Wikipedia/CDC
Ebola is huge news these days and as of today it has killed over 961 people in four countries. Needless to say people are talking about it constantly, including this very blog. But how much of this information is accurate? I'm no doctor, but I have been reading about this particular disease for many years. I'm a layman, but an educated one. Of course, if you think you have the disease, SEE A DOCTOR! Now that that is out of the way I'm going to go through some of the myths and misinformation I have been reading lately. It's going to be in a Q&A format, so lets get started.
I heard that Ebola is an airborne virus/Ebola can only be transmitted through contact with bodily fluids. Which is true?
These two side by side myths are related so I will handle them at once. Both of these statements are mostly true. Both of them are also very misleading. How is that possible? Easy. People don't know what they are talking about. As far as I understand Ebola doesn't qualify as a airborne virus. It isn't like the cold or the flu, you can't get it if someone coughed in the same building as you 10 hours ago. But it isn't like other blood-borne diseases like Rabies or HIV either. If someone with Ebola coughs in your face, you have a chance at catching the disease. How? By aerosol. What is that? Small droplets of liquid suspended in the air. Is it proven that Ebola can spread this way? In the lab, yes. Two studies demonstrated that if the virus is in an aerosol it can survive long enough to infect primates. In the second experiment pigs were infected with the disease and were able to spread the disease to caged monkeys that had no physical contact with the pigs.
Sounds horrifying right? That must mean the disease is fully airborne right? No. These were perfect laboratory conditions and in the real world it doesn't seem that Ebola is quite as hardy as it was suggested. I am sure that under the right conditions the virus could spread this way but Ebola has a lot working against it here. Ebola isn't a respiratory disease so it doesn't cause you to cough or sneeze, which is a great way to create and aerosol for the virus. Ebola does cause vomiting and diarrhea but that rarely results in
aerosols. I am somewhat concerned at the possibility of flushing toilets spreading disease because that has proven to spread viruses and bacteria into the air but I am hoping at that point the patient would already be in treatment. A contained place like an airplane or subway car could spread the disease via the air, but I still don't like Ebola's chances in that scenario. Bodily fluids are much more dangerous.
So to recap, Ebola can become airborne under prefect conditions, but those conditions are rare. Contact with bodily fluids is and will always be the main way the disease spreads. Claiming that it's either a fully airborne virus or can only be spread by contact with fluids however is misleading and dangerous. The first scenario causes undo panic and the second causes people to take risks they shouldn't.
Is Ebola in my country? I just heard about a guy that got sick!
The media has been doing a terrible job at covering this disease. Every time someone gets off of a flight and then keels over the media has had a field day. They have reported people in Canada, America, England, Brazil, Morocco, and Scotland and none of them ended up having the disease. As of right now only four countries have the disease for sure. Those four countries are Sierra Leon, Liberia, Guinea and Nigeria. Two other countries have brought patients home, the United States and Spain, but no one new has gotten sick in those countries yet. Until you hear a news report saying "we have a medically confirmed case of Ebola" any report saying that they have an Ebola patient is just rumor-mongering and hysteria.
I'm sure some would argue that the people have a right to know as soon as possible if there might be Ebola in their country so they can take precautions. Everyone already knows about the disease, so they should be taking precautions anyways. Wash your hands. Don't touch people who look sick. Don't clean up blood or vomit without taking precautions. That's good advice during any period of time, so we don't need to hype up every suspected case. Wait until confirmation before freaking out.
Was it a good idea to bring back patients infected with the disease?
Depends on your point of view. Humanitarians want these people to come home because they have a much better chance of surviving in a western hospital then they do in a barely functional African one. The more cynical among us say that the chances of survival don't outweigh the risks of spreading the disease. It's a hard call either way. In the case of the two Americans that were infected I would say the risk was mitigated by the fact that they had received a new experimental treatment. There is, of course, still a chance that they could infect others, but the data the doctors can gather from them could save many lives. As for the Spanish case, I'd lean towards not supporting it. There is no experimental treatment so bringing the patient there is probably a bad idea. Tough call either way though.
Was this a bio-attack?
Absolutely not. This is a rumor that is going around in several circles, including the tired and true conspiracy crowd. Ebola can and has been weaponized, but this outbreak has none of the hallmarks of a bio-terror attack. A bio-terror attack would have occurred in a large city right away. That would maximize the number of initial infections. This outbreak started in the villages and towns and worked it's way to larger cities. Also, we would have seen thousands of cases right off of the bat instead of the slow dribble of cases that eventually built up some momentum. Instead of an instant inferno we have a slow burn. This is NOT a bio-terror attack.
What are the chances of the outbreak spreading here?
Depends on where here is. If you are in a first world country there is a real chance of a mini-outbreak. It would probably be small and mostly effect health care workers, family members and a few poor people who happen to be very unlucky. The health care system should largely be able to isolate people and handle the outbreak quickly. There is a very, VERY small chance that an outbreak could spread out of control but i just don't see it happening in countries with modern healthcare.
If you are in the third world, I would be considerably more concerned. The health care systems in many third world countries are terrible and overwhelmed easily. Many of these countries have the same kinds of superstitions and paranoia about their governments that the western African countries have.
Still in either case, if airport and other customs agents are doing their jobs it should be rather difficult for the virus to spread. People that show symptoms should not be allowed to board flights. The only reason the disease spread to Nigeria is because the patient was asymptomatic when he boarded the flight and only displayed symptoms, and became infectious, when he was in the air already. That can and will happen again, but it should be a very rare event.
What are the best and worst case scenarios?
The best case scenario is that the disease comes under control in the next month or so and does not spread to other countries. This is very possible. The four countries involved are treating this very seriously and are getting international help. The worst case scenario isn't nearly as bad as people want to make it out to be. This won't be a new Black Death or Spanish Flu. If it does become a global disease it will only largely be a problem for third world countries. It will be a disease of poverty but governments will be able to react to it. The real impact will be economic and political in nature. We could stop the spread of the virus today if we just banned air travel but that would have huge economic costs and could lead to civil unrest. The same thing could happen if we have to start isolating people and setting up quarantine camps. That's what really worries me about the virus. We don't need another global recession or any more unrest, the world is quite chaotic enough as it is.
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