What is Ebola?
Ebola Virus Disease is caused by a virus. It is one of several hemorrhagic fever infections. Other viruses that cause hemorrhagic fevers include Yellow Fever or Dengue. Ebola Virus Disease typically starts with high fever, extreme weakness, muscle aches and headaches. It very often progresses to severe vomiting, diarrhea, liver and kidney damage and shock (dangerously low blood pressure) or even hemorrhage (bleeding) in some patients. The mortality rate of this disease is historically 50-90%. The death rate for this current outbreak is about 55%. There are no medications that effectively kill the Ebola virus. Experimental treatments are just that at this point – experimental. None has been scientifically evaluated yet. Because proven anti-viral medications are not available for the Ebola virus, the mainstay of treatment focuses on supporting patients as their bodies fight the infection. This is best done in intensive care settings where doctors can maintain blood pressure at normal limits, manage bleeding complications and keep electrolytes within range.
How do infections spread?
All infections are spread slightly differently. Some are spread by contact, like staph infections including MRSA. Others are only spread by blood or reproductive fluids, like HIV. Some infections are spread by the bite of mosquitoes or other insects. Many viruses like those that cause the common cold are spread into the air in droplets when someone coughs or sneezes. These droplets cannot travel far in the air, but can remain on surfaces for about 8 hours. They can be transmitted if another person inhales the germs or touches contaminated surfaces and then rubs their eyes, nose, or mouth. Some germs like the chickenpox virus or tuberculosis bacteria are very small and can float in the air for long distances. This is called airborne transmission and is one of the most contagious ways infections are spread.
How is Ebola transmitted?
The Ebola virus is transferred by direct contact through body fluids, including blood, vomit, feces, saliva, and reproductive fluids. Although droplets of these fluids may spread into the air, they quickly fall to the ground, usually within about 3 feet. Ebola virus is not spread by airborne transmission. Fortunately, unlike many other diseases, patients with Ebola do not appear to be contagious until they develop symptoms, making it easier to identify patients and take precautions.
What if Ebola made its way to Utah?
Isolating sick patients from healthy people, avoiding contact with these fluids, wearing protective gowns, gloves and other barriers can substantially decrease the spread of Ebola and many other diseases. Many of these precautions are standard in healthcare facilities in the United States. At Intermountain Medical Center is one of the nation's premier Level I Trauma Centers, a comprehensive infection control program is in place starting from the moment patients enter the hospital until they are discharged. In addition to standard precautions, more intensive precautions are routinely followed for patients suspected of being at high risk of transmitting some very serious infections. The hospital has several negative pressure isolation rooms, which keep airborne pathogens from being forced out of the room as air flow is impacted by a door opening and closing. Although Ebola virus is not transmitted through the air, these types of rooms and other advanced precautions are available to control the spread of infection.
Earlier this week, KSL 5 News visited the Emergency Department and walked through many of the protocols and resources it has in place to help curb the spread of infectious diseases. I invite you to check out those news stories.
Ebola in West Africa
Having recently worked in a very busy rural hospital in West Africa, I believe that one of the reasons the Ebola outbreak has been difficult to control is because of lack of resources to implement precautions that are standard in the United States. Awareness of the disease and how it is transmitted is also challenging in some parts of the world where cultural beliefs about disease are much different. Unfortunately intensive care treatment in developing countries like Sierra Leone and Liberia is not readily available, also contributing to high mortality rates.
How can I learn more?Getting accurate information is important. Up to date information on Ebola virus is available on the Centers for Disease Control website.