Your organs do NOT liquify, contrary to popular literature. Why do you get sick, die? Details here..

[uppityperson]

No photos or visuals are provided, but if you are squeamish about what happens in a non-graphic cellular and system way, you are warned. I am more bothered by "liquify, bleeding from every orifice" language than technical medical jargon, but if you are bothered by technical medical jargon, that is what follows.



Contrary to popular literature, organs do not liquify from ebola leading you to dying by bleeding from every orifice. There are 2 basic things that happen, leading all to often to death. An immune system over reaction leading to cytokine storm, and DIC causing lots of little blood clots, tissue death, then bleeding.

Your immune system over reacts, releasing chemicals that damage blood vessels, letting fluid, blood and plasma leak out. Your blood pressure drops, you die.

DIC is a combination of excessive blood clotting and then the inability of blood to clot since all the clotting factors are used up. The body makes lots of little blood clots that plug up capillaries leading to no blood flow to parts of organs. This kills those parts of the organs. Liver, kidneys, brain, digestive tract, etc.

Because the body has made so many blood clots in inappropriate places and because the blood vessels are damaged and leaky, you then can bleed easily. The blood vessels leading into those parts have open ends and can bleed. Anywhere you bump gets bruised, and the bruised grow quickly on your skin. And inside your body.

Parts of the lining of your digestive tract can slough off when it is dead. But it is not liquified. It is dead.


http://www.npr.org/blogs/goatsandsoda/2014/08/26/342451672/how-ebola-kills-you-its-not-the-virus

At the end stage of the disease, you have small leaks in blood vessels," says Thomas Geisbert, an immunologist at the University of Texas Medical Branch at Galveston. "You end up with essentially no blood pressure. Your body temperature drops and you go into shock."

But when you look at the nitty-gritty details of an Ebola infection, a surprising fact surfaces: The virus isn't what ends up killing you. It's your own immune system.

"The normal job of the immune system is to eliminate infections," says virologist Christopher Basler, at the Mount Sinai Hospital in New York City. "But when it's activated at extreme levels or it's out of control, it becomes damaging to the host."

The most extreme immune attack is the "cytokine storm." Although many viruses, like bird flu and SARS, can trigger this shock and awe assault, Ebola is probably the best at it. And at the end of an Ebola infection, it's the cytokine storm that kills you, Basler says....(more)

http://www.africareview.com/Special-Reports/-/979182/1472576/-/vhdyxoz/-/index.html

(clip)
There have been claims that Ebola liquifies the body organs of infected people, but Dr Mbabazi disagrees. Instead, he says that Ebola interferes with the clotting and bleeding mechanisms of the body.

“The symptoms are initially non-specific, but liver function may be impaired, blood clotting functions (coagulation) are dysregulated, septic shock and multi-organ failure occurs in most cases that eventually die,” Dr Mbabazi says.

Handshakes have also been said to be a fertile ground for the spread of Ebola. Or aren’t they?Dr Mbabazi agrees because hands easily get contaminated when they get in contact with infected material like sweat, vomit, stool, urine, blood, or any other body fluid. Such materials can be picked by the hand in a hand shake directly or inadvertently from door handles, tables, and chairs.”

On whether victims wear zombie-like faces, infectious disease expert Dr Philippe Calain says: “At the end of the disease the patient does not look, from the outside, as horrible as you can read in some books. They are not melting. They are not full of blood. They’re in shock, muscular shock. They are not unconscious, but you would say ‘obtunded’, dull, quiet, very tired.”...

http://www.madsci.org/posts/archives/1996-05/833458824.Vi.r.html
Posted by Tom Wilson Grade level: M.D./PhD, Pathology, Div. of Molecular Oncology, Washington University Medical School

Question 1: Ebola does NOT cause the body to liquefy! I wish I knew
where this description of the disease comes from. Ebola does cause a large degree of tissue destruction in many parts of the body. We call this tissue destruction "inflammation". But it is fundamentally no different than the kind of destruction that occurs in, say, the common cold. This is exactly how your body fights the infection. Unfortunately, the inflammation can sometimes hurt you as much as it helps fight the infection. Part of inflammation is that tissues become leaky to fluid (why your nose runs), and this is compounded in Ebola infection since the virus is infecting (and killing) the cells of the blood vessels (see below), and so there is an even greater leakiness that results in frank bleeding. This results in the very powerful image of an infected person, since they have a bloody drainage at the eyes, nose, mouth, etc., and leads to the name for this disease, which is "hemorrhagic (i.e. bleeding) fever". But this idea that the internal organs turn to liquid is absurd. They are merely having the same kind of inflammation occurring, which does cause fluid
accumulation and severe tissue destruction, but again, it is nothing asfanciful what you have been led to believe.

As for the clotting, part of the bodies normal response to a damaged blood vessel is to form a clot there, to stop the bleeding. A clot is a
solidification of the the liquid components of blood, and is thus a fundamentally different process from the inflammation that is causing the fluid leakiness.

Question 2: Ebola virus does NOT infect every cell in the body! Again, I wish I knew where this idea came from. Ebola infects almost exclusively the cells that line the insides of your blood vessels - we call them "endothelial cells". Since all parts of your body have blood vessels, of course, all *parts* of the body (skin, organs, brain, etc.) can get infected. This is certainly part of why Ebola infection is so severe - by infecting only one cell type, the whole body can be damaged. It is also part of why Ebola can spread about the body so quickly - as soon as virus gets released from a dying cell, it finds itself in the bloodstream where it can now be pumped all over the body very fast.

http://www.nature.com/nri/journal/v7/n7/box/nri2098_BX1.html

In humans and monkeys, the hallmark of filoviral disease is unchecked viral growth that coincides with a relatively wide range of possible disease manifestations including fever, malaise, diarrhoea and vomiting, severe liver damage and various coagulation deficits that cause filoviruses to be categorized among the viral haemorrhagic fevers. The worst of the symptoms, including haemorrhage in a few individuals3, 91, seem to flow from a 'cytokine storm', a profuse release of pro-inflammatory cytokines52 (Fig. 1). In addition to cytokine effects on vascular permeability, causes of excessive bleeding can include plummets in platelet numbers, severe liver damage and the activation of tissue factor in monocytes and macrophages92. The time from infection to death is generally 1–2 weeks, with some variability depending on the virus and host species, as well as on initial dose93. For survivors, recovery is a lengthy process.

[MineralMan]

1. Gruesome details, but important information

for anyone wanting to understand Ebola. Thanks for posting.

I predict, though, that someone will request a warning for your thread title. Lots of people are squeamish about stuff like this.

[uppityperson]

3. Thank you, I edited to add a bit more. I have more problems with the laypersons pop literature

descriptions than medical jargon, but others may be the other way so added some. Thanks MM

[WinkyDink]

26. You know, I have problems with denigration of sources because one feels like it. "The Hot

Zone" was non-fiction, and, moreover, was written when there was no need, perceived or real, to obfuscate hideous details.

Just because a book isn't in research monographs doesn't make it "pop." Or do you also consign biographies and most history books to that heap?

[uppityperson]

27. Too many people confuse the fiction with fact. I have no problem denigrating pop fiction as a sourc

source for honest information.

The "gruesome details" are fictionalizedly overdone to sell the book. But too many believe you die from "bleeding from every orifice" after your "organs liquify".

As a person wrote on another forum

I'm not an "expert" like Preston, I only lecture on viral hemorrhagic fever viruses in grad school courses, and I have done some work on drug discovery on Ebola, but from what I understand much of what he described as the symptomology of filovirus infection was wrong. There is no 'profuse bleeding from all orifices", the organs do not liquefy, etc. In fact, one of the strangest things about the disease is there is relatively little to observe in a post mortem. There may some bleeding from mucous membranes, noticeable internal bleeding in the intestinal tract, and subdermal bleeding, but it is not gross blood loss that kills patients, it is massive inflammation due to an out of control response by one part of the immune system, and this causes shock and drop in blood pressure. The body kills itself.

http://www.reddit.com/r/IAmA/comments/2cscg8/i_am_richard_preston_author_of_the_hot_zone_and/

I prefer to source accurate information from scientific papers, not mass market ficitionalized "based on" books. If you have an issue with these sort of sources, that is up to you.

[kestrel91316]

2. DIC is an ugly way to die. I've seen one case, for sure, decades ago in

Van Nuys in the middle of summer. Guy kept his old dog in a closed-up garage (aka oven) in 100+ heat for days. Dog got heat stroke and in spite of our best efforts it wound up with DIC the next day and died.

[uppityperson]

4. I have taken care of patients with DIC and they weren't the omg bleeding out of every...thing, just

really really sick and feeling like absolute hell.

[kestrel91316]

23. That poor dog had bloody diarrhea and was vomiting blood and had ecchmotic hemorrhages on his skin,

and I think he bled out internally. It was so long ago, but some details still stick with me.

[magical thyme]

20. we had a dic when I was in clinicals

4+ schistocytes in her smears. One day there were no more smears. They never did figure out the underlying disease.

[KinMd]

28. My wife is a veterinary technician. They say DIC is short for..

Death Is Coming

[Baitball Blogger]

5. Nice work.

Thanks for the information.

[uppityperson]

29. You are welcome. I like to learn about things and trying to pass on what I found to help

others understand also.

[truedelphi]

6. Regardless of the terminology, it is still an ugly way to die.

And people who write books about the "coming ebola pandemic" often allow people who witness the effects of the disease to use more hyperbolic expressions.

[uppityperson]

8. My child was assigned The Hot Zone in middle school, had to petition to read Moby Dick instead

The teacher's point of the assignment was getting kids to read who didn't. My child's point was they read lots and after the first chapter saw no need to read a sensationalized book but would rather read a Classic.

Unfortunately too many view it not as fictionalized but as truth.

[truedelphi]

19. Yikes. Sorry to hear that Moby Dick is a book a student has to petition to read. n/t

[Marrah_G]

33. The Hot Zone for middleschoolers?

Seriously?

[uppityperson]

34. He started reading and after the first chapter told me he wasn't going to read more as it was

in his words, well, I will not repeat them. The teacher wanted something that would engage his class and most of them liked it.

[Marrah_G]

35. I would never have given that book to my kids

[Louisiana1976]

7. Very informative post. K&R

[Thespian2]

9. K & R

Now, I understand much more.

[LawDeeDah]

10. Thank you for this important information.

[Avalux]

11. Septic shock. Occurs in end stage disease....

The body's inflammatory response to ebola causes massive vasodilation, increased capillary permeability, decreased systemic vascular resistance, and hypotension...organs cease to function. Once the cascade begins, very very difficult to stop it.

This can happen in bacterial infections and other viral infections too.

[uppityperson]

25. Indeed, that was in one of the articles, that what happens happens with other diseases, issues

[LiberalLoner]

12. Aha, thank you! So it's kind of like a really bad MS attack, in a way. Except for the clots. But

The overproduction of cytokines and the immune system going nuts, I totally get!

Thank you for helping us to understand!

[freshwest]

13. Thanks for the scientific explanation.

...They’re in shock, muscular shock. They are not unconscious, but you would say ‘obtunded’, dull, quiet, very tired...

As excruciating as other conditions leading to death in a hospital. Glad you cleared up the many misconceptions on all aspects of this disease.

[SunSeeker]

14. Yikes. That's even scarier than just bleeding out your eyes.

If ebola makes your immune system attack your blood vessels, turning them into leaky sieves, it attacks everything the blood vessels feed. In other words, it attacks everything. What a horrible way to die.

[Needa Moment]

31. Weird how medical articles

Like this bring about unsolved medical mysteries. Weird that after all this time a precise determination was never made about the Toxic Lady of Riverside's demise. That was such the strangest case I've ever heard when I was graveyard shifting at a gas station and had lots of newspaper reading being done in the 90's.

http://en.wikipedia.org/wiki/Gloria_Ramirez

Was freaky how it affected all medical staff aiding the victim almost immediately.

[Duer 157099]

15. So then are immunocompromised people less likely to die from ebola? n/t

[uppityperson]

16. Huh, let me think. They still have the clotting, tissue death problem. Quick research shows no.

I need to do more research as anything I would say would only be a guess and I'd rather not do that.

I found 1 paper, need to read it. ETA a bit of the article which makes it look like no. You have the virus, get sick from it without the cytokine storm, can't fight it off and it has enough impact otherwise on the body to kill you.
http://jvi.asm.org/content/78/2/958.full

This demonstrates that under certain immunodeficiency conditions, Ebola virus can persist and that loss of primed CD4 T cells accelerates the course of persistent infections.
(clip)
However, in the absence of B cells and antigen-specific CD4 T cells, Ebola virus establishes a persistent asymptomatic infection, with disease symptoms appearing only during the late stage of infection.

[Duer 157099]

17. Very interesting paper, thanks

the issue of such people walking about as reservoirs... not so comforting....

[uppityperson]

18. Positive and negative, but indeed no, immunocompromised are a high risk group, reading more

My immediate reaction was no, but then I thought wouldn't that be something if they were less likely to die. If it were only immune system over reaction, maybe, but not so in the end.

Channel Yoda I do

[Duer 157099]

32. But if it takes longer for immunocompromised people to die from Ebola...

(if, that is) ... then I could see that being an advantage for the virus in that it can have longer to spread itself. If so, then I'd be watching for a mutation in that direction

[Sissyk]

21. Very good info.

Thanks, uppity!

[B2G]

22. I feel so much better now. nt

[Stargazer09]

24. Thank you for the information

I just hope the epidemic can be contained before more people contract the disease. Sounds like a horrible way to die.

[pnwmom]

30. Thanks for the clear information, uppityperson. n/t

[woodsprite]

36. Thank you for posting this description. I find the end-stage symptoms not quite so scary now.

My mother died from DIC (probably diabetes related, but they were never sure what caused it). Lymph was leaking out of her pores, she had a fever, the bruising, and blood in the urine. What was keeping her alive while they tried to diagnose/cure her was the screens they had put in place to catch the blood clots, and the constant platelet transfusions she was receiving. Other than the testing and procedures to put the screens in, she was eating some and didn't seem to be in pain. When even blood specialists at Johns Hopkins and a few other places couldn't find a way to correct it, the family (along with Mom) decided to stop the platelet transfusions and let nature take it's course. Hospital admissions was going to send her back home on hospice care, but the nurses talked to us about the nature of DIC and along with nursing staff, her docs, our family and hospice staff, we got them to keep her in the hospital over the long weekend, so we could get "set up" at home. She passed that Sunday.

What's scary is that this is viral.

[uppityperson]

39. My condolences on your mom. We never want to lose a loved one, but having them be more comfortable

is a strong desire.

[LiberalElite]

37. Definition of "DIC":

http://www.nlm.nih.gov/medlineplus/ency/article/000573.htm

-snip-
Disseminated intravascular coagulation (DIC) is a serious disorder in which the proteins that control blood clotting become over active.

Causes
When you are injured, proteins in the blood that form blood clots travel to the injury site to help stop bleeding. If you have DIC, these proteins become abnormally active throughout the body. This may be due to inflammation, infection, or cancer.

Small blood clots form in the blood vessels. Some of these clots can clog the vessels and cut off blood supply to organs such as the liver, brain, or kidneys. Lack of blood flow can damage the organ and it may stop working properly.

Over time, the clotting proteins in your blood are consumed or "used up." When this happens, you have a high risk of serious bleeding, even from a minor injury or without injury. You may also have bleeding that starts spontaneously (on its own). The disease can also cause healthy red blood cells to break up when they travel through the small vessels that are filled with clots.

Risk factors for DIC include:
-snip-

[uppityperson]

38. Thank you, that is a clear and concise definition/description.

[LiberalElite]

40. I read the OP

once, then a couple of times more, looking for the definition. The "Death is coming" response wasn't too helpful either. So, I looked it up.

[uppityperson]

42. I appreciate it. I get used to reading techno-jargon stuff, appreciate when people post readable

stuff and sometimes I miss what to me is obvious but to others isn't. I find the cellular level information fascinating, but then have been so, done so, for many years. It is like a big puzzle with lots of little tiny pieces that have to fit together just right (meaning how the body works both correctly and incorrectly), lots of little lego pieces to simplify it

[barbtries]

41. pretty horrifying process

even without liquefied organs. i hope it can be brought under control sooner rather than later.