Deadly Ebola Outbreak 'Very Unlikely' to Reach United States

For many Americans, their familiarity with the Ebola virus may only go as far as having seen the Dustin Hoffman movie Outbreak. While the virus has so far been confined to West Africa, more than 700 people have died from the disease and there are growing concerns that this novel strain of the deadly virus could find its way across the ocean to the US.

To help you answer questions from concerned patients, here is a look at 10 things you should know about this outbreak of Ebola:

1. Ebola made a dramatic debut in 1976 when 318 people reportedly contracted the disease in Zaire, also known as the Democratic Republic of Congo. According to the US Centers for Disease Control, 280 of those infected patients (88%) died. It was believed at that time that the disease was spread by close contact with infected people and the use of contaminated needles and syringes in the country’s hospitals and clinics. A similar virus in Sudan infected 284 people that year, with 151 patients dying as a result of infection.

2. From 1976 until 1995 there were only a handful of cases reported, including 52 in Gabon in 1994. The next large outbreak occurred the following year in Zaire, with 315 reported infections and 250 reported deaths.

3. Up until this year the largest reported outbreak was between 2000 and 2001, when 425 people contracted the Sudan virus in Uganda. Thanks to advances in treatment there were only 224 deaths. Some of the infections were the result of people attending funerals for people with Ebola, close contact with patients, and providing care to patients without proper protection.

4. Since March of 2014 Guinea, Liberia, and Sierra Leone have reported an astonishing 814 cases and the death toll and cause of the current outbreak is still being determined.

5. Symptoms of the virus include headache, joint and muscle aches, weakness, stomach issues, and a lack of appetite. Other possible signs of infection include a rash, red eyes, and difficulty breathing and swallowing. The CDC reports symptoms usually appear 2-21 days after exposure, with most patients becoming ill within 8-10 days.

6. The virus is most commonly spread through direct contact between an infected and non-infected person, particularly when caring for an ill relative or through exposure to contaminated needles and other medical equipment.

7. In 2005, the CDC issued guidance for doctors in the United States who may have come in contact with infected patients in this country. At that time patients were considered to be in three risk categories:

• Patients who within three weeks prior to seeking treatment had travelled to a place where the virus had been reported to infect other people
• Patients who had direct unprotected contact with blood, bodily fluids, secretions or excretions of a person or animal with the disease
• Patients who had possible exposure to the virus when working in a lab that might have had the virus under investigation.

“The likelihood of acquiring VHF is considered low in person who do not meet any of these criteria,” the guidance noted. “Even following travel to areas where VHF has occurred, persons with fever are more likely to have infectious diseases other than VHF (eg, common respiratory viruses, endemic infections such as malaria or typhoid fever.)

8. Fully effective treatments for the virus are still being developed. Current methods include balancing a patient’s fluids and electrolytes, maintaining oxygen and blood pressure, and treating any complications that arise as a result of the infection. The CDC has estimated that the mortality rate for this strain of Ebola is around 60%, which is a significant improvement from previous outbreaks when the rate had been close to 90%.

9. Several international organizations have mobilized their resources since the outbreak.

• The World Health Organization (WHO) has sent experts into the infected countries to provide assistance and assist with proper patient care. The WHO is also working to train locals on how to reach out to neighbors and identify other cases of Ebola in their community.
• According to a USA Today story, the Peace Corps has begun the process of removing more than 300 volunteers from the affected nations after two were exposed to the virus. The story noted that the two were exposed to a patient who died from the virus but had not yet shown symptoms themselves.

10. Some Americans have already been infected by the virus, but there are no reports of them bringing the virus back to this country.

• One American has reportedly died of the virus according to a Reuters story. Patrick Sawyer, who had served as a consultant for the Liberian finance ministry died after collapsing at an airport in Lagos. As a result of Sawyer’s death and being ill at the airport as well as other concerns Nigeria’s Arik Air suspended flights to Liberia and Sierra Leone.
• Kent Brantly, 33, a doctor working for Samaritan’s Purse has reportedly contracted the virus after treating patients in Monrovia. He had been in the country since October according to CNN.
• Nancy Writebol, personnel coordinator for Serving in Mission has also tested positive for the virus according to CNN. She has been living in Liberia since last August.
• One of the most noteworthy deaths of this outbreak has been Sheik Humarr Khan, who was considered one of the foremost experts on the virus.

Although several Americans have contracted the virus overseas, the CDC reported in a press briefing that the chances of the outbreak spreading to the US are small.

“I want to underscore that Ebola poses little risk to the US General population,” said Stephan Monroe, director of the CDC’s National Center for Emerging Zoonotic and Infectious Diseases. “Transmission is through direct contact of bodily fluids of an infected person or exposure to objects like needles that have been contaminated with infected secretions. Individuals who are not symptomatic are not contagious.”

“Epidemics of disease are often followed by epidemics of fear and epidemics of stigma,” Marty Cetron, MD, director of the CDC’s Division of Global Migration and Quarantine was quoted by CNN. “All of these things occur in a social context that can make containment very challenging.”

Cetron also added that even if a patient with Ebola had boarded a plane to fly to the United States the chances of spreading the virus to other patients were also “very unlikely,” as it is spread through “direct contact with blood, secretions, or other body fluids of ill people, and indirect contact — for example with needles and other things that may be contaminated with these fluids.”