Infection Report 2: Ebola and you
© 2014 Roy Benaroch, MD
Ebola isn’t actually a new infection, but it’s pretty close: the first cases were reported in the 1970’s, in central Africa. Since then there have been several, relatively small outbreaks, typically beginning in communities with close contact with animals, sometimes with infections appearing in chimps or other primates before appearing in people. The infection itself rapidly causes severe disease, and has been associated with a fatality rate in the 50-70% range.
Symptoms begin 2-21 days after exposure, and typically include high fevers, aches and pains, diarrhea, and vomiting. More severe cases develop “hemorrhagic fever,” with bleeding under the skin and in the gut, followed by shock, cardiovascular collapse, and death. This infection is fast, and it is bad news.
But here’s the thing: unlike horrible epidemics portrayed in movies and novels, Ebola is not actually that easy to catch. A person with Ebola cannot spread the virus before symptoms appear—there is no “silent carriage.” You can ride in a planeload of people who have contracted Ebola, but until one of them actually has symptoms, they’re not contagious, and you’re not at risk. And since the symptoms themselves are not subtle, it is unlikely that someone with Ebola is quietly sitting next to you on a bus. Those people are going to head to the hospital, pronto.
And, even if that person is sitting next to you on the bus is sick with Ebola, you cannot catch Ebola unless you come in direct contact with body fluids: blood, bloody diarrhea, or vomit. Staying away from blood, bloody diarrhea, and vomit is a good idea, whether or not there’s any Ebola around.
Though there’s media panic brewing, containing Ebola in the United States is something we’re equipped to do. We’ve got a good public health infrastructure in place, and we’ve got hospitals equipped to handle infectious material from sick people. What we need to do most, here, is to stay aware of the possibility of Ebola in people who’ve recently been in west Africa, where Ebola cases have truly become epidemic (mostly Sierra Leone, Liberia, and Guinea.) If people who’ve lived or traveled to those areas become ill with fevers and other Ebola symptoms, they need to be treated, isolated, and tracked.
The problem, honestly, isn’t here. The problem is in west Africa, where there is no public health infrastructure, and no hospitals, and no way to protect families and communities from contact with Ebola. When someone gets sick, they stay home with their families, and they are spreading infectious fluids. It’s nearly impossible to clean up those homes or protect people. No gloves, no disposable sheets, no autoclaves, not even enough plastic body bags. It is truly a health disaster, and we need world governments to step up to help the people there—or this is going to spread throughout the developing world. And, of course, the more cases there, the more the risk here, as it becomes more difficult to identify people exposed to cases that might spread to an ever-widening area. Helping the people of west Africa overcome this epidemic is both a moral and public health imperative.
Unlike Ebola, which can’t spread in the air and is only being contracted by people in a limited area, there are far-more-common infections right here, right now, and one of those will end up sickening far more of us in the United States. Yet many of us won’t even bother to take one simple, safe step to prevent it. Want to do something that can really help keep your family safe this winter? Tune in tomorrow!
Next: an infection that kills thousands in the USA… and can be prevented.