How Ebola spreads
While health officials are casting a wide net to find people who may have been around the Ebola patient now hospitalized in Dallas, they’re also stressing that it takes close contact to really be at risk.
WHEN IS EBOLA CONTAGIOUS?
Only when someone is showing symptoms, which can start with vague symptoms including a fever, flu-like body aches and abdominal pain, and then vomiting and diarrhea.
HOW DOES EBOLA SPREAD?
Through close contact with a symptomatic person’s bodily fluids, such as blood, sweat, vomit, feces, urine, saliva or semen. Those fluids must have an entry point, like a cut or scrape or someone touching the nose, mouth or eyes with contaminated hands, or being splashed. That’s why health care workers wear protective gloves and other equipment.
WHAT ABOUT MORE CASUAL CONTACT?
Ebola isn’t airborne. “If you sit next to someone on the bus, you’re not exposed,” said Dr. Tom Frieden, director of the Centers for Disease Control and Prevention.
“This is not like flu. It’s not like measles, not like the common cold. It’s not as spreadable, it’s not as infectious as those conditions,” he added.
HOW IS IT CLEANED UP?
The CDC says bleach and other hospital disinfectants kill it.
Source: Associated Press
Area hospitals and health departments are taking extra steps to protect against a possible outbreak of Ebola following the first confirmed case in the United States, diagnosed at Texas Health Presbyterian Hospital in Dallas earlier this week.
At Miami Valley Hospital, patients who come in with flu-like symptoms similar to signs of the Ebola virus are required to fill out a questionnaire or screening tool to determine whether they recently traveled to West Africa, where a more than six-month-long outbreak of the deadly virus has claimed thousands of lives.
The first question on the questionnaire asks if the person has traveled to West Africa in the past 21 days — the incubation period for Ebola, which is spread by direct contact with infected bodily fluids but is only contagious after physical symptoms, such as vomiting and diarrhea, emerge.
“If you have been screened and identified as having recently gone to West Africa…we would then take the next step with these patients,” said Dr. Darin Pangalangan, an emergency department physician at Miami Valley.
The next step would include isolation, often in “negative pressure” rooms, which have ventilation systems designed to allow air to flow into the room but not escape from room to room.
In addition to environmental control measures, doctors, nurses and and other staff members engaged in treating the patient are required to wear personal protective gear, such as gloves, masks, eye protection and gowns to prevent the possible spread of infection.
“We practice these universal precautions for any infectious diseases,” Dr. Pangalangan said, noting that the same procedures were used recently to treat patients with suspected cases of Middle East respiratory syndrome or MERS and SARS, otherwise known as Severe acute respiratory syndrome. “While (Ebola) is the the one that we’re worried about today, the precautions really are the same.”
Such control and containment measures are the main reasons why the likelihood of having to deal with an Ebola outbreak in the Miami Valley is remote, although an Ebola infected traveler could still land in Ohio, especially since the FAA has yet to issue any travel restrictions related to the virus.
“We have the same risk here as as any other community with an international airport,” said Bill Wharton, a spokesman for Public Health- Dayton & Montgomery County.
Thomas Eric Duncan — the 42-year-old Liberian citizen who was diagnosed with Ebola on Tuesday, days after arriving in Texas to visit family — boarded a plane from Africa. Although he was screened for Ebola, Liberian officials are investigating whether he lied about having previously come in contact with an Ebola victim before boarding the plane.
Even if the same scenario played out here, health care workers have been put on high alert and are ready to respond quickly.
Butler County Health Commissioner Dr. Robert Lerer said public health officials in all 88 counties in Ohio remain up to date on infectious diseases and how to prevent epidemics through containment and quarantines.
Lerer said in a state-wide conference just last week, Ohio’s county and city public health officials discussed epidemic containment in light of the Ebola virus hitting Texas, as well as recent outbreaks of mumps and measles in Ohio.
“We’ve been prepared for outbreaks and epidemics for decades,” Lerer said.
Lerer said in order to contain the spread of these viruses, all family members and close contacts to the infected person are identified, interviewed and examined.
About 80 people have been quarantined or are being monitored after coming into contact with Duncan or one of his family members before he was hospitalized.
Lerer said any additional Ebola cases in the U.S. would likely come from someone who’s traveled from Liberia, Sierra Leone, Senegal, or Guinea. He said currently, passengers leaving Africa are “quizzed about possible exposure and symptoms,” including fever, diarrhea and vomiting.
“We have a sizable local population who have family, business, or missionary links to these African countries, so we must remain watchful and ready to tackle the next epidemic, be it yearly seasonal influenza, measles, mumps or Ebola,” Lerer said.
At Mercy Health – Fairfield Hospital, officials in the emergency department are “geared up” should the need arise, officials said.
“We’re already asking patients when they arrive, have they traveled from Africa recently,” said Kara Smith, nurse manager in the emergency department. “I think we’re very safe here; it’s an isolated situation the CDC is on top of.”
The Centers for Disease Control and Prevention has sent out guidelines for managing patients with known or suspected cases of Ebola to state health departments, which have disseminated the guidelines to local health departments and hospitals across the country.
“While Ebola does not pose a significant risk to Ohio residents, ODH is urging health care providers and hospitals to step up their preparedness efforts given the Texas Ebola case,” reads a statement from the Ohio Department of Health.
In addition to hospitals, Clark County Health Commissioner Charles Patterson said his office has spread the word to doctors’ offices and the staff at medical clinics and urgent care facilities to be as thorough as possible.
“Our medical system is informed about this and taking even greater steps to make sure that if a patient presents (Ebola symptoms) they will handle them in the appropriate manner, basically, so we don’t have a screw-up like what happened in Dallas,” Patterson said.
Patterson was referring to Duncan, who told hospital officials of his travel from West Africa, and twice visited Texas Health Presbyterian complaining of fever and stomach pain before he was admitted.
If Duncan had developed symptoms in his hometown of Monrovia, chances are he would have been turned away from the closest hospital and possibly died because health care workers there don’t have the same numbers, equipment or infrastructure as doctors in America to screen and treat Ebola patients, according to Edwin Dunbar, a Liberian national who has friends and relatives in the Dayton area.
Dunbar said so many patients, nurses and health workers have died in the government hospitals that health care workers refuse to come to work. And there aren’t enough isolation and treatment centers set up by foreign aid workers to help battle the disease.
“The problem is we do not have enough treatment centers,” Dunbar said in an interview with this newspaper via Skype.
U.S., British and French aid workers are frantically building more treatment centers to prop up the broken health system, “but they are overwhelmed, and so they have to turn a lot of people away,” said Dunbar, who is national director of the Great Commission Movement of Liberia.
People are still becoming infected and dying of Ebola everyday, Dunbar said, leading him and his family to stay indoors as much as possible to avoid interacting with large crowds.
He also has stocked up on medicines, including antibiotics and cold remedies, to protect himself and his family from other common illnesses in the region, such as malaria and typhoid fever, which would require trips to the hospital.
“When our children get ill, we try to keep them well and eating properly so that their immune systems can remain strong, because once we are weak with a cold or malaria in this area there is no hospital to go to for treatment,” he said.
They also try to maintain the best hygiene they can despite a lack of running water and a prevalence of Ebola contaminated waste.
But basic supplies, such as hand sanitizer and chlorine bleach, are hard to come by Dunbar said.
Community groups across the country have begun to offer help, including the Dayton Sister City Committee, whose only African sister city is Monrovia.
Subcommittee Chairman and Dayton resident Boikai Twe said his group has contacted the Greater Dayton Area Hospital Association about gathering supplies from association members to send to Monrovia.
“We’re still in the early stages of developing this partnership, but we talked with GADAHA, and they wanted to know what some of the basic needs are,” Twe said. “We’re trying to put together a list of specific supplies, and then will go back.
“But that’s just the first step. The next hurdle will be how do we get these supplies to Monrovia,” he said. “Sometimes it’s not that difficult to collect supplies, but getting them to Monrovia can be a challenge.”
About the Author