Mention Ebola and what you will elicit is fear from most people. And why not? It is a disease with a very high mortality rate and with no specific treatment available. More than 10,000 have been infected with Ebola and nearly half of them have died. The WHO has called it “the most severe public health emergency in modern times.” And the Philippines is particularly vulnerable as there are 1,700 Filipino workers in Liberia, Sierra Leone, and Guinea, plus more than 100 peacekeeping troops in Liberia. But fear can result from ignorance or the lack of accurate information about the virus and the disease.
Herewith are the common questions people ask about Ebola. The answers to these questions are also the most important information you need in order to avoid catching the Ebola virus.
Q. What is Ebola?
A. Ebola virus disease (EVD), Ebola hemorrhagic fever (EHF), or simply Ebola, is a disease caused by an Ebola virus that infects humans and other mammals. Fruit bats are believed to be the normal carrier in nature, able to spread the virus without getting infected. Humans become infected by contact with the bats or a living or dead animal that has been infected by bats. Once human infection occurs, the disease can spread between people as well.
Q. How is Ebola spread?
A. The Ebola virus is transmitted in the bodily fluids of people who are seriously ill, who are likely to be vomiting, bleeding or have diarrhea. Blood, feces, and vomitus are the most infectious fluids, and in the late stages of the disease, even tiny amounts can carry high loads of the virus. A person who got a patient’s blood on his/her hand, could wash it off with soap and water without any ill effects. He/she would become ill only if they had a cut or abrasion on their hand or touched their eyes, nose or mouth, which would allow the virus to enter their bodies through their body fluids.
Q. What are the symptoms?
A. It can take two to 21 days for symptoms to show, although usually it is five to seven days. It usually starts with a fever, sore throat, muscle pain, and headaches. Then, vomiting and diarrhea and rash usually follow, along with decreased function of the liver and kidneys. At this time, generally, some people begin to bleed both internally and externally. Death, if it occurs, is typically six to 16 days after symptoms appear and is often due to low blood pressure from fluid loss.
Q. What about sweat? Can I get Ebola, say, from gym equipment?
A. No. Nobody who had Ebola and was symptomatic with intense muscle weakness and a fever in the early stages would be well enough to go to the gym — and until they are symptomatic, they are not infectious. Sweat is probably not a source of large amounts of virus — in fact, the WHO (World Health Organization) says whole live virus has never been isolated from sweat.
Q. How about saliva?
A. The WHO states that only people who are very sick are able to spread Ebola in saliva. Tears may carry some risk, but the studies are inconclusive. The virus has been detected in breast milk.
Q. Can I get Ebola from a toilet seat?
A. Yes, feces from somebody with Ebola are a real hazard and the virus has also been detected in urine. But there would only be a danger if a seriously sick person had used the toilet and contaminated it, which is most likely to happen in the patient’s home or hospital. Public toilets, in general, are very unlikely to be a risk.
Q. Can it be sexually transmitted?
A. Ebola virus may be able to persist in the semen of survivors for up to seven weeks after recovery, which could give rise to infections via sexual intercourse. Some experts even say that the virus may last in the semen of people who have recovered for as long as 90 days.
Q. Can I catch Ebola from using a taxi that has taken a patient to the hospital? Or an airplane seat that has been used by an Ebola patient?
A. The virus can be transmitted on surfaces that body fluids have touched, so if somebody had bled or vomited on the seat, there could be a risk to anybody who had a cut or touched their face with their contaminated hands.
Q. Can I catch Ebola from door handles or telephones a patient had touched?
A. Yes, if the door handle or telephone was contaminated with blood, vomitus or feces, which would be more likely in the house where the patient had been living when he fell sick, or in the hospital. But if people have intact skin, do not touch their eyes, nose or mouth, and frequently wash their hands, they will not get infected.
Q. What can be done in schools or public places to prevent a spread of the virus?
A. There are strict decontamination procedures — as prescribed by WHO, US Center for Disease Control (CDC), and our own Department of Health. Any area that is visibly contaminated, where there is blood, vomitus or feces — and toilets and surfaces lots of people touch, such as door handles and telephones — must be wiped with disposable towels to remove any visible fluids, then cleaned with detergent or soap and water, and allowed to dry. Then they must be disinfected, for instance, with diluted bleach — one part bleach to four parts water. Those who do the cleaning must be fully covered, with long sleeved-shirts tucked into disposable gloves and trousers tucked into socks and closed shoes. Any cuts or abrasions must be covered with plaster, but there is no need to clean corridors or areas that the person has just passed through.
Q. How long can the virus survive?
A. The virus is quite fragile and is easily destroyed by UV light, drying out, high temperatures, and disinfectants, including soapy water and alcohol gel. The longest it is likely to survive is a few days, if left in a pool of bodily fluid in a cool, damp place.
Q. Is food safe?
A. Yes, if it is cooked. The Ebola virus is inactivated through cooking. Raw bush meat is a risk, however.
Q. Is Ebola virus airborne? Should I wear a mask?
A. No. The virus is not airborne, though some scientists believe it is. The UN Ebola Mission for Emergency Response says extensive studies of the virus have not shown any airborne transmission. Patients do not cough and sneeze a lot with this disease. In an advisory, WHO states, “Epidemiological data emerging from the outbreak are not consistent with the pattern of spread seen with airborne viruses, like those that cause measles and chickenpox, or the airborne bacterium that causes tuberculosis.”
Q. What if somebody coughs or sneezes in my face?
A. There is a theoretical possibility that a person heavily infected with Ebola could cough violently and send wet, heavy droplets into the face of somebody nearby. The person most at risk of catching Ebola this way would be whoever is nursing the patient, and they would hopefully be wearing protective clothing, including a mask.
Q. Are scanners the answer for detecting infected people entering the Philippines?
A. No. All that scanners can detect is raised body temperatures. That could be caused by a cold virus or a bacterial infection — or even non-infectious conditions. Every person with a raised temperature would then have to have a blood test for Ebola. The biggest issue is that people are likely to arrive in the days before symptoms show, so they will not have a high temperature and there is no way to know whether they are carrying the Ebola virus.
The only way of ensuring that the virus doesn’t spread into a country is enforced quarantine for people coming from countries with an outbreak. That is why I am personally in favor of the proposal of Dr. Anthony Leachon, president of the Philippine College of Physicians, and the Department of Health to enforce a 21-day quarantine period.
Despite the fear that many people have expressed about Ebola, there is no need to panic. The reassuring and comforting thought, as expressed quite accurately in a recent issue of Time magazine, is: “Ebola is hard to catch, is not an airborne virus, and can be transmitted only by direct contact with the bodily fluids of an infected and symptomatic person.”
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Sources: UN Ebola Mission, WHO, CDC, DOH, Time magazine, Wikipedia, The Guardian