Ebola Virus: Facts and Myths

The Ebola virus has been a frightening danger for some time, and for good reason. It is a serious infection and causes real harm.  Anxieties run high whenever we are confronted with the prospect of a deadly disease spreading to our country and to the communities where we live, but it is important to separate fact from fiction.   So, let’s start with the bottom line.  Although there is a case of Ebola infection in the United States, two major factors limit the risk of a widespread epidemic in this country:  modernized healthcare systems and the virus’ method of spread.  More on this later.  But first, here are some basics that should help understand what Ebola is all about.

The Disease

The Ebola virus infects mainly the cells that create blood vessels, liver cells, and several cells of the immune system. This means when the infection occurs, these systems are the ones that suffer. 

When the blood vessels get infected, they get leaky, and this causes one of the key symptoms of Ebola virus disease: bleeding. The bleeding occurs anywhere in the body, including reddened eyes, bleeding into the skin, vomiting blood, coughing blood, severe nosebleeds, and many other sites.

The infection of the immune system cells leads to symptoms such as fever, severe muscle pains and stomach pain, headaches, severe tiredness. The infection of the liver, makes it harder for the blood to clot, making bleeding even worse.

As you may notice, the general symptoms of fever, severe pains, and tiredness are seen in many, many viruses, including harmless flu’s. And, in perhaps as many as half of cases of Ebola virus disease, these may be the only symptoms, with no bleeding occurring. 

This means that one cannot rely on symptoms to know who has Ebola instead of some other viral illness, Ebola is best found if the contacts that cause it can be shown to have occurred.

How Ebola Virus Disease is Caught, and How it is Not Caught

The Ebola virus does not enter breath. And so it cannot be caught by air or breathing near an infected person, or in the same building or room as someone through the air.  Unlike influenza, a respiratory virus that transmits via respiratory droplets, you cannot catch Ebola from sitting on a subway or bus with an infected person.  

The Ebola virus is spread by direct contact with an infected person’s body fluids. Examples of body fluids are blood, feces, vomit, urine and saliva.

This is perhaps the best news about Ebola virus, if one can avoid direct contact with an infected person’s body fluids, you can be protected from infection.

Infections that do not spread easily are more easily contained by a modernized healthcare system.  Patients who are symptomatic with Ebola and those who have had contact with body fluids of infected can be isolated, thereby limiting or even eradicating the spread of disease.  In the Texas case, public health officials have quarantined all of those who may have had contact with the infected patient’s body fluids (paramedics, caregivers) and will continue to do so until the incubation period for each of them has passed.   Consider this analogy:

A forest fire spreads by direct contact of nearby trees to the burning fire.  To limit the spread, firemen isolate the fire and then wait until it burns itself out.  The same approach can be applied to managing Ebola, and with appropriate resources, good communication and public education, a modernized country is better able to contain an outbreak than a poor one.  

Nigeria is a good example of this containment strategy.  There have been a few cases of Ebola in Nigeria during this epidemic, but the country has avoided widespread disease.  This is largely due to the strength of Nigeria’s economy and the application of financial resources to eradicate the disease.  Quarantine centers and public health campaigns have been extremely effective at isolating the sick from the healthy, allowing the “virus to burn itself out”.

The Incubation Period

The incubation period for any infection is the time that usually occurs between the virus entering one’s body and the first symptoms appearing. During the incubation period, one is infected, but since there are no symptoms during this period, it is very hard to know if you are infected.

The incubation period for Ebola virus disease is usually about 8-10 days, but some people have developed symptoms as soon as 2 days after catching the virus, and as long as 22 days later.

Note that the person who showed up with Ebola virus infection in the United States on the last day of September of 2014, was infected in Liberia, but had no symptoms, he was still incubating the infection. This is why he was able to fly to the US. He did not know he was sick and no one at the airport would know to be concerned. So he caught the virus in Liberia, came to the US while having no symptoms, and ended the incubation period in the US where he became symptomatic. 

The Risk of an Ebola Epidemic in the United States, and our Risk here in Georgia

As stated at the start of this discussion, it is very, very unlikely Ebola would ever take hold in the US, or ever develop into an epidemic here.

Why is that? Fortunately, for several reasons:

1.There have never been more than one or so cases of Ebola virus disease in the United States. To get an epidemic going, you need more than one case at a time.

2.Since the infection can only be spread by direct contact with an infected person’s body fluids, then a medical system that can limit that contact can very well halt any further spread. This is not just a theoretical advantage, it has taken place in prior outbreaks, and is happening now in Nigeria. The American medical system can stop the spread of this virus from any known infected person.

3.The CDC is very alert to the dangers Ebola can present, and how those dangers can be contained. The current outbreak is limited to a small number of countries in Western Africa. As horrific as this outbreak has been, any large epidemics have only occurred in these three countries. And so the CDC is in an excellent position to monitor the emergence of any symptoms in anyone visiting or returning to the US from these active countries.

4.There are no natural reservoirs of Ebola virus infection in the United States. The virus mainly lives in fruit bats in Africa, human infections are far less frequent. And so outbreaks erupt in these areas of the world.

Bottom Line

Ebola virus does not spread from person to person without direct contact of body fluids, and so it can be contained.

There have been isolated, individual cases of Ebola virus disease in the US, but every single case has been one where the infection began in Africa, and in every instance the medical center they have been treated at has been able to keep even one case from spreading.

Ebola virus disease is a very dangerous illness, but there is every reason to expect it will not become a threat to people living in the US.

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