• New virus in Africa looks like rabies, acts like Ebola

    Frederick A. Murphy / CDC handout via EPA file

    A new virus that appears similar to rabies, but has the symptoms and lethality of Ebola, shown here, has been dubbed the Bas-Congo virus. It killed two teenagers in the Congo in 2009.

    By Maggie Fox, Senior Writer, NBC News

    A virus that killed two teenagers in Congo in 2009 is a completely new type, related to rabies but causing the bleeding and rapid death that makes Ebola infection so terrifying, scientists reported on Thursday. They’re searching for the source of the virus, which may be transmitted by insects or bats.

    The new virus is being named Bas-Congo virus, for the area where it was found.  Researchers are finding more and more of these new viruses, in part because new tests make it possible, but also in the hope of better understanding them so they can prevent pandemics of deadly disease.

    The virus infected a 15-year-old boy and a 13-year-old girl in the same village in Congo in 2009. They didn’t stand a chance, says Joseph Fair of Metabiota, a company that investigates pathogens. Fair is in the Democratic Republic of Congo now, under contract to the U.S. Agency for International Development (USAID) to help battle an ongoing Ebola outbreak.

    “They expired within three days,” Fair said in a telephone interview. “It was a very rapid killer.”

    A few days later a male nurse who cared for the two teenagers developed the same symptoms and survived. Samples from the lucky nurse have been tested and it turned out a completely new virus had infected him, Fair and other researchers report in the Public Library of Science journal PLoS pathogens.

    The genetic sequences went to Dr. Charles Chiu, of the University of California, San Francisco.

    “We were astounded that this patient had sequences in his blood from a completely unknown and unidentified virus,” Chiu said. They weren’t expecting that.

    “Congo is very much known for having Ebola and Marburg outbreaks. Yet about 20 percent of the time we have hemorrhagic fever outbreaks that are completely negative, which means unknown causes and they are not Ebola.”

    The sequencing puts this new virus on its own branch of the bad virus family tree -- somewhat related to Ebola and the virus that causes Lassa fever, another horrific killer, and most closely related to the rhabdoviruses. This family usually only infects animals with one notable exception -- rabies.

    But rabies is not known to cause hemorrhaging. It’s plenty horrible on its own, of course, killing virtually all patients if they aren’t vaccinated soon after infection. 

    A nurse who took care of the first infected nurse had antibodies to the new virus. It doesn’t look like the teenagers infected one another, says Fair, but they probably infected the first nurse, who probably infected the second. Tests of other villagers have found no more evidence of the virus, however, which is good news.

    “Although the source of the virus remains unclear, study findings suggest that Bas-Congo virus may be spread by human-to-human contact and is an emerging pathogen associated with acute hemorrhagic fever in Africa,” the researchers wrote.

    Africa is loaded with nasty viruses. Lassa fever virus comes from a family known as arenaviruses and causes 500,000 cases of hemorrhagic fever a year. Crimean-Congo hemorrhagic fever and Rift Valley Fever viruses are in another family called bunyaviruses; Ebola and Marburg viruses are filoviruses that kill anywhere between 30 percent and 90 percent of victims. They’re also helping wipe out great apes such as gorillas in Central Africa. This adds a new one to the list.

    It worries Chiu because its closest relative is spread by biting flies in Australia. “We think that is potentially a valuable clue. This virus may have come from an insect vector,” Chiu says. “What is scary about this virus is if it does happen to be spread by insects, it has the potential to be something like West Nile."

    West Nile showed up in the United States for the first time in 1999, having never been seen here before. It causes regular outbreaks in Africa and parts of Europe, however, and some experts think a mosquito or an infected person carried it on a flight to New York. It’s killed 147 people in an especially bad U.S. outbreak this year, although more than 90 percent of people infected with West Nile never even know it.

    New viruses often cause disease -- there was severe acute respiratory syndrome or SARS, which killed 800 people and infected 8,000 in 2003 before it was stopped. Scientists are now watching a similar virus that has emerged in the Middle east.

    Chiu says there is not enough information to know how deadly the new Bas-Congo virus is.

    “It  has probably been lurking out there in remote areas and causing sporadic cases of hemorrhagic fever and no one had the resources to discover it,” Chiu said. “This is probably the tip of the iceberg. I believe there are many, many more of these emerging viruses that have yet to be discovered,” he added.

    “This points to the importance of being vigilant, especially these remote areas of Africa and Asia. This is the area that I believe the next generation of emerging viruses will come from.”

    Fair agrees, and says his team will be looking. They’ll also be checking to see if bats or insects can spread it. “It is a frightening prospect. That is why the next step in this process is to look for the vector,” Fair said.

    That’s not so easy. Fair’s team and hundreds of other scientists have been looking for the reservoir -- the animal or insect source --of Ebola. That would be a bat or other creature that can carry it without getting sick itself. So far they have had no luck, although fruit bats are a major suspect.

    And for the new Bas-Congo virus, the trail is now three years old. “Everything we do will be as a forensic investigation,” Fair said. “We really have to go look for a needle in a sack of needles.”

    And in the meantime, there’s an outbreak of Ebola to cope with. Fair says a coordinated effort is going on, although this isn’t the worst outbreak he has seen. It’s killing about 30 percent to 40 percent of patients -- not nearly as bad as some strains, which killed up to 90 percent of victims.

    “If you had to get Ebola, this is the strain to get,” he said.

    Related stories:

     

     

     

    85 comments

    Show more
    Explore related topics: , , , , ,

  • Ebola out of control in Congo, WHO says

    By Reuters

    An Ebola outbreak in Democratic Republic of Congo risks spreading to major towns if not brought under control soon, the World Health Organization said on Thursday.

    The death toll has more than doubled since last week to 31, including five health workers. There is no treatment for Ebola, which is highly contagious and can cause internal bleeding. Depending on the strain, it kills between 50 percent and 90 percent of victims.

    "The epidemic is not under control. On the contrary the situation is very, very serious," Eugene Kabambi, a WHO spokesman in Congo's capital Kinshasa, told Reuters by telephone.

    "If nothing is done now, the disease will reach other places, and even major towns will be threatened," he said.

    The disease has so far struck in the towns of Isiro and Viadana in Orientale province in the north east.

    In August, 16 people in neighboring Uganda died from Ebola infections, although health experts said the two epidemics are not connected. They have blamed the Congolese outbreak on villagers eating contaminated meat in the forests that cover the region. 

     

    Related links:

    Health teams face real-life horror in fighting Ebola

    Ebola kills 14 in Uganda

    Five things you should know about Ebola

     

    Copyright 2013 Thomson Reuters. Click for restrictions.

  • Health teams face real-life horror in Ebola battle

    Isaac Kasamani / AFP - Getty Images

    Officials from the World Health Organization wear protective clothing on July 28 as they prepare to enter Kagadi Hospital in Kibaale District, Uganda.

    By Kari Huus, NBC News

    When officials in Uganda verified an outbreak of the Ebola virus on Saturday, it set international health workers in motion.

    The hemorrhagic virus is the stuff of real-life horror — spreading through contact with infected individuals, their bodily fluids and even clothing they have worn. In many cases Ebola leads to a rapid decline marked by fever, diarrhea, vomiting and internal and external bleeding.

    In the few days since it was reported, medical teams from in and outside Uganda have descended on the source of the outbreak in western Uganda, Kibaale district, where so far, there have been 38 confirmed cases of Ebola (formally Ebola hemorrhagic fever) and 16 deaths, according to the U.S. Centers for Disease Control and Prevention.

    The bible for containing Ebola — and similar contagious viruses — is a 200-page guide to detection, isolation and sanitation procedures developed by international health officials and groups after the 1995 outbreak in the Democratic Republic of Congo. In that case, due to belated reporting, and the absence of precautions, more than 300 people contracted the disease, and about 80 percent of them died.

    Among the groups scrambling to put these protocols in place are the U.S. Centers for Disease Control, Uganda Red Cross, World Health Organization and Doctors without Borders (Medecins Sans Frontieres), an international emergency aid group.

    "Ebola is not completely unknown but it’s not like malaria which (they) see every day,” said Henry Gray, who is with a team from Doctors without Borders that arrived Monday night in Kigadi, the town about 100 miles west of Kampala where the first cases emerged. "When something like Ebola happens, it rarely hits the same place twice, so there’s normally a learning curve" for local personnel.

    One third of the 100-bed Kigadi Hospital has been designated an isolation unit for Ebola infected cases, with a physical barrier restricting access to non-Ebola patients in the hospital, said Gray.

    Within the isolated side, "there’s one area for people under observation, and another for people confirmed (with Ebola). There are other areas where there’s a pharmacy, an area where people get dressed and undressed from protective equipment."

    When there is no space in the building to accommodate a given need, the team puts up tents in the courtyard, also part of the isolation zone.

    Augustin Morales/MSF

    A team from Doctors Without Borders are among those who have launched an emergency intervention against an Eboloa outbreak. Workers are shown at Kagadi Hospital in Western Uganda.

    "The whole of the isolation zone has a risk attached — both low risk and high risk," said Gray. "High risk we don’t go in without full gear — that is not a millimeter square of skin showing so there’s no risk of being splattered by blood or fluids or whatever."

    One of the priorities is to protect and support local medical staff who are frightened. In this outbreak, as in others, some of the first fatalities were two medical personnel who contracted the virus from patients before it had been identified as Ebola.

    "One way to make sure we are supporting them is to put procedures in place. Once they are set we really minimize the risk," said Gray, an engineer. "That, for me, is a way for us to deal with it — to be really, really strict in that."

    In coming days, Doctors without Borders will also be providing psychosocial support to help medical workers and patients cope with the crisis, and the fear it engenders. They have worked out safety procedures for counsellors working with patients who are in isolation, and cared for by people in hazmat suits.

    "People are frightened," said Gray. "The poor people who catch it are in completely unfamiliar surroundings and don’t know what is going on."

    One of the first priorities is to set up isolation units, sanitation procedures and safety gear to prevent the spread of Ebola from patients outside the hospital, and to protect care givers.

    Doctors without Borders and others also provide psychosocial support, including psychologists to work with doctors and patients, as well as family and contacts of those infected.

    So far, Doctors without Borders has a team of 22 expatriate and local staff in Kigadi, working alongside local hospital and health ministry workers, reinforcements from the capital Kampala, and other international groups.

    Gray said the size of the team was expected to double, and could shift from setting up detection and treatment systems, to community education and outreach depending on how the situation develops.

    Ugandan President Yoweri Museveni advised people to avoid shaking hands and promiscuity to reduce the chance of contracting the Ebola virus after a deadly outbreak. NBCNews.com's Dara Brown reports.

    Ebola virus is fatal for anywhere from 20 percent to 90 percent of those infected, depending on the strain. This outbreak is Ebola-Sudan strain, which causes death in up to 70 percent of those infected, according to the CDC.

    There’s no known cure for Ebola, but patients are treated for symptoms including vomiting, diarrhea and dehydration, and some survive.

    It remains unclear to what extent the outbreak had been contained.

    News that one victim of the virus had died in Kampala caused a flurry of panic in the capital city. But the World Health Organization said on Tuesday that the patient had been transferred to Kampala from Kibaale and no infections had occurred outside Kibaale district.

    "The first case appears to have been a 3-month-old girl whose mother was also sick. When the girl passed away, her family tried to find out what she had died from but couldn’t find the answer — though there were rumors of witchcraft and magic," according to Olimpia de la Rosa, emergency coordinator for Doctors without Borders, cited in a news release.

    Fifteen of the 65 people who attended the baby’s funeral became sick, and 11 of them have since died, she said.

    The aid effort was ramping up to grapple with a potential influx of patients.

    In a national address this week, Ugandan President Yoweri Museveni advised people to avoid shaking hands, casual sex and do-it-yourself burials to reduce the risk of spreading disease, Reuters reported.

    "Fears of catching Ebola have twisted people's lives," Tumusiime Jamilo, a reporter at a local radio station told Reuters. "They can't go to the markets to buy things, (others can't) sell their products and that's hitting their pockets."

    People also didn't feel free to travel or go to churches and mosques because of worries about the virus, the report said.

    The World Health Organization did not recommend any travel or trade restrictions be applied to Uganda because of the outbreak.

    It urged avoiding contact with dead animals, especially primates, and refraining from eating wild game or "bushmeat" — which is believed to be one source of the virus.

    By chance, Secretary of State Hillary Clinton arrived in Kampala on Thursday where she was expected to stay one night on an 11-day diplomatic tour of seven African nations.

    Follow Kari Huus on Facebook

  • 5 things you should know about Ebola

    MyHealthNewsDaily

    An outbreak of Ebola in western Uganda has killed 14 people, according to news reports. Here are five things you should know about this virulent and often deadly infection:

    What is Ebola?
    Ebola, officially known as Ebola hemorrhagic fever, is a severe disease caused by the Ebola virus that was first recognized in Africa in 1976.

    Early symptoms can include fever, headache, joint and muscle aches, sore throat and weakness, followed by diarrhea, vomiting and stomach pain, according to the Centers for Disease Control and Prevention. In some cases, the disease causes rashes, red eyes, hiccups and internal and external bleeding, the CDC says.

    Up to 90 percent of people who are infected with Ebola die from it, according to the National Institutes of Health.

    Outbreaks have occurred in African countries, including the Democratic Republic of the Congo, Gabon, Sudan, the Ivory Coast, Uganda and the Republic of the Congo, the CDC says.

    How is it transmitted?
    Humans are not the natural hosts of the Ebola virus, and it's believed that the first person in any outbreak became infected through contact with an infected animal, the CDC says. Animals that are reported to have spread disease to humans include chimpanzees, gorillas, forest antelopes and cynomolgus monkeys, according to the World Health Organization. Once one person has become infected, the disease can spread from person to person through contact with the blood, saliva, mucus or other secretions. In the countries where Ebola has occurred, the disease is frequently spread in health care settings to workers who have had contact with patients and do not wear protective clothing or masks, the CDC says. Re-use of contaminated needles can also spread the disease.

    Researchers still do not know where Ebola naturally resides. Studies have shown bats can be infected with the virus and survive without symptoms of disease, according to the WHO. Some have speculated bats play a role in maintaining the virus in nature, the WHO says.

    How many people have been infected?
    Since Ebola was discovered, about 1,850 cases and more than 1,200 deaths have been reported, according to the WHO.

    Has there ever been an outbreak in the United States?
    Ebola has not caused disease in the United States. In 1990, several researchers in Virginia and Texas became infected with a type of Ebola virus from contact with imported monkeys, the CDC says. However, the type of Ebola in these cases, now called Ebola-Reston, did not cause symptoms in humans, although it was fatal in monkeys.

    Is there a cure?
    No. Patients with Ebola are treated with supportive therapy, which includes balancing their fluids, maintaining their oxygen levels and blood pressure, and treating them for any complicating infections, the CDC says.

    Related content: