Thursday, July 17, 2014

Ebola









Ebola




Picture Legend:

1. The Ebola Virus
2. Earwig
3. Bacteria
4. 2014 Outbreak
5. Chart
6. Medina Market, Conakry, Guinea
7. Fruit bat


   Have you ever had the measles or the flu? I have, I think both diseases... plus chicken pox. It sucked. 
   All three of these diseases are viral in nature. So is smallpox, lassa fever, Rift Valley fever, Crimean–Congo hemorrhagic fever, marburg, andromeda strain, dengue fever, yellow fever, tick-borne encephalitis, omsk hemorrhagic Fever, Kyasanur forest disease, acute febrile pharyngitis pharyngoconjunctival fever, epidemic keratoconjunctivitis, infantile gastroenteritis, coxsackie infections, infectious mononucleosis, some forms of hepatitis, herpes, AIDS, mumps, croup, the common cold, polio, rabies, and whatever has reanimated  Dick Cheney, and infected Sarah Palin with some form retro encephalitis, that shrinks the brain rather than making it swell. 
   That’s a lot of misery and death that these little bastards have inflicted upon humanity, and I’m not only talking about Cheney and Palin.
   To make bad matters worse, unlike Dick and Sarah, viruses believe in, and mutate according to the laws of natural selection, vis a vis, evolution.  
   And they do it real fast. 
   Other diseases are caused by bacteria (anthrax, tuberculosis, the bubonic plague, leprosy, cellulitis, etc.) and other organisms (malaria, dientamoebiasis, scabies, conservatism, etc.), but they’re way bigger and more complex structurally than viruses.
   So what? What is a virus, and why do we care?
   Well I’ve been researching the subject a little bit, and I’m glad you asked.
    Let’s start out with the largest disease causing agents first and work our way down. 
   Conservatism, caused by the common Forficula auricularia, or earwig, as it enters the human ear, laying it’s eggs within the brain (a significant variant of conservatism, teapartius  absurdism, manifests itself when all of these eggs hatch, and begin to eat their way out). This insect is huge (usually about 0.28–1.97 inches long) compared to your average bacterium (an average-size bacterium, such as the rod-shaped Escherichia coli, a normal inhabitant of the intestinal tract of humans and animals, is about 2  micrometers (1 micrometer equals 1 millionth of a meter) long and 0.5 micrometers in diameter, and the spherical cells of Staphylococcus aureus are up to 1 micrometer in diameter). Your average size virus ranges in size from 20 to 250 nanometers (1 nanometer equals 1 billionth of a meter), which is a whole magnitude of of order of smallerness compared to a bacterium.    
   Bactria are cellular living entities. They own a cell wall and a nucleus. It has ribosomes (protein factories), and a little tail (flagellum) so it can get from place to place. Most bacteria are not harmful to humans, and quite a few are beneficial, and some we couldn’t do without.
   Stand up dear readers, and find a mirror. Look at yourself. Smile.
   What you are seeing is an aggregate of anywhere from 15 to 70 trillion cells (some have more cells than others) all stuck together (they become less “stuck" as you get older, believe me) smiling back and impersonating you, give or take a few trill. 15 to 70 trillion! That’s a heck of a lot of anything, let alone cells. 
   Now think about this... there are about ten times more bacteria inside you right now than there are cells (we counted).  
   This aggregate of bacteria is called your personal microbiome (pronounced: micro-bio-me). Your personal microbiome can prevent infections and produce stuff that our bodies needs, like vitamin K (and you thought snorting antibacterial soap during your college years was such a blast).
   There are about 1000 to 2000 different types of bacteria inside you right now, and on your skin.       
   And most importantly, we wouldn’t have cheese if it were not for bacteria. Or beer, or yogurt, or pickles!
   So some bacterium are a good thing... except for those which cause tuberculosis, the bubonic plague, leprosy, and cellulitis.    
   Viruses on the other hand, are a whole different matter. They don’t bother with any of the crap that bacteria rely on.  They openly excoriate cell walls and nucleuses. They scorn ribosomes, and chuckle to themselves over flagellums. 
   Some say they may not even be alive! 
   “It’s alive!” -Victor Frankenstein
   Really?
   Life is often defined as any entity that exhibits all or most of the following physiological functions:
   Homeostasis: which relates to the internal environment of an entity to self regulate in order to maintain a constant state, like sweating or panting to maintain a suitable body temperature. 
   Organization: being made of cells.
   Metabolism: which is the ability to transform forms of energy by converting chemicals and energy into cellular components (anabolism) and decomposing organic matter (catabolism). Living things require energy to maintain internal organization (homeostasis) and to do other things, like move around and reproduce.
   The ability grow in a stable manner: with all parts of the organicism growing at the same rate.
   The ability to adapt: to change over time in response to the environment. This ability is fundamental to the process of evolution and is determined by the organism's heredity, diet, and external factors, like climate change.
   Response to stimuli: which can take a variety of forms, from the ability of plants and flowers to turn themselves toward the Sun (phototropism), to the ability of a troop of girl scouts running from an advancing polar bear.
  And finally reproduction: The ability to produce new individual organisms, either asexually from a single parent organism, or sexually from two parent organisms, which humans do all of the time... probably more than we should. 
   These traits or functions, have underlying physical and chemical bases, as well as signaling and control mechanisms that are essential to maintaining what we like to call life.
   Some say, and I don’t know who, that the definition of life can be simplified by saying all living organism eat, excrete, grow, move, process food into energy, react to stimuli, and reproduce, which is pretty much what we discovered above. 
   Viruses exist in abundance without displaying most of the functions mentioned above. They do replicate, or reproduce, but require a “host cell” in order to do so, because viruses do not utilize cells, which is one of the requirements mentioned above. They also adapt to changing conditions through the process of natural selection, which is one of the components of Charles Darwin’s theory of evolution. 
   But they don’t eat, or metabolize. All viruses do is invade cells of other organisms, even bacteria, reproduce, and mutate. And mutation is not necessarily a good thing for us humans. 
   So those same some people say that viruses are replicants rather than examples of living organisms, or metabolically inert, infectious agents that replicate only within the cells of living hosts, mainly bacteria, plants, and animals, and are composed of a RNA (ribonucleic acid) and DNA (deoxyribonucleic acid) core, a protein coat, and, in some complex types, a surrounding envelope.
   Viral infections in humans and other animals are harder to treat than bacterial infections because the viruses live within the cell, and are protected by the cell wall from medicines that move through the bloodstream. Antibiotics like amoxicillin and tetracycline don’t work on viruses because viruses aren’t bacteria, which these drugs do work on (to a degree. The adaptation characteristic of bacteria (as well as viruses) pretty much dictate that bacteria will become resistant to antibiotic drugs in time through the process of natural selection, making them harder to treat effectively), that’s why they’re called “antibiotics” rather than “antivirals.”
   The flu, or  influenza, is caused by a highly contagious virus that affects the lungs and airways, what we often call the respiratory system. The virus infects it’s host by inhaling microscopic airborne droplets that are produced when another infected person talks, coughs, sneezes, or projectile vomits. The influenza virus can also survive for a short-time on surfaces, like toilet seats, so can be picked up if a person touches an infected surface and then rubs their nose or eyes. When the virus enters the body it invades cells in the airways, where it reproduces to form lots of new copies of itself.
   The new copies of the virus leave the first cells and move on to infect other cells nearby, where the process is repeated. After a couple of days enough cells have been infected that the infected individual feels flu symptoms such as headache, fever and general aches and pains. These continue for about a week until the body's immune system neutralizes the virus.
   The Human Immunodeficiency Virus, or HIV, which results in the Acquired Immunodeficiency Syndrome, or AIDS, has been so lethal to humans since it first manifested itself in the early 1980s (FYI: genetic research indicates that HIV originated in west-central Africa during the late nineteenth or early twentieth century) because it attacks the human immune system, the very system designed through evolution to combat viral infections. With a suppressed immune system death from AIDS does not result from the viral infection itself, but from opportunistic diseases (such as Kaposi's sarcoma, Burkitt's lymphoma, primary central nervous system lymphoma, and cervical cancer) which may be caused by bacteria, other viruses, fungi and parasites that are normally controlled by the immune system.
   The first HIV drug, AZT, belonged to a class of drugs known as nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs inhibit the protein that allows HIV to reproduce its genetic material, which is essential for viral replication, and thus inhibiting further infection. Other classes of drugs involve non-nucleoside reverse transcriptase inhibitors, protease inhibitors, entry or fusion inhibitors, and integrase inhibitors. 
   Modern antiretroviral therapies  involve the use of combinations of these different drugs to achieve a multi-pronged attack on HIV. The virus can develop resistance to certain drugs, thus a wide and growing arsenal of antiretroviral drugs is crucial, and has taken quite a while to develop.
   Still, there is no cure as of yet for AIDS. For now, it can only be treated and maintained. 
   The good news is that most viral infections do not attack the immune system, allowing our bodies to to recover of it’s own volition, usually within a few weeks. 
   The bad news is that some viruses kill us before the immune system can do it’s job... like ebola (ironically the speed in which ebola can kill a victim limits the viruses ability to spread to a significant portion of the population... or I should say, it has so far).
   The ebola virus has been with for a long time. Originating in Africa (as did humans, for that matter), fossils of filoviruses (the taxonomic home of several related viruses that form filamentous virions. Two members of that family are commonly known as the ebola and marburg viruses)  found in mammals indicate that the family itself is at least tens of millions of years old.
   Ebola virus disease (EVD) or Ebola hemorrhagic fever (EHF) is the human disease caused by ebola viruses. Symptoms start about two days to three weeks after contracting the virus with  fever, throat, muscle pains, and headaches. Then one can look forward to nausea, vomiting and diarrhea along with decreased functioning of the liver and kidneys. At this point some people begin to have problems with a little bleeding.
   The first documented outbreak of Ebola Hemorrhagic (associated with hemorrhages, or bleeding) Fever, occurred in 1976 in the county of Zaire (officially the Democratic Republic of Congo), which affected 318 people, killing 288 of them, resulting in a fatality rate of 88%. The disease was spread by close personal contact with other infected people, and by the use of contaminated needles and syringes in hospitals/clinics. This is when ebola was first recognized as a distinct disease.
   So what’s the big deal? 288 people aren’t that many. Why has ebola gained such a nasty rep? 
   The answer to that is the 88% fatality rate, which means that a little more than 4 out of 5 people, at least during this 1976 outbreak, died due to their contracting the disease. 
   How did the outbreak end? For the 30 infected individuals who did not succumb to the illness, their immune systems were able to successfully defeat the disease. And measures to contain the area of infection (quarantine) were also apparently successful. 
   Still, you point out,  and quite rightly, the 1918 flu pandemic (January 1918 – December 1920) which involved the H1N1 influenza virus,  infected 500 million people across the world, and killed 50 to 100 million of them—three to five percent of the world's population. Why don’t I worry more about the flu rather than ebola, which after all is restricted to Africa. 
   The answer is obvious. The flu outbreak of 1918 infected a huge number of people most probably due to technological advances in the availability of transportation.  Modernized transportation systems made it easier for soldiers, sailors, and civilian travelers to spread the disease. The close quarters and massive troop movements of World War I hastened the pandemic and probably both increased transmission and augmented mutation of the virus. The war may also have increased the lethality of the virus, by compromising the immune systems of soldiers who were were weakened by malnourishment, as well as the stresses of combat and those pesky chemical attacks (Adolf Hitler was a victim of a mustard gas attack during World War I. Too bad it was a weak batch), which further increased their susceptibility.
   However, 50 to 100 million affected people died out of 500 million. That’s 1/2 to 1 people in 5, or 1 to 2 in 10. Compare that to ebola’s 4 out of 5, or 8.8 out of 10 rate of fatality. Then imagine this disease subjected to the same forces of modern transportation availability, in other words, ebola spread throughout the world (later outbreaks utilizing better treatment regimens have lowered the fatality rate to approximately 50 to 65%, which of course is still huge). 
   And no, ebola is not restricted to Africa. 
   There is no magic invisible force field  that stops the ebola virus from leaving the borders of Africa. 
   Even my good friend, Steve Kornacki, of MSNBC, who while filling in for the resting Rachel Maddow Tuesday night made this mistake when reporting on a story concerning the Central  American refugee difficulties we’re currently experiencing on our southern borders. In his report he focused on  Rep. Phil Gingrey of Georgia, who claims to be an M.D., and who wrote to the Center for Disease Control to warn them there were reports, to his staff, from boarder patrol agents (unnamed of course), that "Reports of illegal immigrants carrying deadly diseases such as swine flu, dengue fever, Ebola virus and tuberculosis are particularly concerning," Gingrey wrote. "Many of the children who are coming across the border also lack basic vaccinations such as those to prevent chicken pox or measles." 
   He continued, “We cannot afford to wait for this to become a full-blown health crisis. As a physician for more than 30 years, I know that these diseases pose great danger to our citizens and can spread too rapidly to control. Our leaders must act swiftly to get ahead of this threat before it gets out of hand, and give the American people the information they deserve on the dangers it poses to their health.”
   Well, well, well, sounds bad doesn’t it? And it supposed to sound bad, I guess in order to stir up his republican base, and hide the fact that, 1: these refugees are coming from countries were our failed war on drugs promoted the political and criminal atmosphere these people are fleeing from, 2: they are not illegal immigrants, they are people, a great percentage children, who surrender to authorities the moment they cross our boarder, and seek asylum, and 3: hide the fact that republicans have done nothing concerning immigration reform. 
   There are only a few things that bother me about Rep Gingrey’s claims. As we mentioned above, ebola originates in Africa. Central and South America, where these refugees come from, is not Africa. South America looks sort of like Africa, but they are decidedly different. 
   Swine flu is out of season. It begins as early as October and continues sometimes until May. 
   Like malaria, dengue fever is transmitted by  mosquitoes, not refugee children. 
   Tuberculosis affects about 5 to 10% of the population already within the United States. 
   And when it comes to measles or chickenpox, children in Guatemala, El Salvador, and Honduras are more likely to be vaccinated than children in the United States (hopefully, the Affordable Care Act, which Rep Gingrey opposed, will help to alleviate this problem). None of those countries have recorded an outbreak of measles in twenty four years. Kids in Orange County are more at risk.
   Oh, by the way, Gingrey has long-standing ties to the Association of American Physicians and Surgeons, a far-right medical group that opposes all mandatory vaccines. 
   All of this prompted the following comment on Gingrey’s own website, from Robert Murphey, a plastic surgeon who lives in New Jersey:
   “As a surgeon, with an MD from Vanderbilt, and seven years training at Hopkins, I find the fact that you, supposedly a physician, made the spurious claim that Central American immigrants might be carriers of Ebola, as glaring proof of your limited knowledge and rabble rousing duplicity. If you sent this alert to the CDC, I am sure that it gave them a laugh. This is akin to Billy Frist's [former Senate Majority Leader] video diagnosis of Terri Schivo's purposeful mental state, although brain dead. Just another example of Republican anti-science, anti-intellectualism. You may be a physician, but not much of one.”
   Joyce’s Take has secured a copy of Georgia’s final medical licensing exam, which constitutes one essay question: “If you have one bucket that holds two gallons of water, and another bucket that contains five gallons of water... how many buckets do you have?”
   If you answer that question with anything other than “two,” then you too can become a doctor in the peach state.*  
   The mistake that  Kornacki made was his statement that ebola, and ebola outbreaks occur only in Africa. Obviously he’s a fan of Stephen King’s “Under the Dome.” 
   The only known case of Ebola in Europe was in 1976, when a scientist at Porton Down laboratory in Britain accidentally pricked himself with an infected needle. He survived.
   In 1989 a electron microscopist named Thomas W. Geisbert, discovered filoviruses similar in appearance to Ebola in tissue samples taken from Crab-eating Macaque monkeys imported from the Philippines to Hazleton Laboratories in Reston, Virginia., which lies 22.4 miles to the west of Washington D.C. During a period of three months over a third of the monkeys in the facility died, sometimes at a rate of two or three a day. Blood samples were taken from 178 animal handlers during the incident. Of them, six eventually developed antibodies to the mutated ebola strain, testing positive. They remained, however, asymptomatic. 
   Fortunately the strain, which came to be called the Reston virus, had mutated into a form that may have infected humans, but did not manifest disease symptoms. 
   And it turns out the monkeys died of Simian hemorrhagic fever, which was a different strain of virus than the one Mr. Geisbert discovered.
   Ebola has been found in China and the Philippines, but has never caused an illness, or a fatality.
   Which doesn’t mean it won’t in the future. 
   There is no vaccine to guard against ebola infection. There is no specific treatment for the virus with efforts to help people including giving the person either oral rehydration therapy or intravenous fluids. Between 1976, when it was first identified, and the present, fewer than 1,000 people a year have been infected, that we know of.
   Since 1976 there have been at least 28 instances of outbreak, or accidental introduction into a controlled environment. 
   Where does the virus come from? How does it infect humans? Where does it hide between outbreaks? 
   Fruit bats maybe. The virus resides in natural reservoirs such as fruit bat populations, or gorilla and monkey populations, pigs, or antelopes, that carry the disease but are not affected by it. When a person comes into contact with a carrier animal they can become infected. Once infection occurs, the disease may be spread from one person to another. Men who survive may be able to transmit the disease sexually for nearly two months. To make a diagnosis, typically other diseases with similar symptoms such as malaria, cholera and other viral hemorrhagic fever are excluded. The blood may then be tested for either antibodies to the virus, the viral DNA, or the virus itself to confirm ebola infection. 
   At present the largest ebola outbreak in history is transpiring in three west African countries. Guinea, Sierra Leone, and Liberia. Last February, the first recognized case of ebola infection occurred in Guinea. On March 25th, the Ministry of Health of Guinea reported that four southeastern districts—Guekedou, Macenta, Nzerekore, and Kissidougou, were affected with an outbreak. The following day the Pasteur Institute in Lyon, France confirmed the Ebola strain as Zaire ebolavirus. The Zaire ebolavirus is the most dangerous of the six species of Ebola viruses of the Ebolavirus genus which are the causative agents of Ebola virus disease.
   On March 31st, the US Centers for Disease Control sent a five-person team "to assist Guinea Ministry of Health and World Health Organization (WHO) led international response to the Ebola outbreak" By April 23rd, the total number of suspected and confirmed cases in the outbreak had increased to 242, including 142 deaths at a fatality rate of 59%. 
   In Liberia, the disease was reported in Lofa and Nimba counties in late March, and by mid-April, the Ministry of Health and Social Welfare had recorded possible cases in Margibi and Montserrado counties. Sierra Leone, Mali and Ghana identified suspected cases by mid-April, but all clinical samples of suspected cases tested negative for ebolavirus.
   However, between May 23rd and the 27th, three previously affected districts (Guéckédou, Macenta and Conakry, where the capital of Guinea is located), four new districts (Boffa, Télimélé, Boke and Dubréka) and one new country (Sierra Leone) reported several new EVH clinical cases.
   The humanitarian aid organization Doctors Without Borders has a team of 300 staff working in the affected countries, and has set up specialist centers to give medical care to affected people,  sending over 40 tons of equipment and supplies to the regin.  
   Doctors Without Borders described the situation as being "totally out of control" late last month, and on July 3rd, the BBC reported 759 infections with 467 deaths among the three countries.
   Local difficulties faced in attempting to contain the outbreak include the outbreak's multiple locations across country borders, inadequate precautions taken by medical personnel, funeral practices of the local population, and public reluctance to follow preventive practices (analogous to the recent anti-vaccine hysteria observed here in the U.S.), including "freeing" suspected ebola patients from isolation,  and suspicion that the disease is caused by witchcraft, or that doctors are killing, rather than treating patients, for instance at one point the Red Cross was forced to suspend operations in Guinea after staff members were threatened by a group of men armed with knives.   
   “As the number of deaths and cases of ebola continues to rise in Guinea, Liberia and Sierra Leone, the World Health Organization is warning that drastic action is needed,” WHO said in a statement. “This is no longer a country-specific outbreak but a sub-regional crisis that requires firm action by governments and partners. WHO is gravely concerned of the on-going cross-border transmission into neighboring countries as well as the potential for further international spread,” said Dr. Luis Sambo, WHO regional director for Africa. 
   Dear readers, have you heard of this outbreak in the national media? I’ve seen a few reports in print Internet outlets, like Raw Story, and Reader Supported News, but as yet I have not seen one story discussed in the 24/7 news cycle, on any of the numerous cable news programs that I routinely monitor... and I monitor a lot of them (except for Fox so-called News, which make my eyes bleed... OMG! That may be a symptom!). 
   Is there a chance that this 59% fatality rate disease may reach us here in the United States, or Europe, or China, or Australia, India, and South America?      
   Of course there is. The world is no longer separated by huge geological barriers like oceans and mountain ranges. As far as modern transportation is concerned we humans might as well be using Star Trek transporters. We can get from one point on the planet to another on the opposite side in a matter of hours. With an incubation period of 2 to 21 days, travelers can easily carry the disease from one nation to another if certain precautions are ignored, and even if they are not. Oh yeah, so far the WHO said it was not recommending any travel or trade restrictions in the three affected countries. 
   We have a few things going for us. The ebola virus is relatively hard to become infected with. Relatively. And it kills very quickly, which hinders  the spread of the disease by killing the host (and thereby killing the virus within) before the host can infect someone else. 
   "Americans generally do not have an immediate danger but they must be prepared through good public health practice. We can no longer become complacent to any public health danger anywhere," Dr. Cecilia Rokusek, assistant dean for education, planning and research at Nova Southeastern University stated.
   I tend to agree.
   The public should at least be aware of this issue, and the potential magnitude of the problem. That’s a problem for the media. But towards actually dealing with the ebola outbreak in west Africa, much like the incident at Fukushima, a international effort with enough resources to affect a desirable outcome, should immediately be brought to bear. 
   Politicians however tend not to act until they are forced to, either by their backers, or by a massive amount of public opinion. 
   Educating that public is a first step.
   In the mean time, stay away from fruit bats. 




*Thanks go to the 2006 film, “Idiocracy,” written by Mike Judge and Etan Cohen, for the exam question.

Addendum: 7-19-14, Say Hello.                            
Addendum: 7-20-14, Antibiotic Abuse.              
Addendum: 7-24-14: Top Doctor Treating Ebola Outbreak Now Infected with Ebola.                             Addendum: 7-28-14: When Ignorance is a Factor.                        
Addendum 7-29-14: The Crisis Continues.        
Addendum: 7-29-14: Spreading.
Addendum: 7-30-14: Is it Here?
Addendum 8-16-14: The U.S. Readies.
Addendum 8-17-14: Can't Win for Losing.
Addendum 8-19-14: Survivor Guilt.
Addendum: 8-20-14: Violence in Liberia.
Addwndum: 828-14: WHO Warning.
Addendum: 8-29-14: Now in Monrovia.
Addendum: 8-29-14: The Toll Rises.
Addendum: 9-23-14: CDC says possible 1.4 million cases in next 4 months.
Addendum: 9-23-14: Deaths Under Reported.
Addendum: 9-25-14: Dying at Home.
Addendum: 9-30-14: Liberia chaos.
Addendum: 9-30-14: First case in the U.S.
Addendum: 10-1-14: Nigeria seems to have contained outbreak.
Addendum: 10-2-14: Ebola sweeps Sierra Leone.
Addendum: 10-18-14: Hospitals prepare.
                                        Effectiveness of travel ban debated.
                                        GOP trying to use Ebola in election.
                                       Some fear Ebola outbreak may cause nation to turn to science.
                                       Oxfam warning.
Addendum: 10-19-14: CDC to revise Ebola protocol. 
                                        Ebola madness hits the U.S.
                                        And.
Addendum: 10-20-14: WHO clears Nigeria.
Addendum: 10-24-14: Ebola vaccine developed but not tested.
                                        University of Toronto Model.
                                How the right will do anything to promote fear. And here.
                                It was only a matter of time. NYC's first case.  
                                Quarantine called for in New York & New Jersey.   
                                Quarantine seen as possible barrier to volunteers.
Addendum: 10-25-14: Ebola science.

Addendum: 11-1-14: Africans worst respondenters in Ebola Crisis.
Addendum: 11-1-14: Ebola responders in Africa already feeling effects of US Quarantine. 
Addendum: 11-22-14: Exposure in Mali.
Addendum: 11-27-14: Ebola cases near 16,000, Sierra Leone to overtake Liberia soon with most cases according to WHO
Addendum: 11-28-14: Despite Aid Push, Ebola Is Raging in Sierra Leone
Addendum: 12-13-14: Sierra Leone cancels Christmas
Addendum: 12-24-14: lab error may have exposed US technician to ebola
Addendum: 12-30-14: How Ebola roared back.
Addendum: 12-30-14: Patient Zero video.
Addendum: 12-30-14:  hollow tree in a remote village in Guinea may have been the source of the world’s biggest Ebola epidemic,
Addendum: 12-31-14: Ebola Ravages Economies in West Africa
Addendum 1-21-15: Jennifer Lawrence
Addendum: 1-24-15: Number of Ebola cases falling in West Africa
Addendum: 1-25-15: Gorillas
Addendum: 12-1-15: As Ebola Ebbs...
Addendum: 3-1-15: Nearly halted..
Addendum: 3-23-15: One year later
Addendum: 3-27-15: No new mutations, study finds
Addendum: 5-17-15: Liberia declared Ebola free
Addendum: 8-22-15; New test for Ebola
Addendum: 8-28-15: Sierra Leone’s last known hospital patient to be treated for Ebola was released this week

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