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Ebola Transmission, Review of Literature

by 420insight on October 17, 2014
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By: David B. Allen M.D.
Medical Director Cannabis Sativa Inc.

The Ebola RNA virus has spread fear and panic in the media. The severity of the disease process and lack of treatment and isolation of this disease has fueled worldwide concern for our safety. The severity of the disease process also limits our study of the virus because of this fear. Indeed many scientist and medical personnel have died during inadvertent transmission of the Ebola virus by handling objects (fomites) contaminated with virus or accidental injections of this virus.(1) A review of the scientific literature will show little to no scientific studies of the exact mechanism of spread in humans because of the lethal consequences of this sort of study. Studies involving non-human primates (monkeys) are currently the best available information.

How is Ebola spread? Is it by multiple mechanisms? Is it air borne, water borne, food borne, direct contact with skin, mucosa, conjunctiva? How do we protect ourselves? How long does it stay viable and infective outside the body and what conditions promote or degrade viral survival outside the body? What other animals and plants does Ebola infect or host?

Recently Dr. Sanja Gupta appeared alongside with the head of the CDC and made an announcement on CNN that Ebola was not spread by airborne mechanism. This is a bold statement that goes against scientific literature and current reports in the news. The motive for this is obviously to calm people and to minimize panic. Initial containment of the disease would require isolation of any infectious outbreak of a small village or small city. When this isolation expanded to large countries and continents then the financial implications of this isolation would be devastating for the world and not just the countries isolated. A restriction or ban of all travel to these locations would be essential and this ban would have devastating social and financial implications.

Reports of transmission with minimal contact:

Ashoka Mukpo, a NBC cameraman hospitalized in Omaha, contracted Ebola after covering a story in Africa. He contracted the viral disease presumably from washing a car that had carried an Ebola patient. “Although Mukpo isn’t sure how he was infected, he told his father that it’s possible he was exposed when he was spray washing a car in which someone had died to disinfect it.”

In another report from Spain, an assistant of a nurse Teresa Romero Ramos, contracted Ebola after her single exposure of helping her supervising nurse take off protective gear after carrying for Ebola patients. It is obvious from many reports of transmission, that minimal contact is producing infections.

Since we cannot prove these incidental reports as proof of transmission let’s look at some of the data that is currently available and compare that with current questions the public has about transmission.

Question?     How many viral particles can cause an infection? To reword this question; What are my chances of catching Ebola if I am exposed to it?

Answer:         As quoted from Public Health Agency of Canada as little as 1-10 organisms can result in infection. (2) In comparison the Plague requires 100-500 organisms. This makes Ebola a very virulent organism.

In a Sudanese hospital 76 of 230 hospital personnel were infected and 41 died. (33% of the people who worked there)

Dr. Gupta is quoted “The uninfected person would have to have a break in the skin of their hand that would allow entry of the virus, CNN’s Dr. Sanjay Gupta says. But “we all have minor breaks in our skin. And there is a possibility that some of the virus can be transmitted that way.” The rates of transmission quoted above argue against the “you need a cut to get it” theory. Educated people are contracting this disease despite efforts made to minimize the risk.

Question?     How long can Ebola viral particles remain infective outside the body?

Answer:         The Ebola virus can remain outside the body on surfaces like countertops or doorknobs, for days to weeks and in body fluids and it can remain viable for 40 or more days at room temperature. (10)

See Below Ebola survival on dried surface and in liquid media.

graph 1

Figure 1  Survival of Zaire ebolavirus (ZEBOV) and Lake Victoria marburgvirus (MARV) dried onto different solid substrates over a 14-day period. The survival of ZEBOV () and MARV () on different substrates when dried in tissue culture media (closed shapes) or guinea pig sera (open shapes) over 14 days was assessed by the TCID50 microtitre plate assay. Samples were recovered, in triplicate, from the surfaces at various time points. (a) Survival on glass at 4°C, (b) Survival on plastic at 4°C. Each point shows the mean count (please note significant numbers of virus remain after the 14 day trial.)

graph 2

Figure 2  Survival of Zaire ebolavirus (ZEBOV) and Lake Victoria marburgvirus (MARV) in liquid media at two temperatures. The survival of ZEBOV () and MARV () in tissue culture media (closed shapes) and guinea pig sera (open shapes) over 46 days at 4°C (a) and room temperature (b), was assessed by the TCID50 microtitre plate assay over time. At each time point, triplicate samples were taken; the mean count (TCID50) from triplicate samples, plus the standard error, is shown.

Question?     Is Eboli Transmission between humans Airborne? (aerosol) We are hearing continued denials by CDC and others this is not possible. Although the CDC’s assumption may prove to be correct, all evidence suggest otherwise.

Answer:         Humans breath out, varying sizes of liquid particles, from normal breathing that are not related to cough or sneeze. (3)(4)

  • Viruses can occur in the airborne state in two major forms: as droplets that are relatively large (>20 μmeters in diameter) and largely liquid and as aerosols that are relatively small
    (5 μmeters or less) that may be composed of either mostly liquid or solid materials. Particles in the range of about 5 to 20 μmeters also can remain airborne for extended periods of time, especially if they are mostly composed of water, which tends to evaporate, thereby causing the particles to become even smaller in size over time. An important difference in physical properties of these airborne virus-containing particles is that the droplets are so large that they settle out or sediment within short distances (meters) from their source while the aerosol particles can remain airborne for extended periods of time and travel long distances. For virus-containing aerosols (virus bioaerosols), the most important factors affecting virus survival are temperature, relative humidity (RH), moisture content of the aerosol particles, composition of the suspending medium, sunlight exposure, air quality.
  • Transmission by aerosol in Pigs experimentally reproduced in droplet sizes from 0.8 to 1.2 micron size resulted in fulminent death in 4-5 days with as little as 400 plaque forming units. (5) This proves transmission by breathing small amounts of viral particles produce fulminent infections
  • Transmission from Pigs to Monkeys (primates) has been documented (6) by presumed aerosol route with no other contact. This study indicates that aerosol transmission may occur between pigs and Monkeys.
  • Transmission from Monkey to Monkey without direct contact in Biocontainment Facility. The most likely route of infection of the control monkeys was aerosol, oral or conjunctival exposure to virus-laden droplets secreted or excreted from the experimentally inoculated monkeys. (8) Scientist suspect that the virus is transmitted through droplets, not fomites, because evidence of infection in the lungs of the monkeys indicated that the virus was inhaled.

Question?     Can Ebola be transmitted in humans or animals not showing signs of infection? Questionable government statements include; Ebola doesn’t spread before someone gets sick,” Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said “Ebola does not spread … from someone who doesn’t have fever and other symptoms.” The time from viral exposure until death is such a short time that air travel of infected persons is already being documented. Thomas Eric Duncan died Wednesday at a Texas hospital; Mr     Duncan had flown to the United States without showing enough signs or symptoms to alert airport personnel.

Answer:         Pigs with Ebola infections can shed viral particles without signs of infection. Replication of virus in internal organs and viral shedding from the nasopharynx were documented in the absence of clinical signs of disease in infected pigs. These observations confirm not only that asymptomatic infection of pigs with REBOV (a strain of Ebola) occurs, but that animals so affected pose a transmission risk.(9)

Question?     Can Ebola be contracted by food or water? Will burying an Ebola patient contaminate the water table?

Answer:         Ebola has been transmitted by eating meat of infected animals (bushmeat) with the viral diseases. The answer is unclear if Ebola can survive modern water treatment facilities. In the Book Biohazard listed in the references below the Russian scientist decided the safest method of disposing a body contaminated with Ebola was not to incinerate it. To Quote; The body was “wrapped in plastic sheeting. The remains were placed inside a metal box, welded shut, and fitted into a wooden coffin. Only then was it safe to lay him in the ground.” The Russian scientist thought it was too dangerous to just bury the body and risk ground water contamination. Currently there is no data concerning Ebola survival in water treatment facilities.

 

Conclusion:

Many of these simple questions could be answered in very simple test on patients currently infected with Ebola. Test for the Nosocomial spread of Ebola could be completed in a very short period of time and definitive answers could be given. It seems what we are being told about the disease and what we know about viral transmission are two different things.

I believe there is ample scientific proof that cannabinoids may inhibit the Cyotkine Storm that Ebola causes and may offer medical efficacy no other class of medications can.

David B. Allen M.D.

Medical Director CBDS (Cannabis Sativa Inc.)

References:

  1. Biohazard: The Bioweapons Story Ken Alibek, Steven Handleman. Random House, New York, 1999.
  2. Public Health Agency of Canada, Clinical recognition and management of patients exposed to biological warfare agents. Jama, 278(5), 399-411.
  3. Human exhaled breath and observational study, Patricia Fabian University of Massichusetts, Lowell
  4. The role of particle size in aerosolised pathogen transmission: A review Jan Gralton
  5. Lethal experimental infections of rhesus monkeys by aerosolized Ebola virus E. JOHNSON, N. JAAX, J. WHITE AND P. JAHRLING
  6. Transmission of Ebola virus from pigs to non-human primates Hana M. Weingart Scientific ReportsVolume: Article number:811 25 April 2012
  7. Replication, pathogenicity, shedding, and transmission of Zaire ebolavirus in pigs. Kobinger GPDOI: Special Pathogens Program, National Microbiology Laboratory, Public Health Agency of Canada
  8. Transmission of Ebola virus (Zaire strain) to uninfected control monkeys in a biocontainment laboratory. Jaax United States Army Medical Research Institute of Infectious Diseases, Frederick, Maryland 21702-5011, USA. 1995 Dec 23-30;346(8991-8992):1669-71
  9. Ebola Reston virus infection of pigs: clinical significance and transmission potential. Marsh GA J Infect Dis. 2011 Nov;204 Suppl 3:S804-9. doi: 10.1093/infdis/jir300.
  10. The survival of filoviruses in liquids, on solid substrates and in a dynamic aerosolJ. Piercy, 22 MAY 2010
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