Ebola natural history

Cultural impact
Ebola and Marburg have served as a rich source of ideas and plotlines for many forms of entertainment. The infatuation with the virus is likely due to the high mortality rate of its victims, its mysterious nature, and its tendency to cause gruesome bleeding from bodily orifices.

In the movie Outbreak, the virus looks the same as the Ebola virus. In fact, the entire movie's made up virus "Motaba" is based very closely on Ebola. The symptoms and area of infection had relevance.

The Rage Virus from the movies 28 Days Later and 28 Weeks Later is a modified version of the Ebola virus.

In the book Outbreak, by Robin Cook, the Ebola virus is used in name as a possible weapon, with criminal intent. This book is different from the movie Outbreak of the same name

Biological warfare using airborne modifications of the Ebola virus was a main theme in Tom Clancy's novels Executive Orders and Rainbow Six.

In Resident Evil, the T-Virus is a modified version of the Progenitor Virus, created by inserting it with Ebola genes.

Tomb Raider: The Cradle of Life features a biological weapon consisting of a greatly accelerated form of Ebola, capable of causing death within minutes.

Much of the representation of the Ebola virus in fiction and the media is considered exaggerated or myth. One pervasive myth follows that the virus kills so fast that it has little time to spread. Victims die very soon after contact with the virus. In reality, the incubation time is usually about a week. The average time from onset of early symptoms to death varies in the range 3-21 days, with a mean of 10.1. Although this would prevent the transmission of the virus to many people, it is still enough time for some people to catch the disease.

Another myth states that the virus causes patients to melt, liquefy, or bleed profusely. In depictions of this type, victims of Ebola suffer from squirting blood, liquefying flesh, zombie-like faces and dramatic projectile bloody vomiting, at times, from even recently deceased. In actual fact, only a fraction of Ebola victims have severe bleeding, and most accounts of the course of the disease describe patients as dull and lethargic. Approximately 10% of patients suffer some bleeding, but this is often internal or subtle, such as bleeding from the gums. Ebola symptoms are usually limited to extreme exhaustion, vomiting, diarrhea, abdominal pain, a high fever, headaches and other body pains.

The following is an excerpt from an interview with Philippe Calain, M.D. Chief Epidemiologist, CDC Special Pathogens Branch, Kikwit 1996:

At the end of the disease the patient does not look, from the outside, as horrible as you can read in some books. They are not melting. They are not full of blood. They're in shock, muscular shock. They are not unconscious, but you would say 'obtunded', dull, quiet, very tired. Very few were hemorrhaging. Hemorrhage is not the main symptom. Less than half of the patients had some kind of hemorrhage. But the ones that had bled, died.

Complications
Survivors may have unusual problems, such as hair loss and sensory changes. There are also some late complications that may occur due to ebola. They are:


 * Hearing loss
 * Unilateral orchitis
 * Headache
 * Fatigue
 * Myalgias
 * Tinnitis
 * Amenorrhea
 * Bulimia
 * Suppurative parotitis

Prognosis
The prognosis for a patient infected with the ebola virus is typically not good. The mortality rate from ebola can be as high as 90%. Many times patients will die from shock rather than blood loss. It should be noted that patients who are able to survive with ebola for two weeks are usually able to slowly recover.