Thomas E. Duncan, the first person diagnosed with Ebola in the United States, died Wednesday, and fear of the virus continues to spread.
Mr. Duncan traveled from Liberia to Dallas in September and lied when he filled out a form about whether he had been exposed to anyone with Ebola in the past 21 days. Mr. Duncan arrived in the emergency room at Texas Health Presbyterian Hospital on Sept. 26 with a fever and abdominal pain, but was sent home soon after. “The information that he had traveled from Liberia, one of the nations at the heart of the Ebola epidemic, was overlooked,” the New York Times reported last week. Mr. Duncan returned to the hospital three days later, and tests confirmed that he had contracted Ebola.
The case has raised new worries about whether the virus could spread within the U.S. and whether hospitals were prepared to handle an outbreak. But what are the chances of a widespread outbreak of Ebola here in the United States? Highly unlikely, says Amira Roess, an assistant professor at the George Washington University's Department of Global Health. And as Ebola triggers panic throughout the world, it’s easy to overlook a much more common infection: the flu.
Dr. Roess sat down with George Washington Today to give the facts on Ebola and to discuss the symptoms, treatment and prevention of other infectious diseases.
Q: What is Ebola, and how is it spread?
A: Ebola is viral zoonotic disease—meaning that it can be transmitted from contact with animals that carry the virus. Once a person is infected with Ebola and shows symptoms then transmission from that sick person to others can occur through contact with bodily fluids.
Q: How can a person get Ebola?
A: Right now the only people at risk for Ebola are those with close contact to individuals infected with Ebola who are showing symptoms.
The virus is transmitted through direct contact with the blood or bodily fluids of an infected person. That’s why we are seeing household members who’ve taken care of someone with Ebola get sick. That is also why health care workers caring for Ebola patients are at greater risk for the disease. Using personal protective equipment greatly reduces the risk of transmission.
It is critical for those taking care of infected individuals to wear gloves and other protective gear to reduce their risk of becoming infected. It is also necessary to dispose of contaminated material appropriately to prevent further spread of Ebola.
Q: What are the symptoms of Ebola and can someone be contagious if they are not showing symptoms?
A: Symptoms include headache, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, lack of appetite and abnormal bleeding. Symptoms may appear anywhere from two to 21 days after exposure to the Ebola virus. Our experience is that individuals who are not showing symptoms cannot transmit the virus.
Q: How are people traveling from West African countries being screened? Do you think this is effective?
A: People traveling from West Africa may be screened at multiple points along their journey. In most airports in West Africa prior to boarding airplanes passengers are asked if they have had contact with people who have had Ebola or symptoms of Ebola and their temperature may be taken. Upon arrival in most airports passengers are asked the same questions, their temperature is taken and they are asked if they have experienced any of the symptoms of Ebola.
U.S. policy makers are in the process of considering other screening measures. Training of the personnel who conduct the screening is critical for these measures to be effective.
Q: In your opinion, should travel be banned to and from Ebola-stricken countries? Why or why not?
A: A travel ban to and from Ebola-stricken countries has not been implemented. At this point the risk of imported cases, especially with screening procedures in place, is low. Such a ban would likely lead to more harm and would further isolate affected countries, could cause further significant economic losses and could delay the delivery of health care workers, volunteers and supplies to affected regions.
Q: How do officials in the U.S. keep Ebola from spreading?
A: In the U.S., we have evidence-based protocols in place to address outbreaks and minimize their impact. These protocols have been used with success in the recent investigations of suspected Ebola cases. When a suspected case of Ebola is reported, health officials and responders generally will isolate the patient while providing care. They will test for the disease. While waiting for results contact tracing occurs. Close contacts of the patient are identified and if it is determined that there was exposure they may be quarantined for 21 days. Ebola patients are treated in special isolation units that are designed to minimize risk of virus transmission. Health care workers follow infection control practices and use personal protection equipment to reduce their risk of transmission.
Q: Does Ebola pose any significant health risk in the U.S.? Could it in the future?
A: At this point all local health departments and large hospitals are aware of the protocols for responding to and treating Ebola cases. The CDC and other federal agencies are working in conjunction with local health departments to ensure that they all know what to do when a suspected case of Ebola is reported. Contact tracing protocols, quarantine protocols and treatment protocols have been carefully prepared and widely disseminated. In the U.S., we have excellent infection control protocols for health care workers and this will continue to be critical for reducing the risk of transmission in the U.S.
In addition, the U.S. is actively engaged in the response in West Africa. By getting the outbreak under control there, we will greatly reduce the risk of imported cases here in the U.S. and elsewhere.
Q: Are there similarities between flu symptoms and Ebola symptoms?
A: In general the initial symptoms of Ebola are similar to those of flu—fever, muscle ache and headache. Recognizing travel risk factors and contact with people who have recently traveled from affected countries and symptoms is critical for initial differentiation between the two.
Q: Is influenza a greater threat to the GW community?
A: Most of us will not be coming into close contact with Ebola infected individuals and really our risk is greater for influenza than for Ebola. We have entered flu season and GW community members should take advantage of the free flu shot clinics. Remember also to practice good hand hygiene and to follow recommended cough etiquette to reduce transmission to others.
Q: What steps should a person be taking to reduce the risk of getting sick, from infectious diseases, including Ebola?
A: Hand hygiene is extremely important for reducing risk of infectious disease transmission. Remember to wash your hands for 20-30 seconds with soap (sing the happy birthday song twice). It is also important to maintain a healthy lifestyle, which includes eating well and getting adequate sleep. These basic practices can ensure that your immune system will be in the best state possible to fight off infectious diseases.
Colonial Community will offer free flu vaccines to all GW faculty and staff during the 2014 Open Enrollment Fairs in October. More information about dates and times can be found here.
Flu shots are also available at CVS Pharmacy, Rite-Aid Pharmacy, Target Pharmacy and Walgreens Pharmacy at no cost for faculty and staff who participate in any of GW's medical plans. This also includes your spouse/domestic partner and dependent children if they are covered under your GW health plan.
The Student Health Service will also hold flu clinics for GW students in October at the Mount Vernon and Foggy Bottom campuses.
