e4e6You would have to have been asleep over the past few months not to know there is a terrible Ebola virus epidemic raging in West Africa.  While the disease is mainly in Africa currently, with people’s travel habits these days, it could soon be in many countries. The current outbreak in Africa began in March 2014 and is the largest, most complex Ebola virus outbreak since it was first discovered in 1976. This recent outbreak has infected more people and caused more deaths than all previous Ebola outbreaks combined. It has also reached numerous African countries, beginning in Guinea and spreading across land borders to Sierra Leone and Liberia, and by air (1 traveler) to Nigeria, and by land (1 traveler) to Senegal.

Bankaitis (2014) has discussed the disease in her blog.  An expert on infection control in audiology, she states that one method to reduce the spread of the virus among humans is to maintain good infection control in the clinic.  This is always good practice but, based upon the literature, I would suspect that if this virus is in your hospital, the last thing you would be ordering for an Ebola patient is a hearing evaluation. Upon patients’ recovery, however, it is likely audiologists that might see them, as the disorder results in high fever and other possible medical issues that can cause hearing impairment and/or tinnitus in the survivors.

Where did It Come From?

Taylor, Leach & Bruenn (2010) report that Filoviridae have been with us since ancient times, but probably less than 10,000 years.  The Filoviridae family of viruses e2consists mainly of the Marburg virus and Ebola virus, which are hemorrhagic diseases with a high fatality rate in humans.  Since there are no vaccines for these diseases, death rates of  up to 50%-70% have been seen; rates can be even higher if  the disease is not treated properly.

The Marburg virus was first seen in modern times in Marburg, Germany in 1967.  At that time, a group of people were admitted to that hospital who had been in close contact with green monkeys imported for use in research and vaccine production.   However, until 1976, when the Ebola disease broke out in Zaire (previously the e3Democratic Republic of Congo) along the banks of the Ebola River, the tributary of the Congo River for which the virus is named), this disease was virtually unknown. Its first victim was reportedly a schoolmaster in northern Zaire, and it led to 318 infections and 88 deaths.

Other epidemics have come and gone in these African nations, but they have been much smaller than the e5current one that hit West Africa earlier this year. Initially, this new epidemic was thought to be due to people hunting gorillas or chimpanzees for food or possibly to eating dead monkeys or apes that were found in the jungle.  However, since there are no gorillas in West Africa, it is now thought that this time the disease has come from Fruit Bats.

Fruit Bats are hunted for food in various parts of the world and are known to be a source of disease and a mode of human contamination with the Ebola Virus.  According to extreme cuisine cookbooks, Fruit Bats or Bushmeat live on a  low-fat, high-protein fruit diet, and, when cooked, taste a lot like chicken.

Implications for Audiology

e8Audiologists will probably not see Ebola patients.  We may, however, deal with the hearing loss and tinnitus of Ebola survivors.  There is not much literature on the type of impairment that is residual to the Ebola virus victim.  Jackson (2012) indicates that that hearing loss incidence among survivors of these fevers is about 15%-30%.  Audiologists should be on the lookout for these hearing losses and seek to learn more about the effects of these disorders.  As these disorders become more prevalent worldwide there are implications for research among the survivors to learn about their residual hearing impairment and tinnitus.

References:

Bankaitis, A.U., (2014). The connection of Ebola to Audiology. Retrieved November 4, 2014:  http://aubankaitis.com/?tag=ebola-and-hearing

Jackson, A. (2012).  Viral Infections of the Human Nervous System.  Springer Science and Media. Retrieved November 5, 2014:  http://books.google.com/books?id=JK9xvQ4Qh_IC&pg=PA346&lpg=PA346&dq=hemorrhagic+disease+in+humans,+hearing+loss&source=bl&ots=cILB5Db31v&sig=IkJPll2hprZPZm3e32PmwvAxTXM&hl=en&sa=X&ei=ESFaVNWYCc-0yAS444K4CA&ved=0CEQQ6AEwBjgK#v=onepage&q=hemorrhagic%20disease%20in%20humans%2C%20hearing%20loss&f=false

Ross, P. (2014).  How Ebola kills:  What the deadly virus does to the human body. International business Times. October 17.  Retrieved November 5, 2014:   http://www.ibtimes.com/how-ebola-kills-what-deadly-virus-does-human-body-1706965

Taylor, J., Leach, R., & Bruenn, J. (2010).  Filoviruses are ancient and integrated into mammalian genomes.  BMC Evol Biol. Jun 22;10:193.  Retrieved November4, 2014:  http://www.ncbi.nlm.nih.gov/pubmed/20569424

Vurdaft, A.,(2014).  Outbreak of Ebola Virus 2014.  Retrieved November5, 2014:  http://www.slideshare.net/ophthalmist/ebola-virus-outbreak-20132014

Wikipedia (2014).  Ebola virus disease.  http://en.wikipedia.org/wiki/Ebola_virus_disease

Images:

Bat Worlds (2014).  Fruit Bat.  Retrieved November 4, 2014:  http://www.batworlds.com/fruit-bat/

Centers for Disease Control and Prevention (2014).  Transmission.  http://www.cdc.gov/vhf/ebola/transmission/index.html?s_cid=cs_284

Centers for Disease Control and Prevention (2014).  2014 Ebola outbreak in west Africa – Outbreak distribution map.  Retrieved November 4, 2014:  http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/distribution-map.html

Interacoustics (2014).  Audiometers.  Retrieved November 5, 2014:  http://www.interacoustics.cn/com_en/pages/product/audiometers/_index.htm?prodid=4291

MDHealth .com (2014).  Ebola virus disease pictures. Retrieved November 5, 2014:  http://www.md-health.com/Ebola-Virus-Disease-Pictures.html

Rimer, S., Battling Ebola:  Working with a deadly virus.  BU Today.  Retrieved November 5, 2014:  http://www.bu.edu/today/2014/battling-ebola-working-with-a-deadly-virus/

Wikipedia (2014).  Ebola epidemic in west Africa.  Retrieved November 4, 2014:  http://en.wikipedia.org/wiki/Ebola_virus_epidemic_in_West_Africa