There is no vaccine to prevent infection with the Ebola virus, nor are there any approved drugs for its treatment. Treatment for Ebola focuses on offering supportive care so that the patient’s own immune system can fight off the virus. The predominant symptoms of acute Ebola infection are severe vomiting and diarrhea. A person may lose 5 to 10 quarts of fluid a day as a result. Without adequate fluid replacement, hypovolemic shock develops, in which the heart cannot pump enough blood to sustain the body, and vital organs begin to fail. Patients with Ebola can also develop serious and potentially life-threatening hemorrhage, with internal bleeding. Bleeding is often the result of a low blood platelet count and the impaired ability of the blood to clot, a process known as disseminated intravascular coagulation. The mainstays of treatment for Ebola, therefore, are fluid and electrolyte replacement. When a person can no longer drink fluids, they must be given intravenously. Patients who experience significant bleeding often need transfusion of specific blood products such as red blood cells, platelets, or other blood products that contain coagulation factors. Some patients can also be helped by such interventions as mechanical ventilation or kidney dialysis if they suffer from respiratory or kidney failure.
Transfusion Therapy
In the 2014 Ebola epidemic and in earlier outbreaks, some patients received transfusions of blood serum from people who have survived infection with the virus. The rationale for this treatment is that the antibodies to the virus found in the survivor’s blood will help fight the virus in those currently infected. This approach has been used in only small numbers of patients, with some good results although it is premature to know if this will become a standard long-term treatment.
Monoclonal Antibodies
A number of drug treatments for Ebola are in development, including the drug ZMapp, made by Mapp Pharmaceuticals, Inc. ZMapp is a combination of three monoclonal antibodies that bind to the protein of the Ebola virus, inactivating it. The process used to make ZMapp involves inserting a gene into a virus that is then used to infect a tobacco plant. The infected plant cells produce a protein that can be purified and used to fight the Ebola virus. In the 2014 Ebola outbreak, two Americans were treated with drug ZMapp and both survived, although it is not known what role the drug played in their survival or recovery. ZMapp is not yet approved for human use by the Food and Drug Administration (FDA), and very few doses of it were available in 2014.
Surviving Ebola
There is no cure for Ebola, and infection with the Ebola virus is often fatal. Death rates have historically ranged from 50 to 90 percent, depending on which strain of the virus is involved in an outbreak. Yet some people do survive. Exactly what raises the chances of survival is not known, but it may be that survivors receive earlier care, or better care, or have stronger immune systems to begin with. The 2014 Ebola epidemic, the largest to date, will no doubt spur more scientific research on the virus, including research on new treatments and how best to use existing treatments.
