Understanding the Ebola Outbreak
I would guess that, by now, most people have at least a basic familiarity with Ebola, and if not, you've come to the right place. News bulletins and articles seem to be all over the Internet, radio and TV. So much so that this article would hardly seem necessary. I've been shocked and disturbed by the sensationalist and melodramatic coverage of the outbreak though. There is so much misinformation and misleading reporting out there that it's hard to get a solid understanding of it without some effort. Ebola is certainly a serious illness, but it is not a reason to stop talking to anyone who has been through Dallas or New York City for the past six months, nor is it a reason to cast suspicion on everyone who happens to sneeze or cough. For Americans, it is not a cause for panic. Hopefully, this article will be helpful in educating people about the disease so that they can better understand what's going on.
The first known case of Ebola occurred in 1976 in Zaire, now known as the Democratic Republic of Congo, when a man presenting high fever sought medical attention at a local hospital. Almost simultaneously, an outbreak occurred in Sudan. Between the two, over 600 people were infected Since then, the disease has broken out over 20 times, most of them in Africa. It is a type of filovirus, and there are four main strains: Zaire, Sudan, Bundibugyo and Tai Forest. There is a fifth strain known as Reston, but it does not appear to cause symptoms in humans. The current outbreak is of the Zaire strain.
When a person has Ebola, they go through a period of time where they are infected, but asymptomatic. This can last anywhere from 2 to 21 days from the initial infection. When symptoms do begin to appear, they begin with fever and body aches, progressing to include weakness, diarrhea, vomiting, and fatigue. Later symptoms can include abdominal pain, unexpected bleeding, internal hemorrhaging, and rarely external bleeding.
The cause of outbreaks is not known with certainty, but it is likely that these events begin when a person comes into contact with an infected animal, such as a bat. From there, transmission occurs from person to person. Transmission of the virus between humans requires direct contact while the person is exhibiting symptoms. If a person has come into contact with the illness, but has not yet begun showing symptoms, others cannot become infected from them. One person must come into physical contact with an infected person's blood or bodily fluids for the first person to become infected. It does not travel through the air. If you were to travel on a plane with an infected person, you would not get infected unless you touched them or their bodily fluids. If you were to pass an infected person on the street, or eat in a restaurant where an infected person was eating, you would not get infected unless you touched them. It is not spread by water, by air or by insects. Direct contact is the only method of transmission. Furthermore, once a person has recovered and stops showing symptoms, they can no longer infect others.
This does raise questions though of how the outbreak in Africa has become so severe if it is actually not so simple to transmit. The truth is that there are a number of factors which make Africa particularly vulnerable. The biggest is a lack of resources. Health care providers are at the highest risk during an outbreak of Ebola as they are regularly in direct contact with patients. Many facilities in Africa lack the protective gear that facilities in more developed regions have which would help to keep doctors and nurses safe. Disposable equipment is highly beneficial in preventing the spread of the disease as well, but is another resource which many facilities in the effected regions lack. For instance, single use, disposable bedding, clothing and dishware. Abundant access to needles, IV's and medicine. It is also extremely important to thoroughly sterilize anything which cannot simply be thrown away. In addition to being underfunded and understocked though, most of these facilities are also understaffed, making it difficult to ensure that things like sterilization are performed rigorously.
There is no readily available medicine or vaccine to protect against Ebola, though there are a number of experimental treatments still in testing. Zmapp made news when it was used early this year on two infected health care workers, both of whom survived. There is also a promising antiviral called Brincidofovir, which has been used on a few infected patients. Results for both of these are hopeful, but it's still too soon to tell. Perhaps the most hopeful treatment yet is the transfusion of blood plasma from Ebola survivors to the infected. The plasma contains antibodies which can help patients fight off the disease. This has been used in a number of cases with a high rate of survival, and is looked at by many doctors as the most sensible short term solution for those already infected.
For those not infected, prevention is key. Make sure to wash your hands regularly. Avoid direct contact with people that are sick. If you become sick seek medical attention promptly, and try not to come into contact with others. Avoid contact with bats and monkeys. Avoid traveling to infected regions of Africa. Also keep in mind that this is flu season, and both flu and Ebola share a number of early symptoms. Flu is much easier to contract and much more likely to be the culprit of sickness in America. It is also causes many more deaths every year than Ebola, averaging in at over 30,000 deaths a year. If you're concerned about getting sick, go get a flu shot. It's the most helpful thing that people can do right now to prevent the spread of illness and of panic.
To prevent the further spread of Ebola at a global level, the effected countries have instituted quarantine procedures, which appear to be helping. The CDC in America has instituted measures to deal with sick passengers entering the country. They are also closely monitoring any cases which appear on American soil. Medical personnel that come into contact with infected patients are subject to monitoring until they're out of the initial twenty-one day window. Thanks to these guidelines, only four cases of Ebola have been diagnosed in America. The first was a man named Thomas Eric Duncan who had traveled from Liberia to Dallas, Texas in order to visit family. Duncan went on to die from the illness. Two of the nurses who treated him went on to contract Ebola, Nina Pham and Amber Joy Vinson. Both have since recovered. The fourth case, in New York City, was a doctor names Craig Spencer who had just returned from Guinea, Africa after working with Doctors Without Borders. He also went on to recover.
As you can see from this, the risk of transmission in America is very low. Every person in America diagnosed with the disease was either traveling in Africa, or was in direct contact with an infected person. Furthermore, three of the four cases went on to recover. The risk of contracting Ebola is exceptionally low for the average American. That being said, if you are concerned, please consider donating to causes which are supporting the effort to end the outbreak in Africa. It has been devastating to many communities in Liberia, Guinea, Sierra Leone and Nigeria, and has impacted the availability of doctors, nurses and medical staff particularly hard. Consider donating to Doctors Without Borders, an international, independently run organization which sends doctors to areas in need around the world. They are working to contain Ebola, but they also work hard to help people everywhere with any pressing health concerns and they are invaluable to areas that lack advanced medical infrastructure. And, if you donate before December 2nd, Giving Tuesday, send an email to Felix Salmon at Slate Money including the details of your donation. He has pledged to match all donation made before then.
In conclusion, Ebola is a very serious illness. It has killed many people and devastated communities in Africa, but with proper medical care and governmental action, it can be contained and eradicated. It's a very minor threat to Americans which should be monitored with care, but not with panic.
If you're interested in learning more, or you're still afraid, I encourage you to check out some of these resources which explain Ebola's origins, it's biology and it's global effects expertly and in much more detail.
- Understanding Ebola by Stuff To Blow Your Mind (podcast)
- Ebola by Sawbones (podcast)
- The Hot Zone by Richard Preston (This is recommended with a grain of salt by Dr. Sidnee McElroy as interesting and educational, but also melodramatic, so keep that in mind)
- Ebola: The Natural and Human History of a Deadly Virus by David Quammen (Less dramatic book)
Also, if you're interested in helping the global effort to fight Ebola: