially reported in medical literature in 1976, mostly in sub-Saharan Africa, and there have been semi-regular outbreaks in that region, of various sizes ever since, and very likely before that, too.

This disease is spread through direct contact with the body fluids of someone who’s infected, and it’s thought that this is probably how the disease made the leap from animals, like primates, to human beings: locals sometimes come into close contact with local primates, either while just coexisting, or while hunting bushmeat, hunting monkeys for food.

It’s thought that fruit bats serve as hosts for the virus, long-term, and it then spreads to other animals, and then sometimes to humans, in some cases causing illness along the way in those other species, but not always; bats are not negatively afflicted by it, for instance, but humans very much are.

Despite not being an airborne pathogen, so it’s not spread by coughing or talking too close to someone, like a cold or Covid-19, ebola can still be spread person-to-person through bodily fluid contact. That means fluids like saliva and blood and semen and breast milk, and research has shown that even after someone survives and recovers from ebola, the disease can linger in their fluids for months. So if someone catches it, survives, and then breast-feeds their child, or kisses or has sex with their partner, or gets a cut and then someone else comes into contact with their blood, like a health worker, that can lead to the transmission of the disease, despite their having been well and seemingly fully recovered for weeks or months.

That lingering contagiousness is a confounding factor with this disease,