Media reports detailing the ongoing outbreak of Ebola virus disease, or EVD, in west Africa have caused a lot of anxiety among viewers and readers, many of whom are unfamiliar with the disease process for Ebola, how it spreads and their risk for contracting the virus.
Recently, a hospital in North Carolina temporarily closed a portion of its emergency department to isolate a patient who workers thought might have Ebola virus disease. That case turned out to be a false alarm — the patient most likely had malaria and has since been discharged home — but highlighted the fear many Americans have that the Ebola outbreak might spread stateside.
To bring residents in west Georgia and east Alabama up to speed on what they need to know about the Ebola outbreak, Tanner Health System has prepared the following four facts that residents concerned about the virus should know.On July 31, the World Health Organization (WHO) reported that the death toll in the west African Ebola outbreak has risen to 729 out of more than 1,300 confirmed or suspected cases, and the U.S. Centers for Disease Control and Prevention (CDC) issued a travel warning for the region, discouraging Americans from traveling to the affected nations of Guinea, Liberia and Sierra Leone. (Nigeria, which is not included in the travel warning, has had a single suspected Ebola death.)
1. There’s almost no risk of anyone in west Georgia or east Alabama contracting the disease.
According to Rajesh Mathew, MD, a board-certified infectious disease specialist with Infectious Disease Specialists of West Georgia, part of Tanner Medical Group, the actual process through which the disease spreads makes it unlikely that it would move widely through the region.
“Ebola is transmitted through direct contact with bodily fluids from infected, symptomatic people,” said Dr. Mathew. “For instance, you could ride a bus sitting right next to a person with Ebola, and as long as you did not come into contact with his or her body, blood, vomit, etc., you’d be fine.”
In the regions of Africa where the virus has spread, however, contact with bodily fluids from infected individuals is more common. Funeral services are often conducted by families and villages, for instance, rather than professional mortuaries, and the bodies of the dead are washed and handled extensively by loved ones with no protective protocols.
The CDC and other organizations are also working to prevent people infected with Ebola from leaving west Africa, helping with active screening efforts on the ground to prevent sick travelers from getting on planes. Part of this effort includes taking the temperature of airline passengers, since fever is one of the earliest symptoms of Ebola infection. People who are not symptomatic of Ebola are not contagious.
Even should a passenger slip through the screening process and board a flight, the CDC has implemented protocols to protect against further spread of the virus. Airlines have been directed to notify the CDC of ill passengers, so that the CDC can investigate the likelihood that a given passenger might have Ebola virus disease and prepare, if necessary, to quarantine the passenger before the plane even touches down at its destination.
2. The Ebola-infected patients brought to Atlanta for care are American, and they have been brought to one of only four facilities in the nation best equipped to care for the disease.
Emory University Hospital in Atlanta has, in partnership with the CDC, committed to admitting and providing care for two American aid workers from Liberia who have contracted the virus. The infected aid workers consist of a doctor and a missionary.
“While every hospital has plans to deal with an outbreak, the particular kind of facility where these patients will receive care is a specially designed isolation unit, and there are not many like it in the world,” said Laura Larson, MD, a board-certified infectious disease specialist with Infectious Disease Specialists of West Georgia and medical director of infection prevention for Tanner Health System. “In fact, there are only three others like it in the United States.”
Relocating the Ebola-infected patients to Atlanta is a reflection of the metro region’s role as an emerging destination for biomedical research. The region boasts two state research institutions — Georgia State University and the Georgia Institute of Technology — and two medical schools, at Emory University and Morehouse College. The city also hosts the headquarters for the CDC.
Because of the strict infection control precautions that type of isolation facility provides, there’s little risk of the disease spreading to the metro area.
“Healthcare workers can become infected with Ebola while treating patients if infection control precautions are not strictly followed,” said Dr. Larson. “This often happens in the field where maintaining these precautions is challenging. In this instance, the whole facility is designed for preventing the spread of infection.
3. Stopping the spread of the disease is the global community’s top priority.
There is no licensed vaccine for Ebola virus disease, though several potential vaccines are currently undergoing laboratory tests to evaluate their effectiveness and safety for clinical use.
Since the spread of the Ebola virus can’t be stopped through vaccination efforts, the disease must be contained geographically as much as possible. That’s the focus of the CDC’s travel warning and screening efforts on the ground.
Workers are currently going house to house in the affected countries to find and recover potentially infected individuals to limit exposure to their loved ones in the homes and villages. And though Ebola virus disease outbreaks have a case fatality rate of up to 90 percent, according to the WHO, healthcare workers are trying to save as many individuals as possible.
“Since Ebola is a virus, there’s not an antibiotic that we can administer to treat the disease,” said Dr. Mathew. “The focus on caring for someone with Ebola virus disease is intensive, supportive care. They need rehydration with solutions containing electrolytes to keep their organs — especially their kidneys — functioning, as well as medications to help relieve fever and pain.”
Ebola wreaks life-threatening havoc within the body by attacking multiple organ systems at the same time. Early diagnosis of the disease can improve outcomes, but that’s made difficult since the earliest symptoms of the disease — headache and fever — can be attributed to a large number of illnesses.
4. Ebola outbreaks happen with some regularity.
Though the ongoing outbreak in west Africa is the worst that has been seen since the virus was first discovered in 1976, outbreaks of the virus occur every few years.
In 2012, an outbreak in the Democratic Republic of Congo resulted in 57 cases, with 29 deaths. Two separate outbreaks that same year in Uganda produced 31 cases and yielded 21 deaths from the virus. In 2007, separate outbreaks in Uganda and the Democratic Republic of Congo resulted in 413 cases and 224 deaths. Sudan, Gabon, Congo and other nations also have reported cases since the 1970s.
“The current outbreak is bad,” said Tom Frieden, MD, director of the CDC. “It’s the biggest, the most complex, and the first time it’s been present in this region (of Africa).”
However, said the CDC director, an outbreak of Ebola in the United States is “not in the cards.”
To find an infectious disease specialist or another physician on staff at Tanner, call 770.214.CARE (2273). Infectious Disease Specialists of West Georgia, part of Tanner Medical Group, has locations serving Carrollton and Villa Rica. For more information about the practice online at www.InfectiousDiseaseSofWestGa.org. Infectious Diseases of West Georgia is the practice of Laura Larson, MD, and Rajesh Mathew, MD.