Ebola Perspective
EBOLA. Just hearing the word brings about an "end of the world" type reaction from most people. In reality, it is not the end the world and humans, through our intellectual, scientific, resourceful and humanistic nature, we tend to always triumph. FYI, Ebola isn’t a new disease. It was first identified in 1976, but its viral family, the filovirus, was initially identified in 1967. The natural reservoir is small rodents, particularly bats, not primates or monkeys, unlike the somewhat sci-fi popular belief. As a matter of fact, Ebola is also equally fatal in these animals as it is in humans. The current outbreak is due to the Zaire species of Ebola which is the most deadly species. The overall mortality rate since Ebola’s elucidation has been 70%. People die of the viral hemorrhagic fever leading to severe hemorrhage and overwhelming sepsis. In the current West African outbreak (since March 2014), there have been over 8,000 reported cases of Ebola with an approximate 50% mortality rate. As you are well aware, Ebola has made its way to the United States and claimed the life of a Liberian traveler just two weeks ago. The CDC predicts that over one million citizens may be infected with Ebola by January 2015 if this trend continues. So the entire world needs to pull together to get a handle on this epidemic.
Knowledge is the most important factor in preparing ourselves. Signs and symptoms which include fever, headache, diarrhea, abdominal pain, muscular pain, vomiting, and unexplained bleeding or bruising, may appear anytime from 2 to 21 days after exposure to an infected person or object. The average time to the appearance of symptoms is eight to ten days following direct contact with the blood or bodily fluids of an infected person, or direct contact with contaminated objects, such as needles and syringes. Airborne transmission is an ineffective mode of transmission of the Ebola virus, however, there have been cases of aerosolized transmission in healthcare personnel while intubating infected patients.
The CDC has a prepared checklist and protocol for the steps necessary for hospitals to prepare themselves for the potential exposure to the Ebola virus. Some of the recommended steps for healthcare workers include: wearing of protective clothing (masks, gloves, gowns, boots, and eye protection), practicing proper infection control and sterilization measures, and isolation of patients with Ebola from other patients. Many of the additional steps necessary for hospitals and healthcare workers will also apply to the community at large and include: practicing careful and meticulous hand hygiene, avoiding handling items that may have come in contact with an infected person's blood or bodily fluids (clothing, bedding, medical equipment, needles, etc.), and the need to always notify health officials after any direct contact with blood or bodily fluids of a person infected with Ebola (including but not limited to feces, saliva, vomitus, urine, and semen).
Americans are calling for a travel ban for three African countries. It’s a natural response to want to isolate yourself from the problem. In my opinion, a travel ban is not the entire answer. We need to be able to allow aid workers, medical staff and other essential personnel into these countries to do their jobs. They need to be able to get the food and supplies they need to do their jobs. I think the best way to contain the Ebola outbreak is to make sure it doesn’t become widely spread to other countries through screening and containment methods, as well as treatment of individuals prior to the boarding of all commercial modes of travel, particularly airplanes. Perhaps the individuals coming from endemic areas should be contained for 21 days based on the incubation of the virus which ranges from 2 to 21 days. We need the scientists to continue working, tirelessly and expeditiously on the creation vaccines and treatments. Also, the various health care leaders and medical personnel need to continue to be educated on infection control, the recognition of the Ebola disease, and sharing the information with the general public.
Agree or disagree on how Ebola is being handled, Ebola has become "Primetime" and unfortunately we are on the "Late show". Now we need to pull together as a world community along with the CDC, WHO and other world health leaders, not only to keep Ebola contained and end this epidemic but to fully "wipe EBOLA from the face of the earth."
Philbert J. Ford, M.D.
