National Science & Technology News Service and #BLACKandSTEM Ebola Chat
The National Science & Technology News Service uses media advocacy to increase the interest and awareness of STEM in the African American community. NSTNS consists of STEM professionals and journalists who work to together to broaden the reporting of STEM news to the African American community and to expand the representation of African American STEM professionals in media. Follow @theDarkSci on twitter.
The ongoing outbreak of the Ebola Virus Disease in West Africa and the Congo has claimed nearly 2000 lives in laboratory confirmed cases and is speculated to be responsible for over 3000 deaths. Very few understand the disease, which also claimed the lives of experts who had dedicated their lives to studying Ebola. The media has left many with questions as headlines and stories, at times, appear to be more about getting views than communicating credible and useful information about the virus. The communication of potentially damaging information appeared to increase exponentially when just two days ago, it was announced that Ebola was diagnosed in a patient within the United States. For today’s joint chat with the National Science & Technology New Service (NSTNS), we will focus on connecting the #BLACKandSTEM and broader community with credible information on the Ebola Virus Disease, its impacts, and avenues to contribute to combating the disease.
Today’s blog and chat features experts within the #BLACKandSTEM community and NSTNS who will serve as resources to answer our questions about the Ebola Virus Disease. Follow the #BLACKandSTEM hashtag, @theDarkSci, @BlackPhysicists, and @BLACKandSTEM. Today’s chat questions: What are your questions and concerns regarding the Ebola Virus Disease? What is the role of #BLACKandSTEM in the combat of Ebola and similar diseases? What has the Ebola outbreak shown us about the impact of technology in the communication and tracking of disease outbreaks? Remember you can answer throughout the day. And use the #BLACKandSTEM hashtag.
Join @theDarkSci at 12pm EST as they host Dr. A. Oveta Fuller @ProfAOFuller to discuss #Ebola! Keep reading for a part of their interview of Dr. Fuller. Note: if you wish to respond to a question listed here during the twitter chat, use an “A1, A2, A3, …” format so that we know which question you are responding to.
A. Oveta Fuller, PhD is an Associate Professor in the Department of Microbiology & Immunology at the University of Michigan. Dr. Fuller’s work focuses on human virus entry, pathogenesis, and infection preventions. @BlackPhysicists interviewed Dr. Fuller about the Ebola Virus Disease.
Q1: What is the origin of the Ebola virus? First discovered in Zaire (now Democratic Republic of the Congo) in 1976 and determined as a new virus. Can follow timeline for the ~30 human outbreaks in history. (CDC Ebola Timeline http://www.cdc.gov/vhf/ebola/outbreaks/history/chronology.html#thirtytwo)
Q2: How did the current outbreak start? Patient 0 was a 2 year old in Guinea who died on December 6, 2013 followed by his mother, sister and grandmother in a region close to the boundaries of Guinea, Sierra Leone and Liberia. It was not identified then as Ebola virus. Note that the child’s caregivers are females who fit typically care provided for a sick household member. This trend is frequent for spread of Ebola.
Q3: How does lack of public works infrastructure, i.e. sewage treatment, potable water, etc increase the spread of infection? The major lack of infrastructure affects health care in facilities and in homes. Conditions mentioned also contribute to more contact between people, body fluids and items touched (fomites). People who are sick with diarrhea, vomiting, bleeding shed fluids full of virus. Virus is highly infectious- contact with a small amount of fluid that has many viruses can infect a new person. Also lack of electricity in many places contributes to spread of infection.
Q4: How does Ebola compare to other viruses in terms of its structure and genome? Ebola is an RNA virus with a complex structure. Other viruses with RNA genetic material are influenza, SARS, the common cold virus, HIV, measles, mumps, West Nile virus, Dengue fever virus, respiratory syncytia virus, hepatitis A virus. What difference does an RNA genetic material make? RNA is less genetically stable than DNA. Mutations that naturally occur as mistakes in virus replication are not corrected. Human cells have no means for correction of mistakes for RNA as they do for DNA. A change can be amplified into many such viruses. If the mutation has a replicative advantage it brings about a virus that is slightly different than what the immune system may have been primed to attack. Variation occurs faster and is higher in a population of RNA viruses.
Q5: How does Ebola infect host cells? Virus in fluids or on objects touched by those fluids enters into host cells and circulates in the body as it reproduces itself to high numbers. It can reproduce in many different types of cells for a broad tropism in human and animal hosts. What determines cell tropism of a virus? For most viruses, tropism is determined by a cellular molecule at the service or an enzyme that is needed for virus replication. Because Ebola is so deadly, it has to be studied in a Biosafety Level 4 facility. Thus, only a few laboratory investigators have studied it at the molecular biology level. This is also why there are few vaccines or anti-virals that have been developed for Ebola virus.
Q6: How does this compare contrast to other common viruses, e.g., HIV, HSV, influenza and rhino virus, etc.? They are similar and different in several important ways. All except HSV, have RNA genetic material that affects stability and effectiveness of vaccines or anti-virals. Some of these are respiratory transmitted (influenza, rhinovirus) different than Ebola, HSV and HIV that require direct contact. HSV (all herpesviruses like chickenpox, Epstein Barr virus, genital herpes, infectious mono virus) is a DNA virus that can remain dormant long-term in cells. In contrast, Ebola, influenza and rhinovirus are acute viruses. They get into host, replicate and eventually move on to another host as the immune system suppresses their reproduction in an infected host. They cannot remain stored (latent) or hidden away in the host like HIV or HSV.
Q7: Once the virus is in host cells, what is cellular/molecular pathology of Ebola infection? Thoughts are that Ebola virus makes a protein or product that affects a common mechanism in cell gene expression or membrane uptake that regulate cellular fluid control. It may also encode a toxin that affects blood clotting.
Q8: Are there attractive drug targets in the viruses genome like integrase and reverse transcriptase in HIV? There have not been enough studies yet to understand the Ebola virus replication well enough to identify man of these sites or processes. There are no integrases or RTs because the RNA virus does not have a DNA step or integrate into cellular genetic material. However, there may be sites yet to be discovered or understood as drug targets.
Q9: What are some other attractive drug targets for Ebola infection? Will be answered during twitter chat
Q10: What exactly is in the treatment, Zmapp serum, used for the two Ebola patients brought to the US? Zmapp contains a humanized monoclonal antibody (combination of regions from a human protein and a mouse or rabbit). It is made against a region of the virus protein that contacts the cell. The antibody is made to high levels in a virus produced and purified from tobacco leaves. It is placed in serum from an Ebola patient when possible. (Will check on use of human serum).
Q11: Explain why it was important bring the 2 patients to US and flex the treatment protocols at Emory? There was not high level isolation and treatment with support in West Africa. At Emory they could get the best available safe care using latest technology and monitoring. Lack of such high care facilities in West Africa, especially needed for health care providers who are on the frontlines, has been a major concern with getting more personnel into affected areas.
Q12: Were the recoveries of Brantly, Writebol and the 3rd patient more about the supportive care or about the serum they were given? We do not know. No controls were in place to determine how anyone of these alone contributed to recovery. Likely contribution of all- supportive care, serum and ZMapp.
Q12a: Does the serum contain an anti-Ebola mAb? Does it bind free virus, or to virus-infected cells, or elicit phagocytic responses? Serum from a patient who has survived Ebola infection contains antibody to Ebola that can reduce virus replication. Those antibodies can bind to virus and infected cells to bring in defense processes of other members of the immune system- including phagocytosis of viral infected cells.
Q13: What specific medical waste handling protocols were used at Emory Hospital? Were human wastes pre-treated in the hospital before being discharged into the normal public works system? Yes, at a biosafety level 4 facility, everything is disinfected or autoclaved before disposal in regulated biologically safe ways. In BL4 facilities, there is a controlled hepa-filtered air that only flows into the room, not out. People can only enter when wearing protective gear that is shed in an interim air controlled room before they enter into contact with other spaces. There is head to toe coverage so no skin surface is exposed.
Q14: What is the differential diagnosis for Ebola infection vs other viral hemorrhagic fevers and E.coli infections? Ebola infection is confirmed by a PCR of fluids to show Ebola RNA. Symptoms are similar to many other infections. Fever is first, headache, sore throat, red eyes, weakness, diarrhea, vomiting, internal and external bleeding. Many of these are similar for flu, malaria, common cold or other early viral infection symptoms.
Link to NSTNS Storify of chat