Friday, June 20th, 2014
6

Ebola and You

An outbreak of Ebola is on track to become the largest in history, and it's showing no signs of slowing down. There are now over 500 recorded cases spread across Guinea and Sierra Leone; the last few appeared in Monrovia, a dense city with about half a million people (and another half a million clustered close nearby).

In the history of Ebola, this is Very Bad: It's major outbreak in an unexpected location. But coinciding with this horrifying story seems to be a sterilization of the news itself—the b-matter in these stories is soft, considering. Here's how NPR backs readers up:

Ebola often kills around two-thirds of the people it infects. And it kills quickly, sometimes within days, sometimes within weeks. That actually makes outbreaks relatively easy to stop, says of the University of Texas Medical Branch.

Here's the AP in a wire stub:

Fear of the disease, which causes horrible bleeding and for which there is no cure, has hampered efforts to isolate the sick.

A longer AP report doesn't bother to describe the disease, suggesting only that it's very, very bad. Is the assumption that everybody already knows? Or is the collective sense of impending apocalypse so strong that it seems cruel to go into detail?

In any case here, for weekend reading, is a passage from one of the most terrifying books I have ever read, Richard Preston's The Hot Zone, describing an early case of Marburg Fever, a hemorrhagic fever similar to Ebola.

He is holding an airsickness bag over his mouth. He coughs a deep cough and regurgitates something into the bag. The bag swells up. Perhaps he glances around, and then you see that his lips are smeared with something slippery and red, mixed with black specks, as if he has been chewing coffee grounds. His eyes are the color of rubies, and his face is an expressionless mass of bruises. The red spots, which a few days before had started out as starlike speckles, have expanded and merged into huge, spontaneous purple shadows: his whole head is turning black-and-blue. The muscles of his face droop. The connective tissue in his face is dissolving, and his face appears to hang from the underlying bone, as if the face is detaching itself from the skull. He opens his mouth and gasps into the bag, and the vomiting goes on endlessly. It will not stop, and he keeps bringing up liquid, long after his stomach should have been empty. The airsickness bag fills up to the brim with a substance know as the vomito negro, or the black vomit. The black vomit is not really black; it is a speckled liquid of two colors, black and red, a stew of tarry granules mixed with fresh red arterial blood. It is hemorrhage, and it smells like a slaughterhouse. The black vomit is loaded with virus. It is highly infective, lethally hot, a liquid that would scare the daylights out of a military biohazard specialist. The smell of the vomito negro fills the passenger cabin. The airsickness bag is brimming with black vomit, so Monet closes the bag and rolls up the top. The bag is bulging and softening threatening to leak, and he hands it to a flight attendant.

When a hot virus multiplies in a host, it can saturate the body with virus particles, from the brain to the skin. The military experts then say that the virus has undergone "extreme amplification." This is not something like the common cold. By the time an extreme amplification peaks out, an eyedropper of the victim’s blood may contain a hundred million particles. In other words, the host is possessed by a life form that is attempting to convert the host into itself. The transformation is not entirely successful, however, and the end result is a great deal of liquefying flesh mixed with virus, a kind of biological accident. Extreme amplification has occurred in Monet, and the sign of it is the black vomit.

He appears to be holding himself rigid, as if any movement would rupture something inside him. His blood is clotting up his bloodstream is throwing clots, and the clots are lodging everywhere. His liver, kidneys, lungs, hands, feet, and head are becoming jammed with blood clots. In effect, he is having a stroke through the whole body. Clots are accumulating in his intestinal muscles, cutting off the blood supply to his intestines. The intestinal muscles are beginning to die, and the intestines are starting to go slack. He doesn’t seem to be fully aware of pain any longer because the blood clots lodged in his brain are cutting off blood flow. His personality is being wiped away by brain damage. This is called depersonalization, in which the liveliness and details of character seem to vanish. He is becoming an automaton. Tiny spots in his brain are liquefying. The higher functions of consciousness are winking out first, leaving the deeper parts of the brain stem (the primitive rat brain, the lizard brain) still alive and functioning. It could be said that the who of Charles Monet has already died while the what of Charles Monet continues to live.

And then read this, too, and never go outside again.

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6 Comments / Post A Comment

hershmire (#233,671)

Guess I better get this cough checked out.

Madeline Shoes (#240,390)

I literally had The Hot Zone open on my lap when I read the news about the latest outbreak. That shit is scary!! Also, for those of you that haven't read the book – READ IT NOW. It's amazing. It's horrifying, but it's seriously one of the best book's I've ever read (and re-read).

Freddie DeBoer (#4,188)

"it kills quickly, sometimes within days"

Which limits its danger. Diseases that kill very quickly are actually less likely to become pandemic than diseases such as HIV/AIDS that kill slowly, because there's less opportunity for them to spread. People who get visibly sick quickly are easier to avoid, have less opportunity to travel and spread the disease, and generally less time in which to infect others. In fact, it's precisely because HIV has such a long incubation period that made it such a terribly pernicious virus; you can have it for a long, long time without knowing it, making it much more likely that you'll spread it to others. It's slowness is its danger.

John Herrman (#8,286)

@Freddie DeBoer Oh I absolutely recommend 'The Coming Plague' by Laurie Garrett, it spends a lot of time on the idea of severity. There are diseases that behave and spread in terrible ways and diseases that unfold in terrible ways, and nobody's very good at predicting the center of the Venn.

@Freddie DeBoer : I skipped down to comments just to point this out, so I'm glad you beat me to it.

charlsiekate (#231,720)

Seriously. Have you ever read Camus's The Plague? I have a friend in Sierra Leone, and he recently spent some time in the Ebola area with a community outreach program. Apparently it's difficult to convince people to bring the sick people to the hospital, and the early symptoms of the disease are vague, so people don't get immediate treatment and continue walking around spreading it. Basically, the situation is not under control. At all.

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