Ebola: The Facts

I've heard a lot of people talking about the Ebola outbreak in Africa, worrying about such an outbreak happening here in the United States.  My gut reaction is that we are basically safe due to our health care system and standard safety practices, but sometimes a gut reaction is wrong.  So I did some research as to what we know about Ebola.

In the beginning...Ebola first appear in 1976 in two outbreaks:  one in Sudan and one in the Democratic Republic of the Congo next to the Ebola river, hence the name.  Scientists believe that local fruit bats are carriers of the virus, and that it jumped from the fruit bats to humans through careless handling of dead fruit bats or dead animals who were bitten by the fruit bats.

Transmission Vectors Transmission vectors are the ways and methods which a virus uses to travel from one host to another.  Some viruses trigger coughing and sneezing, using the air as a transmission vector to travel.  The Ebola virus relies on bodily fluids to infect a new host.  These fluids include blood, saliva, sweat, semen, and other secretions.  In fact, a man may carry the virus in his semen for almost two months after recovering. In layman's terms, you need direct contact an infected host's fluids to get the infection.  That means either touching an infected person, an infected animal, or an object that contains a fluid, such as sweaty sheets. You CANNOT get the Ebola virus through:

1. Air

2. Water 

3. Casual contact (e.g. walking next to someone)

4. Food grown or legally purchased in the U.S.
   

The DangerWhy are we so worried about Ebola, unlike the common cold or a host of other viruses?  Because Ebola is almost certainly deadly for people who don't get any treatment, and averages about a 50% death rate for people who do get treatment.  Actually, the range is 20% - 90% for various outbreaks over the years.  Still, that means a person with Ebola in the hospital still has a 1 in 2 chance of dying.

SymptomsThe Ebola virus starts out like any other viral infection, first you get a fever with muscle aches.  It then ramps up to one or more of these possibilities:

1. Headache

2. Vomiting

3. Diarrhea

4. Stomach pain

5. Unexplained bleeding or bruising

6. Rash

7. Internal and external bleeding, e.g. bleeding gums or bloody stools

8. Symptoms of limited liver and kidney functions, such as swelling of the hands, feet, or legs; shortness of breath; weakness; confusion,...

9. Low platelet count, low white blood cell counts, and elevated liver enzymes in lab work

Symptoms appear anywhere between 2 and 21 days after exposure to the virus.  If a person remains symptom-free after 21 days, he does not have the Ebola virus.  Also, a person is not contagious until he develops symptoms.  

Why We Shouldn't WorryDespite the fact that two nurses in Dallas contracted the Ebola virus, generally speaking it is not easy for a person to contract this disease due to the limited transmission vectors, unlike the 1908 flu which spread through the air.  Plus, a person needs to be showing symptoms to be contagious, unlike Fifths Disease where a person is contagious until symptoms appear.   We already have procedures in place in all healthcare environments to eliminate contact with another person's bodily fluids.  These procedures began in the 1980s in response to the AIDS epidemic, and have continued since. The real reason there is an Ebola outbreak in Africa lies in their handling of dead bodies and the deliberate denial of the problem by local governments.  It is tradition to wash a dead body to prepare it for burial.  Sadly, the washers are the ones who contract Ebola and then pass it on to other people.  Because the local governments deny any problem, people are unaware that a simple fever and muscle aches can turn into something much worse, leading people to ignore the first symptoms. In the United States, we tend to err on the side of caution.  In most hospitals outside of Dallas, if a patient shows up in the E.R. after being in Africa with symptoms that might be Ebola, that person is immediately put into quarantine and watched. So calm down and carry on.  The Ebola virus might be running rampant in Africa, but we are safe.