What you need to know about Ebola

Christina Silcox, PhD

Updated 2014

With the Ebola situation changing daily, here’s what you need to know to stay safe.

WHAT IS EBOLA?

Ebola (scientific name: Zaire Ebolavirus) is a deadly virus that is spread through direct contact with the bodily fluids of a person who already has symptoms of the disease. Death is generally caused by massive organ failure. There is a 30%-50% chance of survival.

WHAT ARE THE SYMPTOMS?

Ebola starts as severe flu-like symptoms: a high fever, weakness, vomiting and diarrhea. Sneezing and coughing are not common symptoms of Ebola.

As the person becomes sicker, he or she may start bleeding from the eyes, ears and nose, as well as internally. This bleeding means the body no longer has enough blood to pump through the body and the person’s blood pressure drops. As a result, the person’s organs start to fail. If not successfully treated, death usually occurs within 2 weeks after the high fever begins.

HOW DOES EBOLA SPREAD?

Ebola is spread through direct human contact with body fluids, not by merely touching a person who is sick. A sick person’s blood or other bodily fluids need to pass into another person’s body through the eyes, nose, mouth or cuts or abrasions in the skin.  Ebola cannot be caught by breathing the same air as an infected person, sitting near them, or by shaking hands.

IF I AM AROUND AN INFECTED PERSON, AM I GOING TO GET SICK?

People who have Ebola but aren’t yet showing symptoms do not spread the virus. Even after a person has a fever, bleeding, or other symptoms, they won’t spread the Ebola virus unless their blood, mucus, vomit, feces, sweat, tears, breast milk, urine, or semen get inside a cut or other opening in another person’s body (such as getting it on one’s hands and then touching their mouth).

It’s reassuring that none of the friends or family that lived with the Liberian Ebola patient in Texas became ill, nor has anyone who visited him before he went to the hospital.  Since friends and family were not wearing the protective gear worn by hospital workers, this shows that the early stages of Ebola are not very contagious, even after the patient has already shown some symptoms.

An Ebola patient is much more likely to infect others as the disease progresses and he or she becomes very sick, and the amount of Ebola virus in the patient’s body greatly increases.  At that point, many patients are bleeding or vomiting, which also makes it easier to spread.  That is why healthcare workers treating patients with or suspected of having Ebola need to take extensive precautions, using gloves and covering their entire bodies with what look like space suits so they can’t accidentally touch a patient’s bodily fluids and then touch their mouth or eye.  Only two of the dozens of nurses and doctors who came in contact with the Liberian patient with Ebola in Texas became ill.

MY FAMILY MEMBER IS A HEALTHCARE WORKER. SHOULD I BE WORRIED?

Unless your family member is caring for Ebola patients, you don’t need to worry.  If your family member is treating Ebola patients, or patients that might have Ebola, they need to be trained how to use and remove protective gear and to follow directions exactly in order to protect themselves. The CDC and the Department of Defense has also committed to sending a “rapid-response” team of experts to any hospital that admits a patient with Ebola to help with logistics and training.1

HOW LONG AFTER A PERSON IS INFECTED WILL THEY GET SICK?

A person will start to get sick between 2 and 21 days after he or she is infected by an Ebola patient who is already showing symptoms of the disease.  The 21 days has already ended for the friends and family members of the Liberian Ebola patient in Texas, and none of them became ill.

CAN ANIMALS GET OR SPREAD EBOLA?

Experts believe that fruit bats spread the disease to humans in Africa.  When pigs, horses, and goats have been infected in experimental studies, they did not get seriously ill and did not spread the disease.

There have been no reports of dogs or cats getting sick with or spreading the Ebola virus, on the African continent or any other continent.  In previous Ebola outbreaks, dogs have been exposed to Ebola and have developed antibodies to it, but have not gotten sick.

There is no evidence that mosquitoes or other insects can transmit Ebola virus.2

HOW LONG DOES THE VIRUS LIVE OUTSIDE THE BODY?

The Ebola virus can live for several days outside the body in blood or other body fluids. However, once the fluid dries, the virus will only survive a couple of hours and then will no longer be dangerous. Bleach and other hospital-grade disinfectants will kill Ebola, as will careful incineration at high temperatures.

WHAT IS THE TREATMENT?

Currently, there is no known cure for Ebola. Only 30%-50% of people who have been infected with this strain of Ebola have survived.

However, Ebola patients treated in the United States have had much better outcomes. This is likely due to several reasons:

1. The healthier the patient is when they get infected, the more likely they are to survive.

2. Hospitals in the United States have more medical personnel and supplies. When a patient is admitted to a hospital in the United Sates and diagnosed with Ebola, blood pressure and blood oxygen levels are carefully monitored and maintained. It is especially important to make sure the patient doesn’t get dehydrated, so patients are given specially-formulated drinks, IV fluids and blood transfusions as needed. This helps to keep the patients alive and healthy long enough for their immune system to fight off the virus.

3. Most patients in the United States have been given one or more experimental treatments. However, it is impossible to know at this time if the experimental treatments were what cured them. Paul Farmer, an infectious disease specialist, explains that “if patients are promptly diagnosed and receive aggressive supportive care – including fluid resuscitation, electrolyte replacement and blood products – the great majority, as many as 90 per cent, should survive.”

WHAT ABOUT EXPERIMENTAL TREATMENTS?

Experimental treatments and vaccines are being used for a small number of patients, but we do not know how effective they are.  Some patients have survived after getting experimental treatments, but others have died.

An experimental drug called ZMapp made headlines when three American health workers who got Ebola while treating patients in Liberia were treated with it. Although it had only been tested on a small number of monkeys and never in humans, the FDA allowed it to be used on these patients through a special humanitarian policy for people in urgent need of treatment.  Of the 7 patients who are reported to have gotten ZMapp, 5 survived and 2 died. It is impossible to know if the drug worked or if those patients would have lived even without the experimental treatment. As of August, the company that makes ZMapp has said they do not have any more of the drug and it takes a long time to manufacture. The US government has announced it will pay millions of dollars to several advanced laboratories to start producing it.

Another experimental drug named TKM-Ebola, which is still being studied to determine if it is safe or effective, has also been used to treat some patients. Two vaccines are also in development.

Another treatment is made from antibodies in the blood of people who have survived Ebola. Nicknamed “gold in the blood”, there is no conclusive proof that it works. However, several small experiments have shown the treatment has promise and the World Health Organization (WHO) has endorsed its use during this epidemic.  It has been used by at least one of the Texas nurses who got sick.

 

  1. href=”http://www.cdc.gov/media/releases/2014/t1014-ebola-reponse-update.html”>http://www.cdc.gov/media/releases/2014/t1014-Ebola-reponse-update.html  
  2. href=”http://www.cdc.gov/vhf/ebola/transmission/qas-pets.html”>http://www.cdc.gov/vhf/Ebola/transmission/qas-pets.html; href=”http://well.blogs.nytimes.com/2014/10/17/do-mosquitoes-spread-ebola/?ref=health”>http://well.blogs.nytimes.com/2014/10/17/do-mosquitoes-spread-ebola/?ref=health