Dr. Rapp: Ebola Hemorrhagic Fever: Put Facts before Fear

*The fear of the Ebola hemorrhagic fever has gone worldwide and understandably so. There have been at least 319 deaths in Guinea,, 224 deaths in Sierra Leone, and 129 deaths in Liberia as of July 31^st.

The U.S. placed its second Ebola patient in an isolation ward at Atlanta’s Emory University hospital yesterday.  Spain is treating a priest with symptoms.   A man with symptoms of Ebola hemorrhagic fever who flew to Saudi Arabia 3 days ago from Sierra Leone has died today. The U.S. Centers for Disease Control have issued warnings to avoid nonessential travel to Liberia, Sierra Leone, and Guinea. Lastly, the International Civil Aviation Organization is considering passenger screenings.

Let us give attention to some facts before fear.

What is Ebola hemorrhagic fever (Ebola HF)?

Ebola hemorrhagic fever is one of many Viral Hemorrhagic Fevers.  It is a severe disease that has had mortality rates up to 90% during outbreaks according to the World Health Organization (WHO).  It first appeared in 1976, in 2 simultaneous outbreaks.  One was in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo near the Ebola River where it got its name.

It usually occurs near tropical rain forests in Central and West Africa, and there are five distinct species.   Three have caused large outbreaks in Africa. One species found in the People’s Republic of China and the Philippines can infect humans but has caused no reported illnesses or deaths.

How is it transmitted?

According to the CDC, it is believed that the first person in an outbreak contracts the disease through contact with an infected animal.  It is then transmitted from human to human, when broken skin or mucous membranes come in contact with blood, bodily secretions, or needles contaminated with infected bodily fluids.

The virus often spreads to family, friends and healthcare workers caring for the infected person, when they fail to wear masks, gowns, and gloves.  It is not food borne.  It is not water-borne.  It is not spread through the air.  It is not an airborne illness like the flu or colds.  Direct contact with blood or body fluids is required.

What are the symptoms?

The symptoms of Ebola HF can be found with many viral illnesses. These include but are not limited to:

Fever

Headache

Joint & Muscle Aches

Weakness

Abdominal Pain

Vomiting & Diarrhea

A Rash

Cough

Difficulty breathing

Sore Throat

Red Eyes

However, a unique finding with Ebola HF includes internal and external bleeding during the late stages.  If a person has no symptoms, they are not contagious.

How is it diagnosed?

After other more common diseases are ruled out, blood samples for antibody and serum testing are needed. Cell cultures are also done.

How is Ebola HF treated?

Therapy is supportive, meaning treatment is directed at symptoms. For example, dehydration is treated with fluid rehydration, addressing any electrolyte imbalances. Shortness of breath is treated with oxygen.   Testing is done to find treatable infections.

What is the risk of catching Ebola HF during airplane travel?

The CDC says it is very unlikely that an infected person could spread the disease to his/her fellow passengers. Flight crew members have been instructed to keep a person showing signs concerning for Ebola from other passengers, to wear disposable gloves, and provide the ill person with a surgical mask to protect others from fluids spread by coughing, talking or sneezing.

Is there a cure?

There is no cure and currently, there is no proven vaccine.  However, according to CNN, an experimental drug called ZMapp appears to have brought about major clinical improvement in 2 American missionary workers, one of whom was expected to die.   Also, the NIH has awarded a five-year, $28 million dollar grant to aid a collaboration of researchers from 15 institutions in their fight against the virus.  The NIH will also be starting a safety trial of an Ebola vaccine in September.

 How can the spread of Ebola HF be stopped?

Recognize the symptoms. Protect yourself with standard and droplet precautions when around people with symptoms of Ebola HF and avoid contact.  Practice good hygiene. The usual hospital disinfectants are reported to kill the virus on surfaces.   Avoid areas  where outbreaks are occurring.

What is the risk to Americans?

The risk to Americans is, to quote CNN, “relatively low.”  Airports and flight crews are on alert.  African airports in Ebola-affected regions are closely screening passengers.  U.S. health experts want the public to know that they not only know very well how Ebola HF functions, but also how to treat its symptoms, how to prevent it.  and have the resources  to do so.  The CDC, our hospital systems, and airports are well armed with knowledge and resources in the fight against Ebola, and we are now armed with the facts to fight our fears.