By now you’ve read the headlines, maybe watched the press conference, and likely have Googled “Ebola.” Yesterday, September 30, the Center for Disease Control and Prevention (CDC) announced that a patient tested positive for the Ebola virus right here in the metroplex.
And suddenly we all had a lot of questions we wanted answered . . . now.
While all the facts surrounding this patient are unknown, we Fort Worth Moms Blog mamas, like you, want to know how we can keep our families and our communities safe. A Fort Worth infectious disease specialist, Dr. Bryan Youree with Tarrant County Infectious Disease Associates, graciously discussed with us the ins and outs of Ebola–its symptoms, treatment, and how the virus is transmitted. His comments and insights were too informative, too timely not to share with you, dear readers.
So, without further ado, a note about Ebola from Dr. Youree:
A patient was diagnosed with Ebola virus disease (EVD) at a hospital in Dallas, Texas. A lot remains unknown at this point, and information will trickle out slowly. However, it is crucial to highlight some important facts. What started out as an exotic illness in far away Africa earlier this year has suddenly become more of an acute concern with the first diagnosis of an Ebola case in the United States.
The World Health Organization (WHO) first announced an outbreak of Ebola hemorrhagic fever in Guinea on March 25, 2014. The ensuing months demonstrated the ferocity and tenacity of this viral illness as it spread to multiple countries in West Africa including Guinea, Liberia, Nigeria, Senegal, and Sierra Leone. In the interim, a second, unrelated outbreak occurred in the Democratic Republic of Congo beginning in August. According to the most recent CDC data, there have been a total of 6,574 cases with 3,091 deaths. These numbers are frightening to be sure, but the total number of cases may be underestimated as resources are limited to perform adequate screening. The actual mortality rate cannot be determined at this time until more surveillance studies can be performed.
Traditionally, Ebola virus disease has been associated with mortality rates up to 90 percent. There are many factors that contribute to this such as limited medical resources, delay in initiating supportive care, and secondary illnesses that be present at the same time. However, it is not unfair to say that Ebola is a very lethal disease.
We now know that the infected person traveled to the United States from West Africa and did not become ill until after arriving stateside. The patient went to the emergency department once and was discharged home before returning and being admitted after it was discovered he or she had traveled from West Africa. At this time, we have limited information on potential contacts that were exposed. However, the United States does have experience with other cases of viral hemorrhagic fever as well as another member of the Ebola family that is not pathogenic to humans (Reston virus). Therefore, one should be assured that every precaution is being taken by the CDC, local health departments, as well as the medical facility treating the patient.
I would like to point some important facts about the Ebola virus to prevent the spread of misinformation.
1. Ebola is not infectious like influenza or SARS, which is a good thing. It is not an airborne virus. You literally have to come in contact with body fluids (vomit, diarrhea, mucus, blood, sweat, saliva, tears, and urine) and then rub your eyes, mouth, or a break in skin to become infected.
2. Ebola is not spread through the air, water, or mosquitos. The food supply is unlikely to be a vector as well.
3. Ebola can survive on dry surfaces such as countertops and door knobs for several hours, but can be killed with household bleach. The virus can survive much longer in body fluids.
4. Symptoms of Ebola include fever greater than 101.5 F, severe headache, weakness, muscle aches, diarrhea, vomiting, abdominal pain, and easy bruising and bleeding. Symptoms can appear anywhere from 2-21 days after exposure, and a person is infectious only after symptoms begin.
5. Although vaccines and treatments are in development, the principles of care for Ebola are primarily supportive: IV fluids, maintaining oxygenation and blood pressures, and addressing secondary infections.
6. The healthcare system in the United States is more adequately prepared to care for Ebola. Many cultural practices and limited healthcare resources have led to the spread of Ebola in West Africa. These conditions don’t exist in the same manner here and likelihood of virus spread in the United State is much lower. Senegal and Nigeria have already halted spread of cases that came from the affected area of West Africa.
7. Due to more healthcare resources, the mortality rate of Ebola would likely be much lower here in the United States. This is not to imply that it is not a serious viral infection.
9. Lastly, for some perspective, the CDC estimates that between 1976 and 2007, an average of 6,309 deaths occurred annually in the United States as a direct result from influenza while an average of 23,607 influenza-associated deaths, meaning deaths due to other illnesses/complications from influenza or in conjunction with the flu, occur annually (48,614 occurring in the 2003-2004 influenza season). In reality, Americans are more likely to die from influenza than Ebola.
Bryan Youree, MD, is an infectious disease physician with the Tarrant County Infectious Disease Associates in Fort Worth, Texas. He has worked in the infectious disease field for nine years. He attended Baylor College of Medicine and completed his post-graduate training at Vanderbilt University Medical Center. He served on faculty there before joining the Fort Worth practice.