There’s something rather human about being scared of the ebola virus. It’s a “bogeyman” virus – the stuff of nightmares; hovering in the shadows of our imagination like a half-glimpsed specter. Like most imagined horrors though, the reality of ebola is much more mundane.
The latest episode of Risk Bites takes a look at five things worth knowing about ebola that help demystify the virus:
Useful links to additional information:
- University of Michigan School of Public Health Ebola topic page
- University of Michigan Risk Science Center Ebola articles
- New York Times Ebola facts
- SciShow: What You Need to Know About Ebola (video)
- Centers for Disease Control and Prevention Ebola resources
- National Library of Medicine Ebola Outbreak 2014: Information Resources
Updated 10/23/14, 11:03 AM
Hi Dr Maynard,
I was wondering if you see patients at all? You know— hands on examination. What we do know is this disease has a capacity to kill caregivers and healthcare professionals not to mention the patients being cared for. There is a possibility of transmission in the air with this particular strain. That concerns me especially in a hospital setting when an infection can be passed to others. Hospitals without the BSL 4 patient containment seem to be transferring their ICU patients to other hospitals as it seems to be labor intensive to take care of just one patient in an ICU setting. Maybe this will be just a blip on the radar or it could be something more serious for the American healthcare system which has evolved into more of a business than what it was intended to be. Time will tell. The saddest thing is what it has done to those in Africa.
Hi Nancy – I’m a PhD, not an MD, and so don’t see patients. As you rightly point out, Ebola is a serious issue for caregivers, especially in the later stages of the disease. However, there is no evidence to my knowledge that airborne transmission is an issue with this outbreak – the indications are that infection transmission in medical facilities is associated with intimate exposure to bodily fluids. This is also supported by the low (zero I think in the US at the moment) rates of transmission to close friends and family.
I agree that the the greatest challenge and the biggest challenge is what is still occurring in West Africa – this is certainly where I would suggest our concern and our efforts are needed to contain the disease and save lives.
Hi Dr Maynard,
Thanks for responding. I also agree that the situation in West Africa is going to be challenging in regards to controlling this epidemic. While epidemics have been controlled in Africa previously, this seems to be quite different in that it occurred in 3 countries which have porous borders and now has spread to the US. I believe that the real heroes are those healthcare workers on the front lines who really don’t have the technology that the United States has. Their courage and dedication have been exceptional. They are truly laying down their lives for their brothers. I believe much more must be done for these West African nations. I am concerned that the vaccines and antiviral therapy (in animal studies and initiating Phase 1 studies) may be expedited such a way that these precious people are used in studies without proper ethical restraints. We do know that plasma from those infected seems to have helped the ebola patients here in the US.
The epidemic strain is also very concerning to me. Mike Osterholm MD at the Center for Infectious Disease Research and Policy at the University of Minnesota has said on C span that he has had discussions with Gary Kobinger head of Special Pathogens at the University of Manitoba. Dr Kobinger has studied this current strain from West Africa and said that this strain is worse than any strain seen before and may be likely to spread by aerosols than strains which scientists have previously encountered.
Dr Peter Jahrling at NIAID who apparently discovered the Reston strain has studied patients from Liberia. He thinks that this West African strain is much more contagious. His studies have suggested that these patients have a much higher viral load in the blood. There is also the fact that the virus is shed in semen for a significant period of time.
Meryl Nass MD who is an expert on Anthrax and bioweapons has pointed out that the CDC has just issued a new poster in regard to droplets and particles. She also pointed out on her blog, Anthrax vaccines, that a paper in JID Feb 1999 that 5 Ebola patients in Kikwit outbreak has no physical contact to explain transmission and suggests other mechanisms. Dr Nass has also pointed out the study at USAMRIID by Zumbrun et al in regard to the development of a murine model for Ebola virus infection.
While we do know some things, we don’t know everything about this strain of ebola. While Africans have been dealing with Ebola for some time, we may have to learn some things day to day. In my career I have learned to be cautious in what I know to be true and what I don’t know. I have told medical students that the day a doctor makes a comment in regard to knowing it all, that ‘s the day they become a dangerous doctor.
God bless you. Thanks for allowing me to share.