Episode 6: The Return of the Virus

Or why we just can’t kill these buggers off. 

Treating Ebola

There are no good options for “curing” viruses. In order to explain why, we have to address a primary difference between bacteria and parasites VS the virus. Bacteria and parasites are living things. They have their own little microbe way of eating and “breathing” depending on how they live. You can target their little microbe energy factories, or their walls/membrane/skin. You can poke holes in them and let the harsh environment butcher them. You can starve them out. But not the Virus. The virus uses your own body as a host. Your cells are the ones doing its dirty work and then exploding with newly made virus after its gutted your cells like a used up neutronium rod. Nothing left but waste. 

What’s a doctor to do? Don’t dismay, we have options. We created or discovered compounds that stick to a virus and block its ability to invade a cell. That’s what Zmapp is, the Ebola drug that was used up this week on the patient in Norway. The company is scrambling to make more, but the process is slow and lengthy. It’s actually three antibodies stuck together in a way to paralyze Ebola and keep him from wriggling his way into your white blood cells.  

 

Poor Mr. Ebola is getting eaten by the Police.

We also have drugs that inhibit special types of viral synthesis, but that only works on certain “strandedness” of RNA viruses. See you can have RNA viruses- positive or negative strand versions, DNA viruses, and you can have single or double strand versions of both. Occasionally we’ll find proteins to target that inhibit some of these replication types without killing the human holding the virus inside. For example, a lot of HIV drugs do this, anything that ends in -cyclovir. But these drugs tend to be very specific. They only work for the one subtype of viral replication.

You might be asking, what about Tekmira, the other anti Ebola drug? Well that’s a unique baby all in its own class. Tekmira is a micro RNA or small interfering RNA (siRNA for short). What it does is 1. get inside the host cell, 2. find the viral RNA and 3. insert itself to disrupt the viral code. Stops replication in its tracks, IF you can get the code sequence just right. Which is why Tekmira hasn’t been used on a patient yet, other than some lab research monkeys who all managed to survive Ebola with the drug on board. Promising stuff!

Hospital Care:

So with all these Ebola patients, why are we keeping them in hospitals with no drugs available? Part of keeping these people alive is supporting their failing bodies. They are dehydrated, we’re trying to give them IVs and oral electrolyte solutions. AKA mega-gatorade. If they get bacterial infections secondary to the Ebola trashing their digestive tract, we’ll treat those with antibiotics to kill the bacterial freeloaders. 

And in Africa, we’re trying to give them proper nutrition, to correct long standing mineral and vitamin deficiencies that are impairing their immune systems’ abilities to fight back. We need to support the person and then let them do the dirty work of surviving Ebola, if they can, while we wait for the pharmaceutical industry to push out brand new technology as fast as they can make it.

Vaccines:

Vaccines are great, if you have one! We had Polio eradicated for a long time, or so everyone thought, by widespread global vaccination strategies. The influenza vaccine helps billions reduce the severity of their infections so they can stay out of the hospital and not get secondary pneumonias when the flu visits their office building. Things like measles and mumps were a glimmer of the past for a long time because children were routinely vaccinated.

 No thanks to the anti-vaccine movement, we now see measles trashing up the skin of young children again in America. Maybe those parents will learn their lesson when their teenager comes to give them grief in 10 years about the scars maiming their bodies just because they didn’t “believe” in vaccination for common childhood diseases. Regrettably, vaccines for Ebola are still in the works. Although believe me, the research industry is powering through a lot of sleepless nights to get a product out there and start protecting the healthcare workers and healthy family members of the sick.

-Dr. M