c2014, Vicki Hinze

c2014, Vicki Hinze

We’re not docs, and we don’t have a week or a month to sift through the data and find out what we need to know about Ebola.  We want the facts—quickly.  So here are the fast facts:

Ebola Virus Disease (EVD) has been around since 1976. This outbreak started in March 2014 in two separate outbreaks that occurred simultaneously in Sudan and the Congo in a village near the Ebola River. It spread to Guinea, then to Sierra Leone and Liberia. One air traveler took it to Nigeria and one traveller to Senegal. One air traveller brought it to the United States.

At the time of this writing, there are active cases in the U.S. (Not including the doc and nurse who first returned with it.) More cases are, unfortunately, expected.

• The news cameraman (who contracted it and returned to the U.S. with his crew). The crew was placed under “self-quarantine.” One crew member voluntarily broke the quarantine in New Jersey over the weekend (10/11 – 10/12) by going to her “favorite soup place.”
• The initial traveller who brought it to the U.S. has now died. (He had no fever when entering the U.S. so would not have been quarantined on arriving into the country. No symptoms were yet present.)
• A nurse who cared for the initial traveller during his second visit to the hospital, while wearing full gear (gown, shield, gloves, etc. as required by the CDC [Center for Disease Control]), has tested positive for EVD.
• A second nurse has tested positive for EVD.

Multiple sources agree Health Care Workers often contract the disease from EVD patients due to increased exposure in caring for their patients and handling their specimens (blood, etc.).

How is EVD transmitted? 

• By eating infected animals (fruit bats, chimps, gorillas, forest antelope and porcupines) or direct contact with their bodies.
• Absorbing infection through the eyes, mouth, nose or other orifices.
• Infected fluids absorbed or ingested.
• Touching infected surfaces (i.e. bedding, handrails, etc.).
• Direct contact with broken skin and mucous membranes (someone infected sneezes and you inhale it).
• Burying the dead (direct contact with the body of the person who died from the disease).
• After exposure, the EVD incubation period is 2 days to 21 days.

What are the EVD symptoms? 

• First:  Fever, fatigue, muscle pain, sore throat and headache.
• Second:  Vomiting, diarrhea, rash.
• Third:  Impaired liver and/or kidney function.
• Sometimes but not always:  internal and external bleeding (blood in stool or bleeding gums).

The CDC says people aren’t infectious until they spike a fever or show symptoms.

How long are people infectious?

The World Health Organization says they’re infectious “as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.”

What is the treatment?

There is no proven treatment.  Hydration (IV fluids) and treating symptoms is what we have. There are potential treatments being studied, and two potential vaccines being tested. None are yet licensed.

The doc first returned to the U.S. with EVD was given an experimental medicine and he survived. There is no more of that experimental drug at this time—and no word of producing more through public channels could be found at the time of this writing.

Right now,  what’s being reported?

• Those knowingly exposed to EVD, self-monitor, taking their temps several times a day.
• If they spike a fever, they’re to report to the hospital, where they’ll be isolated for the incubation period and tested for EVD.
• Incubation time is 2 to 21 days. It’s recommended to call ahead and let the hospital know you’re coming, and that you’ve been directly exposed or suspect that you might have been exposed to EVD.

Twenty-Four countries have stopped incoming flights from the infected countries. The U.S. is not among them.

The reason cited is that the CDC wouldn’t be able to get health care workers and supplies in.  Frankly, that rationale fails the truth test. Military flights and charter flights could be used, and only commercial flights stopped. Especially considering 10,000 new cases per week are expected in Africa through the end of the year.

The CDC and some infectious disease experts expect that there will be more cases of EVD in the U.S.

One medical expert said the best we can do to protect ourselves now is to wash our hands frequently.  The virus does survive on surfaces for a period of time. How long? Answers range from two hours to they can’t say definitively.

In looking back to 1976 at case fatalities, the range is from 41% to 100%. Many are 80-100%, and many countries have been infected multiple times (i.e. Democratic Republic of Congo in 1976, 1977, 1995, 2007, 2008, 2012.)

I wondered why the long span between 1977 and 1995 with no outbreaks in the Congo.  The fatality rate in 1977 was 100%. In 1995, the fatality rate was 81%. One deduction is that there was no one in 1977, and then far fewer survivors in 1995, to transmit EVD—until it was reintroduced and inhabitants were re-infected.

These are the things I considered important to know.  For more information, visit the World Health Organization, Center for Disease Control, and Wikipedia websites. *

Blessings,

Vicki