As we discuss the current Ebola virus outbreaks, it is critical that we avoid both panic and the spread of misinformation.
The case of Thomas Eric Duncan, the first diagnosed case of Ebola in the US, illustrated correctable problems. Communicating his travel history was essential. Also, Mr. Duncan was sent home the first time he visited the hospital despite giving a travel history of coming from Liberia. He was discharged and sent home with a fever. By the time he was admitted to the hospital four days later, he was in critical condition. His delay in receiving timely care very likely contributed to his demise. It is concerning that his care may have been impacted by his race and lacking health insurance. So far none of his 72 contacts have shown symptoms of the disease. However, there has been considerable stigmatization of the contacts and neighbors.
To date only two confirmed Ebola virus infection cases connected to Mr. Duncan are healthcare workers from the hospital that treated Mr. Duncan. The worker has only one known contact since she developed symptoms. The Centers for Disease Control and Prevention (CDC) and state public health department are involved in close monitoring of contacts and evaluating how the health worker became infected. Seventy-six people were involved in Mr Duncan’s care while he was in the hospital. So far only one worker has been diagnosed with Ebola. Contrast this to the many West African healthcare workers who have died due to their work with Ebola patients.
The scale up has begun to bring healthcare workers, resources and facilities upgrades to Guinea, Liberia and Sierra Leone. It will take a sustained international effort to gain control of the current outbreaks. There is urgent concern that the speed of the scale up needs to increase as infections in West Africa continue to double every several weeks. At the same time US hospitals, healthcare workers and the CDC continue to work on policies and procedures to safely treat people in the US with Ebola, as well as, to limit the spread of Ebola. We have been fortunate in the US that Ebola cases have been limited to six people.
Here are some important things to know about Ebola:
1) Direct contact with an Ebola virus infected person’s body fluids is the primary way to get Ebola. Crucially, determining who is at risk for Ebola requires taking a travel history in addition to evaluating them for symptoms.
2) We should be mindful of the members of our communities that have family and friends living in the impacted areas in Liberia, Sierra Leone, Guinea and the Democratic Republic of the Congo (DRC). People living in the Ebola outbreak areas are at a higher risk for infection due to a fragile medical infrastructure and lack of resources.
3) We can assist our West and Central African family, friends and neighbors by continue to press for timely and accurate news about Ebola virus outbreaks. Media and public attention will continue to encourage global public health organizations, governments and NGOs to continue the scale up of volunteer healthcare workers, supplies and facilities to stem the outbreak.
4) Evidenced-based information is critical. Social media such as Twitter is a rapid way to access expert information and conversations on Ebola. For example, the National Science & Technology News Service (NSTNS, of which I am a member) recently hosted an Ebola Twitter chat with Professor A.O. Fuller, a virus expert from the University of Michigan. There are a host of Ebola virus related hashtags with very good information. It is critical to avoid sources that claim that Ebola is a hoax, a conspiracy or isn’t real without any basis.
5)Ebola virus disease (EVD) is an infection that causes bleeding, vomiting, diarrhea and fever. These conditions are referred to as hemorrhagic fever. Importantly, people infected with Ebola virus are not contagious until they experience EVD symptoms. The virus overwhelms the immune systems and causes blood vessels to become leaky, which causes severe dehydration and bleeding. Amounts of virus sufficient to transmit to other people are found in the body only once a person has symptoms such as fever. Ebola can be contracted by direct contact with a patient’s blood, vomit, diarrhea, saliva and sweat. Ebola is not airborne – so one cannot catch it by casual contact alone.
6) Infectious disease experts have been studying Ebola since it was first discovered in the first recorded outbreak in 1976 in Zaire, which is now known as the Democratic Republic of the Congo. The virus was named for the Ebola River, which is near the where the first infections occurred. Bats and apes carry Ebola virus, Ebola can be transmitted to humans that eat “bush meat” (e.g., bats, small rodents and apes), other foods or materials contaminated by infected animals. Also deforestation and mining in Guinea, Liberia and Sierra Leone have brought humans in closer contact with animal sources of the virus.
7) In person-to-person infections, family caregivers and healthcare providers are at higher risk to contract Ebola virus. Taking care of symptomatic patients increases the risk of coming into contact with bodily fluids containing high levels of Ebola virus. Appropriate safety equipment and carefully following safety protocols is the best way to protect healthcare workers while caring for patients.
8) Frequent hand-washing and disinfecting surfaces are also important in areas experiencing an outbreak and routine care of Ebola patients. There are several experimental treatments for Ebola that have been used on a limited basis. Primary treatment includes giving fluids, blood transfusion and antibiotics if a patient develops a bacterial infection.
9) Current Ebola virus outbreaks are rapidly spreading in Liberia and Sierra Leone because of the lingering damage done during the civil wars from 1983-2005. Complicating the response to the outbreak has been fragile regional economies, partially destroyed infrastructure and a shortage of physicians and nurses. Many available clinics and hospitals lacked basic personal protection equipment like gloves, goggle, masks and gowns, as well as limited running water and electrical power. Government organizations and NGOs working in these areas have been overwhelmed as the numbers of patients have outstripped available treatment beds and healthcare workers.
Ebola is real. Our response to stop Ebola will depend upon continued advocacy for health equity for all.
Find more evidence-based Ebola information here:
- Partners in Health
- Doctors without Borders/MSF
- Ebola Survival Fund
Caleph B. Wilson, Ph.D. is a full time biomedical researcher, science communicator and STEM outreach advocate. Follow him on Twitter as @HeyDrWilson