Ebola: What You Should Know

The deadly Ebola virus is on the move in the West African nations of Guinea, Sierra Leone, Liberia and Nigeria (see outbreak map.) As of August 7, CDC reports the outbreak has infected over 1,700 people and claimed the lives of more than 900. Ebola Hemorrhagic Fever – the formal name of the disease – first appeared in 1976 in Sudan and the Democratic Republic of Congo. The virus was introduced to humans through close contact with the organs, blood, and other bodily fluids of infected animals, such as chimpanzees, gorillas, fruit bats and monkeys.

Ebola has closed schools in Liberia and prompted the president of Sierra Leone to quarantine affected neighborhoods and conduct house to house searches for people who might have been exposed to the virus. What should you know about Ebola?

Important Facts about Ebola1

  • Ebola becomes contagious only when symptoms appear in infected people. It is NOT contagious in an individual without symptoms.
  • Symptoms of Ebola include: fever, headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, lack of appetite and abnormal bleeding.
  • Symptoms may appear anytime from two to 21 days after exposure to the virus; most commonly, symptoms appear between eight and ten days after exposure to the virus.
  • Ebola infections are fatal up to 90 percent of the time.
  • Transmission of the Ebola virus is through direct contact with bodily fluids2 of an infected individual or through exposure to objects like needles that have been contaminated with infected bodily fluids. Based on a 2012 experiment in which Ebola was spread from pigs to monkeys without direct contact between them, CDC and the World Health Organization (WHO) are also concerned about the potential for limited airborne transmission.
  • Ebola is not transmitted from contaminated food or water.
  • Although researchers are working on vaccines, as of now there are no medicines or vaccines to cure Ebola. However, a highly experimental serum, “ZMapp,” a monoclonal antibody, is showing promising results in reversing the course of the disease (see CNN Health report).

The Role of Infection Control

CDC Information for Travelers

On July 31, CDC issued a “Level 3” alert to avoid nonessential travel to Guinea, Sierra Leone and Liberia. A Level 3 alert protects travelers and limits their use of overburdened clinics and hospitals in outbreak-affected regions. Consult the CDC Ebola Hemorrhagic Fever webpage for updates on Ebola’s geographic spread.

Practice good hand hygiene, washing your hands frequently with soap and warm water for at least 20 seconds; if soap and water are unavailable, alcohol-based hand sanitizer may be used.

Because Ebola symptoms usually take between eight and ten days to appear, and early symptoms may be nonspecific, it is possible that the virus will continue to spread geographically by travelers from West Africa who do not know they are infected. That is why it is so important, according to the WHO, that healthcare workers “apply standard precautions consistently with all patients – regardless of their diagnosis – in all work practices at all times. These include basic hand hygiene, respiratory hygiene, the use of personal protective equipment (according to the risk of splashes or other contact with infected materials), safe injection practices and safe burial practices.”

WHO notes further measures for healthcare workers caring for patients with suspected or confirmed Ebola virus include avoiding exposure to the patient’s blood and body fluids and direct unprotected contact with the possibly contaminated environment. WHO provides explicit directions for preparing bleach solutions for disinfecting reusable equipment, gloved hands between patients, spills of infectious body fluids and more.

Halting the Outbreak

The World Health Organization documents 24 Ebola outbreaks between 1976 and 2012. Commenting on “the biggest and most complex Ebola outbreak in history,” CDC Director Tom Frieden, MD, MPH noted CDC would supplement its current staff of approximately 24 disease control experts in West Africa with 50 additional workers to assist efforts to prevent Ebola-infected people from boarding airplanes. In the event that a sick passenger does board a plane, CDC has issued guidance to airlines for managing ill passengers and crew and for disinfecting aircraft.

There is no question that in addition to CDC participation, this outbreak will require harnessing a strong global public health partnership among the nations of the world. It’s what we need to do to combat the Ebola killer.

Ralph Morris, MD, MPH, is a Physician and Preventive Medicine and Public Health official living in Bemidji, MN.

1 Based on CDC information at: http://www.cdc.gov/vhf/ebola/outbreaks/guinea/qa.html and World Health Organization information at: http://www.who.int/mediacentre/factsheets/fs103/en/
2 Bodily fluids that may transmit Ebola include blood, urine, stool, semen, saliva and sweat.