test please delete

[Moscow Mule]

Species

[edit] Zaïre ebolavirus
Known human cases and deaths during outbreaks of Zaïre Ebolavirus between 1976 and 2003
Known human cases and deaths during outbreaks of Zaïre Ebolavirus between 1976 and 2003

The Zaïre Ebolavirus has the highest mortality rate, up to 90% in some epidemics, with an average of approximately 83% mortality over 27 years. The case-fatality rates were 88% in 1976, 100% in 1977, 59% in 1994, 81% in 1995, 73% in 1996, 80% in 2001-2002 and 90% in 2003. There have been more outbreaks of Zaïre Ebolavirus than any other strain.

The first outbreak took place on August 26, 1976 in Yambuku, a town in the north of Zaïre. The first recorded case was Mabalo Lokela, a 44-year-old schoolteacher returning from a trip around the north of the state. His high fever was diagnosed as possible malaria and he was subsequently given a quinine shot. Lokela returned to the hospital every day. A week later, his symptoms included uncontrolled vomiting, bloody diarrhea, headache, dizziness, and trouble breathing. Later, he began bleeding from his nose, mouth, and anus. Lokela died on September 8, 1976, roughly 14 days after the onset of symptoms.

Soon after, more patients arrived with varying but similar symptoms including fever, headache, muscle and joint aches, fatigue, nausea, and dizziness. These often progressed to bloody diarrhea, severe vomiting, and bleeding from the nose, mouth, and anus. The initial transmission was believed to be due to reuse of the needle for Lokela’s injection without sterilization. Subsequent transmission was also due to care of the sick patients without barrier nursing and the traditional burial preparation method, which involved washing and gastrointestinal tract cleansing.

[edit] Sudan ebolavirus
Known human cases and deaths during outbreaks of Sudan Ebolavirus between 1976 and 2003
Known human cases and deaths during outbreaks of Sudan Ebolavirus between 1976 and 2003

Sudan Ebolavirus was the second strand of Ebola reported in 1976. It apparently originated amongst cotton factory workers in Nzara, Sudan. The first case reported was a worker exposed to a potential natural reservoir at the cotton factory. Scientists tested all animals and insects in response to this, however none tested positive for the virus. The carrier is still unknown.

A second case involved a nightclub owner in Nzara, Sudan. The local hospital, Maridi, tested and attempted to treat the patient; however, nothing was successful, and he died. The nurses did not apply safe and practical procedures in sterilizing and disinfecting the medical tools used on the nightclub owner, facilitating the spread of the virus in the hospital.

The most recent outbreak of Sudan Ebolavirus occurred in May 2004. As of May 2004, 20 cases of Sudan Ebolavirus were reported in Yambio County, Sudan, with 5 deaths resulting. The Centers for Disease Control and Prevention confirmed the virus a few days later. The neighbouring countries of Uganda and the Democratic Republic of Congo have increased surveillance in bordering areas, and other similar measures have been taken to control the outbreak. The average fatality rates for Sudan Ebolavirus were 53% in 1976, 68% in 1979, and 53% in 2000/2001. The average case-fatality rate is 53.76%.

[edit] Reston ebolavirus

Main article: Ebola Reston

First discovered in November of 1989 in a group of 100 Crab-eating monkeys (Macaca fascicularis) imported from the Philippines to Reston, Virginia. A parallel infected shipment was also sent to Philadelphia. This strain was highly lethal in monkeys, but did not cause any fatalities in humans. Six of the Reston primate handlers tested positive for the virus, two due to previous exposure.

Further Reston Ebolavirus infected monkeys were shipped again to Reston, and Alice, Texas in February of 1990. More Reston Ebolavirus infected monkeys were discovered in 1992 in Siena, Italy and in Texas again in March 1996. A high rate of co-infection with Simian Hemorrhagic Fever (SHF) was present in all infected monkeys. No human illness has resulted from these two outbreaks.

[edit] Ivory Coast ebolavirus

This species of Ebola was first discovered amongst chimpanzees of the Tai Forest in Côte d’Ivoire, Africa. On November 1, 1994, the corpses of two chimpanzees were found in the forest. Necropsies showed blood within the heart to be liquid and brown, no obvious marks seen on the organs, and one presented lungs filled with liquid blood. Studies of tissues taken from the chimps showed results similar to human cases during the 1976 Ebola outbreaks in Zaïre and Sudan. Later in 1994, more dead chimpanzees were discovered, with many testing positive to Ebola using molecular techniques. The source of contamination was believed to be the meat of infected Western Red Colobus monkeys, which the chimpanzees preyed upon.[3]

One of the scientists performing the necropsies on the infected chimpanzees contracted Ebola. She developed symptoms similar to dengue fever approximately a week after the necropsy and was transported to Switzerland for treatment. After two weeks she was discharged from hospital, and was fully recovered six weeks after the infection.

[DS23]

what about butterfly migration?

[n5gooner]

[edit] Richard's marriage

Before leaving Cyprus, Richard married Berengaria, first-born daughter of King Sancho VI of Navarre. The wedding was held in Limassol on 12 May 1191 at the Chapel of St. George. It was attended by his sister Joan, whom Richard had brought from Sicily. It should be noted that when Richard married Berengaria he was still officially betrothed to Alys and that Richard pushed for the match, in order to obtain Navarre as a fief like Aquitaine for his father. Further, Eleanor championed the match, as Navarre bordered on Aquitaine, thereby securing her ancestral lands' borders to the south. Richard took his new wife with him briefly on this episode of the crusade. However, they returned separately. Berengaria had almost as much difficulty in making the journey home as her husband did, and did not see England until after his death. Although after his release from German captivity, Richard showed some degree of regret for his earlier conduct, he was not joined by his wife.

Richard had to be ordered to reunite with and show fidelity to Berengaria in the future, being told to "remember the destruction of Sodom and abstain from illicit acts." This may be further evidence that Richard engaged in homosexual activities, although it is argued that "the sin of Sodom" could be interpreted more broadly: the Biblical story concerns attempted male rape; Richard had already been accused of raping women. Some modern writers[citation needed], elaborating on the theory, have alleged that Berengaria's own brother, the future Sancho VII, was one of Richard's early lovers. Nevertheless, when Richard died in 1199, Berengaria was greatly distressed, apparently having loved her husband very much (although that does not imply mutuality on Richard's part). The picture is further muddied by the fact that she had to sue the Church to be recognised as his widow. Historians remain divided on the issue.

[Moscow Mule]

Ebola hemorrhagic fever

[edit] Symptoms
1976 photograph of two nurses standing in front of Kinshasa case #3 (Nurse Mayinga) who was treated and later died in Ngaliema Hospital, in Kinshasa, Zaïre
1976 photograph of two nurses standing in front of Kinshasa case #3 (Nurse Mayinga) who was treated and later died in Ngaliema Hospital, in Kinshasa, Zaïre

Symptoms are varied and often appear suddenly. Initial symptoms include high fever (at least 38.8°C (~102°F)), severe headache, muscle, joint, or abdominal pain, severe weakness and exhaustion, sore throat, nausea, and dizziness[4]. Before an outbreak is suspected, these early symptoms are easily mistaken for malaria, typhoid fever, dysentery, influenza, or various bacterial infections, which are all far more common and less reliably fatal.

Ebola may progress to cause more serious symptoms, such as diarrhea, dark or bloody feces, vomiting blood, red eyes due to distention and hemorrhage of sclerotic arterioles, petechia, maculopapular rash, and purpura. Internal and external hemorrhage from orifices, such as the nose and mouth, may also occur, as well as from incompletely healed injuries such as needle-puncture sites. Hemorrhage is due to the virus having the ability to stop platelets from clotting and making the cell membranes permeable[citation needed]. Other secondary symptoms include hypotension (less than 90 mm Hg systolic /60 mm Hg diastolic), hypovolemia, tachycardia, organ damage (especially the kidneys, spleen, and liver) as a result of disseminated systemic necrosis, and proteinuria.

The span of time from onset of symptoms to death is usually between 7 and 14 days. By the second week of infection, patients will either defervesce (the fever will lessen) or undergo systemic multi-organ failure. Mortality rates are generally high, ranging from 50% - 90%[5]. The cause of death is usually due to hypovolemic shock or organ failure[6].

[edit] Transmission

Among humans, the virus is transmitted by direct contact with infected body fluids, or to a lesser extent, skin or mucus membrane contact. The incubation period can be anywhere from 2 to 21 days, but is generally between 5 and 10 days.

Although airborne transmission between monkeys has been demonstrated by an accidental outbreak in a laboratory located in Virginia, U.S.A, there is very limited evidence for human-to-human airborne transmission in any reported epidemics. Nurse Mayinga might represent the only possible case. The means by which she contracted the virus remain uncertain.

So far all epidemics of Ebola have occurred in sub-optimal hospital conditions, where practices of basic hygiene and sanitation are often either luxuries or unknown to caretakers and where disposable needles and autoclaves are unavailable or too expensive. In modern hospitals with disposable needles and knowledge of basic hygiene and barrier nursing techniques, Ebola rarely spreads on such a large scale.

In the early stages, Ebola may not be highly contagious. Contact with someone in early stages may not even transmit the disease. As the illness progresses, bodily fluids from diarrhea, vomiting, and bleeding represent an extreme biohazard. Due to lack of proper equipment and hygienic practices, large scale epidemics occur mostly in poor, isolated areas without modern hospitals or well-educated medical staff. Many areas where the infectious reservoir exists have just these characteristics. In such environments, all that can be done is to immediately cease all needle-sharing or use without adequate sterilization procedures, to isolate patients, and to observe strict barrier nursing procedures with the use of a medical rated disposable face mask, gloves, goggles, and a gown at all times. This should be strictly enforced for all medical personnel and visitors.

Ebola is limited on a global scale due to its difficulty in spreading by airborne transmission and the period of time that the virus can use a living and contagious victim to spread compared to other infectious diseases. In isolated settings such as a quarantined hospital or a remote village, most victims are infected shortly after the first case of infection is present. In addition, the quick onset of symptoms from the time the disease becomes contagious in an individual makes it easy to identify sick individuals and limits an individual's ability to spread the disease by traveling. Although bodies of the deceased are still infectious, many doctors implemented measures to properly dispose of dead bodies in spite of some traditional local burial rituals.[7]

[edit] Treatments
A hospital isolation ward in Gulu, Uganda during the October 2000 outbreak
A hospital isolation ward in Gulu, Uganda during the October 2000 outbreak

Treatment is primarily supportive and includes minimizing invasive procedures, balancing electrolytes, replacing lost coagulation factors to help stop bleeding, maintaining oxygen and blood levels, and treating any complicating infections. Despite some initial anecdotal evidence, blood serum from Ebola survivors has been shown to be ineffective in treating the virus. Interferon is also thought to be ineffective. Ribavirin is ineffective. In monkeys, administration of an inhibitor of coagulation (rNAPc2) has shown some benefit, protecting 33% of infected animals from a usually 100% (for monkeys) lethal infection. In early 2006, scientists at USAMRIID announced a 75% recovery rate after infecting four rhesus monkeys with Ebola virus and administering antisense drugs.[8]

[edit] Vaccines

Vaccines have been produced for both Ebola [9] and Marburg [10] that were 100% effective in protecting a group of monkeys from the disease. These vaccines are based on either a recombinant Vesicular stomatitis virus or a recombinant Adenovirus[11] carrying the Ebola spikeprotein on its surface. Early human vaccine efforts, like the one at NIAID in 2003, have so far not reported any successes.[12]

[edit] Viral reservoirs

Despite numerous studies, the wildlife reservoir of Ebolavirus has not been identified. Between 1976 and 1998, from 30,000 mammals, birds, reptiles, amphibians and arthropods sampled from outbreak regions, no Ebolavirus was detected[13] apart from some genetic material found in six rodents (Mus setulosus and Praomys species) and a shrew (Sylvisorex ollula) collected from the Central African Republic in 1998.[14] Ebolavirus was detected in the carcasses of gorillas, chimpanzees and duikers during outbreaks in 2001 and 2003 (the carcasses were the source of the initial human infections) but the high mortality from infection in these species precludes them from acting as reservoirs.[13]

Plants, arthropods and birds have also been considered as reservoirs, however bats are considered the most likely candidate[15]. Bats were known to reside in the cotton factory in which the index cases for the 1976 and 1979 outbreaks were employed and have also been implicated in Marburg infections in 1975 and 1980.[13] Of 24 plant species and 19 vertebrate species experimentally inoculated with Ebolavirus, only bats became infected.[16] The absence of clinical signs in these bats is characteristic of a reservoir species. In 2002-03, a survey of 1,030 animals from Gabon and the Republic of the Congo including 679 bats found Ebolavirus RNA in 13 fruit bats (Hyspignathus monstrosus, Epomops franquetti and Myonycteris torquata).[17] Bats are also known to be the reservoirs for a number of related viruses including Nipah virus, Hendra virus and lyssaviruses.

[edit] Weaponization

Because Ebola is lethal and since no approved vaccine or treatment is available, Ebola is classified as a Biosafety Level 4 agent, as well as a Category A bioterrorism agent[18] and a select agent by the CDC. Ebola was considered during biological warfare research at both Fort Detrick[19] in the United States and Biopreparat[20] in the Soviet Union during the Cold War.

Ebola shows potential as a biological weapon because of its lethality but due to its relatively short incubation period it may be more difficult to spread since it may kill its victim before it has a chance to be transmitted. As a result, some developers have considered breeding it with other agents such as smallpox[21] to create so-called chimera viruses.

As a terrorist weapon, Ebola has been considered by members of Japan's Aum Shinrikyo cult, whose leader, Shoko Asahara led about 40 members to Zaire in 1992 under the guise of offering medical aid to Ebola victims in what was presumably an attempt to acquire a sample of the virus.[22]

[edit] Cultural impact
An Ebola virus cuddly toy
An Ebola virus cuddly toy

[n5gooner]

Richard in OutremerKing Richard landed at Acre on 8 June 1191. He gave his support to his Poitevin vassal Guy of Lusignan, who had brought troops to help him in Cyprus. Guy was the widower of his father's cousin Sibylla of Jerusalem, and was trying to retain the kingship of Jerusalem, despite his wife's death during the siege of Acre the previous year. Guy's claim was challenged by Conrad of Montferrat, second husband of Sibylla's half-sister, Isabella: Conrad, whose defence of Tyre had saved the kingdom in 1187, was supported by Philip of France, son of his first cousin Louis VII of France, and by another cousin, Duke Leopold V of Austria. Richard also allied with Humphrey IV of Toron, Isabella's first husband, from whom she had been forcibly divorced in 1190. Humphrey was loyal to Guy, and spoke Arabic fluently, so Richard used him as a translator and negotiator.

[DS23]

chaos theory?

[Moscow Mule]

gis a chance - haven't finished ebola yet

Main article: Ebola inspired entertainment

This section is a stub. You can help by expanding it.

Ebola and Marburg have served as a rich source of ideas and plotlines for many forms of entertainment. The infatuation with the virus is likely due to the high mortality rate of its victims, its mysterious nature, and its tendency to cause gruesome bleeding from body orifices.

Much of the representation of the Ebola virus in fiction and the media is considered exaggerated or myth.[citation needed] One pervasive myth follows that the virus kills so fast that it has little time to spread. Victims die very soon after contact with the virus. In reality, the incubation time is usually about a week. The average time from onset of early symptoms to death varies in the range 3-21 days, with a mean of 10.1. Although this would prevent the transmission of the virus to many people, it is still enough time for some people to catch the disease.

Another myth, portrayed by books like Germ by Robert Liparulo, states that the symptoms of the virus are horrifying beyond belief.[citation needed] In depictions of this type, victims of Ebola suffer from squirting blood, liquefying flesh, zombie-like faces and dramatic projectile bloody vomiting, at times, from even recently deceased. In actual fact, only a fraction of Ebola victims have severe bleeding that would be even somewhat dramatic to witness. Approximately 10% of patients suffer some bleeding, but this is often internal or subtle, such as bleeding from the gums. Ebola symptoms are usually limited to extreme exhaustion, vomiting, diarrhea, abdominal pain, a high fever, headaches and other body pains.

The following is an excerpt from an interview with Philippe Calain, M.D. Chief Epidemiologist, CDC Special Pathogens Branch, Kikwit 1996:
“ 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. Very few were hemorrhaging. Hemorrhage is not the main symptom. Less than half of the patients had some kind of hemorrhage. But the ones that had bled, died. ”

[n5gooner]

Richard and his forces aided in the capture of Acre, despite the king's serious illness. At one point, while sick from scurvy, Richard is said to have picked off guards on the walls with a crossbow, while being carried on a stretcher. Eventually, Conrad of Montferrat concluded the surrender negotiations with Saladin, and raised the banners of the kings in the city. Richard quarrelled with Leopold V of Austria over the deposition of Isaac Komnenos (related to Leopold's Byzantine mother) and his position within the Crusade. Leopold's banner had been raised alongside the English and French standards. This was interpreted as arrogance by both Richard and Philip, as Leopold was a vassal of the Holy Roman Emperor (although he was now the highest-ranking surviving leader of the imperial forces). Richard's men tore the flag down and threw it in the moat of Acre. Leopold left the Crusade immediately. Philip also left soon afterwards, in poor health and after further disputes with Richard over the status of Cyprus (Philip demanded half the island) and the kingship of Jerusalem. Richard suddenly found himself without allies.

[DS23]

eboli - good one. what about elephantisis? that was always fascinating. those blokes with gonads in wheelbarrows.

[Moscow Mule]

Young & Co's Brewery Plc is a vertically integrated British regional brewer founded in 1831 by Charles Young and Anthony Bainbridge when they purchased the Ram Brewery in Wandsworth. Before the closure of The Ram Brewery in 2006, the Ram was one of the two remaining large London breweries along with the Griffin Brewery run by Fullers in Chiswick.

Young & Co now brews its beers through its jointly owned brewing operations with Charles Wells. This venture is known as the Wells & Young’s Brewing Company, located at the Eagle Brewery in Bedford. Young's & Co is still an independent family owned brewer; it operates its own pub estate and with a 40% stake in its co-owned Wells & Young’s, brewing is a significant part of the business. All of Young & Co's beers are branded as Young's and are sold through its chain of pubs and suppliers.