Revenge of the
Rainforest
The Current Threat of Ebola
and Other Rainforest Viruses
G. Richard Olds, MD, MACP
Vice Chancellor, Health Affairs
Dean, School of Medicine
University of California, Riverside
All the “rainforest viruses” are infectious diseases of
another animal species that have been geographically
isolated from large human populations.
The first step is when those viruses make the species
jump to man. This is now happening more
frequently as human populations increase in these
regions.
• Over the last 35 years we have had to
handle many new rainforest viruses
• Oropouche - 1961
• Marburg - 1967
• Lassa Fever - 1969
• Four new South American Hemorrhagic
Fevers (Argentine, Bolivian, Venezuelan
and Brazilian)
But have any rainforest viruses
even reached out to the U.S.
before?
HIV/AIDS
SARS
AP Photo 3/17/03
Perhaps the best example is
what happened in Wisconsin
involving prairie dogs and
monkey pox.
Monkeypox
Background
• First “discovered” in 1970 following
smallpox eradication
• Endemic in west and central Africa
• Disease of rodents who can transmit disease
to primates (including man)
• Infection had never been reported outside of
Africa
BBC Photo 1/9/04
In 2003 I was called to the
Emergency Room at my University
Hospital in Milwaukee to see a sick
veterinarian who had developed a
painful, umbilicated pustules after
being bitten by a sick prairie dog.
There are only three viruses that could
have caused this type of pox…
• Smallpox
Eradicated but potentially in the hands of
terrorists
• Monkey Pox
Previously never seen outside of Africa
• Cow Pox
A rare disease in cattle that we use to
immunize against smallpox – vaccinia
All patients, contacts, doctors and nurses
were immediately quaranteened. Two
weeks later the surprising answer came
from the CDC…
…Monkey Pox
When all was SAID AND DONE
73 people in six states
developed the disease
but fortunately, NO ONE DIED.
How did this happen?
Where did “patient zero” (a 2 year old boy) get Ebola?
The Hollow Tree
What is the disease
Ebola?
• Illness with this specific West
African strain is a little different
than that described in the “Hot
Zone”.
• Early on it looks like the flu; fever,
muscle aches and pains, headache
and GI problems.
• After a few days patients begin to
vomit, have bloody and perfuse
diarrhea
• Hemorrhagic complications are less
common than that observed in the
central African cases and are an
ominous sign.
• Fatal cases often develop kidney
failure, respiratory failure, shock
and heart failure.
What are the important public health facts about
Ebola
• Incubation period is 2 – 21 days
• People are not infectious at all until
they develop symptoms
• People are not very infectious for a
few days and then become very
infectious when they start to vomit
and have perfuse diarrhea
• The virus is not transmitted by air
but requires broken skin or mucus
membrane contact with body
secretions
• When patients recover they rapidly
become non-infectious
Important Health Factors Continued
• Dead bodies and bodily
secretions can remain infectious
for a few days/weeks
• We are not sure but we believe
Ebola survivors are now
immune to the disease
• New problem: Not sure how
recent MD got Ebola
• Blood tests don’t turn positive
right away
Why are we in less danger than
those living in Africa?
3rd World Country
Modern Technology
What should you know about Ebola?
Some of the things we are doing today are overreactions and
some are critically important.
•
•
•
•
Overreactions
Isolating husband of
asymptomatic wife
Stopping visa applications
from endemic countries
Avoiding people from
Africa
Quarantining large numbers
of travelers and pets
Important
• Create a CDC response
team for domestic cases
• Establish more referral
centers
• All hospitals should select a
small Ebola response team
and have them train on
equipment and protocols
What should you know about Ebola
• Even if we had a cure for Ebola today, it would
have little effect on the spread of the epidemic.
• Even if we had an effective vaccine it would
not stop the spread of Ebola but would protect
first responders and medical staffs.
• The hard truth is that this epidemic will only
be stopped by good public health measures
Conclusion
• When we change the world we live in, there are many
unexpected consequences
• What happens in the most remote corner of the world can
impact us in Southern California
• With Ebola specifically we are far safer here in the US
than people living in the poorer areas of the world
• We should invest far more than we do in public health both
here and overseas
• With the “rainforest viruses” we have more to fear from
Mother Nature than ISIS
Questions