Sunday, October 12, 2014

Ebola's Bark is worse than it's Bite (At least for those in developed countries)

Many years ago I remember reading about Ebola, it scared me more than I can say.  A disease that is incurable, highly infectious (a single virus can cause disease) and that kills people by liquefying their internal organs.  The disease still scares me, I would rather not get it, but I now know more about it and I can think about it more rationally.

Ebola is very scary, I have nothing but admiration for the health care workers who put their lives on the line each time they work with patients who have or might have the disease.  This is especially true in developing countries many of which simply don't have the resources to keep these workers safe and yet these people still go to work to care for others.   I also respect the others who do the testing to confirm these cases, again a rather dangerous job.

Ebola is scary, but the people who are getting sick and dying are those in Africa who don't have the resources or the healthcare infrastructure that is present here in the US.  It is those people who should really be scared.  Those of us in developed countries really have very little to fear.  Unless you are caring for or in close contact with a symptomatic Ebola patient or their bodily fluids, you won't get it.  The disease is just not that contagious (easily transmitted from person to person).  Even if you do get it and you live in a western country, your chances of survival are much greater than if you are living in a third world country.

My purpose here is to give people the tools (facts) that can help them understand this disease, understand the risks and move from fear to compassion that comes from understanding.   I am going to provide a number of links, I am not a doctor, nor an Ebola researcher so I would rather point you in the right direction rather than giving out the information myself

What is Ebola? 

Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and nonhuman primates (monkeys, gorillas, and chimpanzees).

Ebola is caused by infection with a virus of the family Filoviridae, genus Ebolavirus. There are five identified Ebola virus species, four of which are known to cause disease in humans: Ebola virus (Zaire ebolavirus); Sudan virus (Sudan ebolavirus); Taï Forest virus (Taï Forest ebolavirus, formerly Côte d’Ivoire ebolavirus); and Bundibugyo virus (Bundibugyo ebolavirus). The fifth, Reston virus (Reston ebolavirus), has caused disease in nonhuman primates, but not in humans.

Ebola viruses are found in several African countries. Ebola was first discovered in 1976 near the Ebola River in what is now the Democratic Republic of the Congo. Since then, outbreaks have appeared sporadically in Africa.

The natural reservoir host of Ebola virus remains unknown. However, on the basis of evidence and the nature of similar viruses, researchers believe that the virus is animal-borne and that bats are the most likely reservoir. Four of the five virus strains occur in an animal host native to Africa. (From the CDC, About Ebola Virus Disease) 

Where did it come from?

While we don't know for sure exactly where it came from the article "'In 1976 I discovered Ebola - now I fear an unimaginable tragedy'"  Gives an interesting angle and perspective to the history of Ebola.  For more information: Outbreaks Chronology: Ebola Virus Disease; An Introduction to Ebola: The Virus and the Disease

Disease information (from the CDC: Signs and Symptoms)

Symptoms of Ebola include

  • Fever (greater than 38.6°C or 101.5°F)
  • Severe headache
  • Muscle pain
  • Weakness
  • Diarrhea
  • Vomiting
  • Abdominal (stomach) pain
  • Unexplained hemorrhage (bleeding or bruising)
Symptoms may appear anywhere from 2 to 21 days after exposure to Ebola, but the average is 8 to 10 days.
Recovery from Ebola depends on good supportive clinical care and the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.

Transmission (from the CDC: Transmission)

Because the natural reservoir host of Ebola viruses has not yet been identified, the manner in which the virus first appears in a human at the start of an outbreak is unknown. However, researchers believe that the first patient becomes infected through contact with an infected animal.
When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with
  • blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
  • objects (like needles and syringes) that have been contaminated with the virus
  • infected animals
  • Ebola is not spread through the air or by water, or in general, by food. However, in Africa, Ebola may be spread as a result of handling bushmeat (wild animals hunted for food) and contact with infected bats. There is no evidence that mosquitos or other insects can transmit Ebola virus. Only mammals (for example, humans, bats, monkeys, and apes) have shown the ability to become infected with and spread Ebola virus.
Healthcare providers caring for Ebola patients and the family and friends in close contact with Ebola patients are at the highest risk of getting sick because they may come in contact with infected blood or body fluids of sick patients.
During outbreaks of Ebola, the disease can spread quickly within healthcare settings (such as a clinic or hospital). Exposure to Ebola can occur in healthcare settings where hospital staff are not wearing appropriate protective equipment, including masks, gowns, and gloves and eye protection.
Dedicated medical equipment (preferable disposable, when possible) should be used by healthcare personnel providing patient care. Proper cleaning and disposal of instruments, such as needles and syringes, is also important. If instruments are not disposable, they must be sterilized before being used again. Without adequate sterilization of the instruments, virus transmission can continue and amplify an outbreak.
Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. People who recover from Ebola are advised to abstain from sex or use condoms for 3 months.

 Other information regarding the disease:

WHO information regarding Ebola much like the CDC information page on the disease, but with more links to research and worldwide prevention measures.

Case counts in the West African Outbreak 2014 (can link to info about other outbreaks from here)

Visual of the spread of Ebola

Great set of articles from the BBC regarding the West African Outbreak of 2014, they describe the treatment centers, have stories from survivors and descriptions of the disease, how to protect yourself etc.

It really does not seem that Airport Screening will have much effect other than inconveniencing travelers from those countries:


  1. Ebola Guidance for Airlines | Quarantine | CDC

    www.cdc.gov/.../air...
    United States Centers for Disease Control and Preve...
    Oct 2, 2014 - Interim Guidance about Ebola Infection for Airline Crews, Cleaning ... This rule applies to all flights of U.S. airlines, and to direct flights (no ...
  2. WHO | WHO: Air travel is low-risk for Ebola transmission

    www.who.int/mediacentre/.../ebola-travel/en/
    World Health Organization
    Aug 14, 2014 - WHO today reiterated its position that the risk of transmission of Ebola virus disease during air travel remains low.
  3. WHO | West Africa - Ebola virus disease

    www.who.int/ith/updates/20140421/en/
    World Health Organization
    Apr 21, 2014 - 2014 Ebola Virus Disease (EVD) outbreak in West Africa. Travel and transport risk assessment: Recommendations for public health .... procedures recommended by the International Air Transport Association (IATA):.
  4. What is the risk of catching Ebola on a plane? - CNN.com

    www.cnn.com/2014/07/31/travel/ebola-planes-air-travel/
    CNN
    Jul 31, 2014 - Deadly diseases like Ebola are only a plane ride away. In today's interconnected world, linked by transoceanic flights, one infected person can ...



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