Ebola: Fact or Fiction?

Imagine a highly contagious disease with a mortality rate anywhere from fifty to ninety percent – a disease for which there is no vaccine or cure. Victims of this disease suffer from liquefying flesh, melting organs, and massive hemorrhaging – bleeding from every orifice of the body. This description sounds like it could come straight out of a horror film. While the disease that is described is real; however, its symptoms are not. The disease is Ebola hemorrhagic fever, a viral infectious disease that originated in Africa. The stories of the symptoms of Ebola are perhaps some of the most overblown and exaggerated of any disease, and misinformation about the virus has spread to the general public. By dramatizing the symptoms, painting Ebola as a disease that is inherently African, comparing Ebola to AIDS, and using military metaphors, media and popular culture misinterpret Ebola as a disease that is far more gruesome than it actually is. The impact of books and news reports on Ebola's representation has caused the virus to be viewed as one of the world's most deadly and horrific diseases.

Several books have drawn the public's attention to the Ebola virus. One book, Richard Preston's The Hot Zone, was number one on the New York Times non-fiction bestseller list and sold over two and a half million copies. Preston's book is based on the actual events of the Ebola Reston outbreak in 1989 in the United States, as well as detailing the history of Ebola and its outbreaks in Africa. The Hot Zone is a compelling read, but Preston has been criticized for "his often hyperactive imagery" which "has undoubtedly energized his readers' imagination as far as Ebola is concerned" (Semmler 154). The fact that Preston's story is non-fiction and is based on actual events makes it believable, but the average person does not know enough about Ebola to realize that Preston's descriptions of Ebola's symptoms are greatly embellished. In the first few pages of the book, Preston describes in gruesome detail the death of a man infected with the virus. In the waiting room of the hospital, the man finally collapses on the floor with "pools of blood spread out around him, enlarging rapidly" (Preston 24). Anyone who works with or has researched viral hemorrhagic fevers knows this description is highly exaggerated. C.J. Peters, former Chief Of Special Pathogens at the CDC, states in the forward of his own book, Virus Hunter, that while popular books about the virus have helped bring awareness to Ebola, "some of these books are very entertaining, but not really authoritative, and others are quite exaggerated" (Peters xii). The media and popular culture have brought attention to Ebola; however, they have done so at the expense of providing accurate, straightforward information.

When Ebola and its symptoms are described, whether the description is in books or news headlines, the symptoms are often exaggerated, and many myths exist about the virus. One of the most common exaggerations is the extent to how much the victims of Ebola hemorrhage. An article from The Guardian, a British newspaper, declares: "At its worst, Ebola turns internal organs to mush and causes profuse bleeding from virtually every orifice" (Joffe 962). While it is true that Ebola causes patients to bleed, hemorrhage does not occur externally in every patient, and if it does, it is usually subtle, not profuse. As the CDC states, "a rash, red eyes, hiccups and internal and external bleeding may be seen in some patients" (CDC). The most common symptom of Ebola is fever, not hemorrhaging. However, describing fever as a symptom is not nearly as dramatic as describing hemorrhage. Often times, the public hears the most about the grisly symptoms of Ebola. In an interview in 1996, Philippe Calain, M.D. Chief Epidemiologist, CDC Special Pathogens Branch, attempts to dispel some of the misconceptions about Ebola and its effects on the patient. He states: "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. Very few were hemorrhaging. Hemorrhage is not the main symptom. Less than half of the patients had some kind of hemorrhage" (Regis 104). Another myth about Ebola is that the virus "kills its victims so quickly that it burns itself out before it has real occasion to spread" (Ungar 50). The CDC's webpage about Ebola, though, negates this fallacy as they inform the public that "the incubation period for Ebola HF ranges from 2 to 21 days" (CDC). What prevents Ebola from spreading any further than it does are the efforts of doctors and health officials, not the fact that Ebola burns itself out by killing its victims quicker than it can transmit itself to a new host. Clearly, when the public hears exaggerations and myths such as these, those people perceive Ebola as more horrific than it is in reality.

Another way that the media shapes Ebola's representation is by portraying it as a predominantly African disease. Ebola was first recognized in Zaire (now known as the Democratic Republic of the Congo) and is named after the Ebola River in Zaire. While it is true that it many times breaks out in African territories, the media has done its fair share in mentioning Africa in headlines and news articles about Ebola, thus perpetuating the myth. In a study done about Ebola in British news, researchers looked at several newspapers and tabloids and found that "a third of the tabloids first refer to Africa as a whole in association with Ebola" (Joffe 960). Some of the headlines from the tabloids refer to Ebola as a "killer African virus" or an "African disease" (Joffe 960). In newspapers, the articles tend to discuss where Ebola originated and why it spreads so easily, attributing the spread of the virus to the living conditions in Africa. When participants of the study are asked about the spread of Ebola, "most responses are distributed over five themes: poverty, tribal rituals, poor hospital hygiene and water quality, monkeys, and forests" (Joffe 960). Many of the themes are things that are usually associated with Africa, causing people to believe that the virus has little chance of spreading to more developed countries simply because the conditions that exist in Africa are not as common in other countries. In literature about Ebola, authors often describe Africa vividly. "Africa, particularly the jungle, has a history of suggesting darkness, impenetrability and mystery"; so by relating Africa and Ebola, both are viewed the same way symbolically (Semmler 163). Adding to Ebola's mystery is the fact that no one knows where Ebola's reservoir is, even after numerous studies. On the World Health Organization's (WHO) website, they affirm that the location of the reservoir is not known, but it "seems to reside in the rain forests on the African continent" (WHO). Several possibilities for the reservoir include primates, bats, and other animals that inhabit the rainforests. At one time, Kitum Cave, located in Mount Elgon in Kenya, was thought to be a reservoir of Ebola and its relative, Marburg. Two people known to have visited Kitum Cave later contracted Marburg and died. Preston describes his visit to Kitum Cave in The Hot Zone and theorizes that Ebola may be hiding deep within the cave, as well as deep within the African rainforests. In these associations with Africa, both geographically and culturally, Ebola comes across as an African disease.

The media and popular literature often compare Ebola to other diseases such as AIDS in order to represent Ebola as more dangerous and threatening. In the study of British newspapers, researchers found that "comparisons between Ebola and AIDS are used to amplify fear in the newspapers…the existing illness to which Ebola is most frequently anchored in the press is HIV/AIDS (25 of the tabloid articles, 19 of the newspaper articles)" (Joffe 962). Comparing Ebola to AIDS introduces the idea that Ebola could one day become as widespread as AIDS. People outside of Africa do not view Ebola as much of a threat to them personally because Ebola appears to be contained in Africa, but when Ebola is compared to AIDS, which is present all over the world, the comparison brings the threat of Ebola closer to home. When asked about the public's fascination with viruses, Preston of The Hot Zone brings AIDS into the equation, stating: "There's a deep curiosity, there's a sense of horror. And I also think that in the backs of people's minds, ever present, is the AIDS virus" (Semmler 155). Susan Sontag, in her essay AIDS and its Metaphors, suggests of AIDS that "the taste for worst-case scenarios reflects the need to master fear of what is felt to be uncontrollable…it also expresses an imaginative complicity with disaster" (Sontag 175). What Sontag says about AIDS can certainly be related to the Ebola virus – the same fears about both viruses exist. The mention of the AIDS virus tends to awaken people's fears, thereby causing more alarm over the Ebola virus when the two are compared.

The use of military metaphors is also used to incite fear of Ebola. In Preston's The Hot Zone, he describes a patient with the virus as "a human virus bomb" (Preston 21). When the patient begins to hemorrhage in the middle of a hospital emergency room, Preston describes the last phase of the disease: "the human virus bomb explodes" (Preston 23). As the patient bleeds to death, each drop of his blood contains thousands of virus particles, ready to spread to and infect new hosts, wreaking death and destruction much like the radioactive material from a nuclear bomb. Even further, what makes these military metaphors so disturbing is the real threat of Ebola someday being used as an agent of biological warfare. One example of this is the CDC's classification of Ebola as a Category A potential biological terrorism agent (Rotz). Susan Sontag, in discussing military metaphors attributed to the AIDS virus, claims that "the effect of the military imagery on thinking about sickness and health is far from inconsequential…it overmobilizes, it overdescribes, and it powerfully contributes to the excommunicating and stigmatizing of the ill" (Sontag 182). Sontag makes the argument that military metaphors are not necessary in describing illnesses, because doing so over-dramatizes the illness and can even contribute to feelings of shame for those with the disease, as well as rouse fear about the particular disease and those who carry it. By using military metaphors, media and popular culture provoke further fear about Ebola.

Although Ebola is a serious disease that has a high mortality rate and lacks a vaccine and cure, it is still just a disease. Ebola is not the monster that media and popular culture represent it as, but because of the way authors embellish Ebola's symptoms and the media's need to attract readers with sensational headlines, Ebola is perceived by many people as a monster. The media and books should not downplay the effects of the virus, but they should not exaggerate them either. If authors and the media would provide straight facts instead of over-dramatizing Ebola to create shock value, misinformation about the virus would not be so rampant. In addition, if military metaphors were not used and comparisons to other diseases were not made, there would not be as much unnecessary fear surrounding Ebola. By exaggerating Ebola's symptoms, using military metaphors, and comparing Ebola to AIDS, the media and popular culture have mixed fact and fiction to taint the public's view of Ebola.