[MUSIC] So let's talk just a little bit about another illness, which is a really serious illness that's happening now around the world. We have the first worldwide epidemic, if you will, associated with Ebola. And it is a really serious disease and has really serious consequences, especially in resource deprived areas where the medical infrastructure is very limited. The reason that it's important to think about Ebola in the context of this course is, because we believe there are certain things that we think are true about Ebola. Okay, we think that Ebola is actually, that the reservoir for Ebola, the place where it resides is actually in fruit bats. And an event, which we call a spillover event, occurred at some point from fruit bats, the supposed reservoir into people. There are couple of ways we think, or can envision, that that would occur. One is, fruit bat consumption through bushmeat. So bush meat is a common source of protein in resource deprived areas, particularly in Africa, and fruit bats are one of the components of bushmeat, depending on who's producing the bushmeat, where they live, what animals are available to them. The other possibility, in terms of what could have happened in relation to this spill over event, is that it actually spilled over to people during the slaughter and processing of fruit bats. Of course the producer of bush meat must process those animals and if they have any kind of little cut or abrasion in their skin that is one of the ways that Ebola is introduced into a person. So that spill over event occurred, probably from food production or eating of foods. The other possibility, besides eating fruit bats through bush meat would be, because Ebola is transmitted basically through bodily fluids, so blood, semen, saliva, diarrhea, vomitus, these kinds of things. Fruit bats, of course, eat fruits, and they don't always like the taste of a fruit that they take a bite out of, so they throw it on the ground. That piece of fruit might be picked up by a person, the saliva from the fruit bat is on that piece of fruit. They may eat that piece of fruit. So there's transmission potential that way. The other possibility is, because fruit bats hang in trees, they congregate. In our country we see bats congregating in caves. Well, bats in Africa congregate also, and as a result there's a lot of bat feces in and around the areas where they congregate. And if they are in trees which have fruit in them, that fruit falls on the ground it has the potential to become contaminated by bat feces. That then is pick up and eaten by people, potentially without using appropriate food hygiene associated with the consumption. So that's what we believe causes the spill over than to happen associated with the Ebola. How it begun in people with this most recent outbreak. But then, now we're in a circumstance where it's being passed person to person, actually without the food component. Again, the sources in the person to person transmission are blood, vomited, feces. All of the bodily fluids that have the potential to have virus in them can transmit the virus then to another individual. It's a really serious disease causing high mortality in countries in Western Africa. I was actually in Sierra Leone teaching tropical epidemiology. In the last two weeks of March, the first week of April, when the outbreak began, or the main portion of the outbreak began in Guinea. And they closed the border between Sierra Lione and Guinea while I was there. In those kinds of countries where medical services are very limited, it compared to U.S. standards, at least, or compared to Western standards. The mortality rate is going to be, and is very, high, unfortunately, because when people get sick with this disease, they have a large increase in excretion of bodily fluids. So they developed diarrhea. They get sick and vomit repeatedly. And so they become dehydrated and consequently the mortality rate in those countries is going to be high because it is a really serious disease. Up to the level of actually causing hemorrhaging. It is a hemorrhagic disease, and of course, the blood that would come potentially from such individuals because they may develop hemorrhages from the eyes, hemorrhages from breaks in their skin and various orifices. Is and can be quite serious, and of course that blood then is contaminated. If you look at the kind of PPE or personal protective equipment that recommended to be used in order to protect people from becoming infected, I'm sure they'd be at risk. Because they must interact with the person who actually has active symptomatic Ebola. It's tremendous. Even the PPE which was used when we did observation of Bently the dog that was quarantined, who was owned by the nurse in Texas that came down with Ebola, Those individuals were wearing boots, they were wearing [INAUDIBLE] impermeable suits, they're double gloved with tape around, they're wearing a PAPR device, P-A-P-R, powered air purifying respirator. Although we don't think that the disease is airborne so to speak. It could be transmitted. A virus particle could be transmitted from someone who spits accidentally. If there's virus in the saliva. We're doing everything we can when an individual is potentially at risk for exposure to Ebola by having them in these types of personal protective equipment. Ebola is an example of a zoonotic disease or condition. Lots of viruses and lots of bacteria are moveable between various animal species, right? And humans are just one of the animal species that inhabit this earth of ours. So we can receive diseases from animals and we can also transmit diseases back to animals. The types of species that are involved with Ebola are, subhuman primates, pigs, and dogs, besides humans of course. And let me share with you just a little bit about what we know about dogs. So we know from studying areas where there were outbreaks that occurred Going in and actually sampling the dogs that some portion, roughly about a fourth of those dogs, seroconvert. The dogs were never known to be sick and they are not known to be responsible for transmission. Two people of the virus. But they are processing that virus or virus particles in some fashion enough that they develop antibody to Ebola virus or some portion do. The same thing is true with people, people who are in close contact with Ebola infected patients, that are symptomatic and therefore spreading the virus throughout their bodily fluids, are A symptomatic, they seroconvert to Ebola, but they never develop the disease The two main sources that really are excellent sources and places for you to get information associated with Ebola, and really, all infectious diseases that have human implications, and some of which have animal implications, CDC is just excellent. And the WHO, the World Health Organization, both of those places are providing new information on regular basis now associated with this Ebola outbreak. Ebola has socio-economic elements associated with the actual spread of this disease because of the source We do not consume bats in this country. There are areas of the world though that do consume bats and other species that are outside of the normal consumption patterns that we have in the US. As a consequence, they're exposed to different types of diseases. And then they're in environments which don't allow for the same types of medical treatments that we have here and available in the US. We shouldn't be afraid of brining people, who have Ebola, to this country. In fact, bringing them to western countries where they can get proper medical care, is the main reason Are the main way that they will actually be able to have a lower mortality rate. [MUSIC]
