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HealthOctober 30, 2014

Ebola myths and facts

Separate fact from fiction on the origins, transmission, symptoms, and treatments for Ebola.

While the hysteria over Ebola has largely died down now that the virus has been contained in the U.S., there is always the chance that someone else could bring another case here from overseas.

Ebola virus disease (EVD), formerly known as Ebola hemorrhagic fever, is a severe, often fatal illness in humans. The Ebola virus first appeared in 1976 in two simultaneous outbreaks, one in Nzara, Sudan, and the other in Yambuku, Democratic Republic of Congo. The latter occurred in a village near the Ebola River, from which the disease takes its name. The current outbreak in West Africa (first cases notified in December 2013) is the largest and most complex Ebola outbreak since the Ebola virus was first discovered.

The virus is transmitted to people from wild animals via close contact with the blood, secretions, organs, or other bodily fluids of infected animals such as chimpanzees, gorillas, fruit bats, monkeys, forest antelope, and porcupines found ill or dead in the rainforest.

Ebola then spreads through human-to-human transmission via direct contact (through broken skin or mucous membranes) with the blood, secretions, organs, sweat, or other bodily fluids of infected people, and with surfaces and materials (bedding, clothing) contaminated with these fluids, which can remain infectious for at least several days

Nurses and other healthcare workers in West Africa have frequently been infected while treating patients with Ebola. In some cases infection control precautions were not strictly practiced, but in most instances in American facilities and top African facilities, it was contact with an individual who was not yet showing or reporting signs and symptoms that caused physicians to become infected.

The incubation period—the time interval from infection with the virus to onset of symptoms—is two to 21 days. Humans are not infectious until they develop symptoms. First symptoms are the sudden onset of fever, fatigue, muscle pain, headache, and sore throat. This is followed by vomiting, diarrhea, rash, symptoms of impaired kidney and liver function, and in some cases, both internal and external bleeding (oozing from the gums, blood in the stools). Death occurs from overwhelming shock. Laboratory findings include low white blood cell and platelet counts and elevated liver enzymes.

Community engagement is the key to successfully controlling outbreaks, the World Health Organization suggests. Effective outbreak control relies on applying multifaceted interventions, including case management, surveillance and contact tracing, a good laboratory service, safe burials, and social mobilization.

Before jumping to conclusions, carefully consider the following myths circulating about Ebola:

Myth: You cannot contract the virus from a deceased person.

Fact: After a person dies, the body remains contagious.  Therefore, when dealing with the body to prepare for a funeral, handlers must exercise great caution. Only personnel trained in handling infected human remains and wearing recommended personal protective equipment should touch or move any remains that contain Ebola virus.

Myth: The Ebola virus is airborne.

Fact: The virus is spread through bodily fluids—it is not airborne.

Myth: The Ebola virus is not sexually transmitted.

Fact: The Ebola virus is passed through the exchange of bodily fluids, and this includes semen. It also includes saliva, so even safe sex is not safe in terms of Ebola.

Myth: A person who has recovered from the Ebola virus is still infected, and can spread the disease.

Fact: Only people exhibiting Ebola symptoms currently can pass on the virus through casual contact.  Sexual transmission is known to occur for up to 3-months post-infection. Lactating mothers may also transmit infection for a limited time.

Myth: There is a cure to the Ebola virus.

Fact: While there has been a multitude of research dedicated to finding medicinal solutions to Ebola, and some isolated incidents of success, no cure has yet been found. Early supportive care with rehydration and symptomatic treatment improves survival. There is as yet no licensed treatment proven to neutralize the virus, but a range of blood, immunological and drug therapies are under development.

Myth: People can get vaccinated against Ebola.

Fact: There are currently no licensed Ebola vaccines, but two potential candidates are undergoing evaluation.

Is your facility prepared to handle a patient with Ebola? Tell us which steps have been taken so far.

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