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Why the Ebola virus is so deadly

It is not the virus that directly causes the infamous bleeding. Yes, the virus attacks different organs as well as the immune system, but the most serious problem is a severe over-reaction by our own immune system, called a cytokine storm. This causes blood clotting in all the wrong places, called disseminated intravascular coagulation,24 which damages organs such as the liver. Also, this uses up all the blood clotting factors, meaning that clots won’t form where they should, resulting in uncontrollable bleeding.25,26 It’s notable that the deadliest epidemic of Ebola’s fellow negative-sense–RNA virus influenza also caused cytokine storms. This is why the pandemic killed so many previously healthy people—they had the strongest immune systems, and these were turned against them. In the case of influenza, the immune system severely inflamed the patient’s lungs.27

At present there is no cure or vaccine for Ebola. Treatment involves rehydration, pain relief, and pro-coagulants to control bleeding. Also, there is blood transfusion to replace loss, as well as blood plasma from Ebola survivors containing antibodies that could fight the disease. Indeed, Dr Brantly was helped by a 14-year-old former patient’s transfusion, and he has since donated blood plasma to other sufferers.28

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