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Reviewed by Arefa Cassoobhoy, MD, MPH
Aug. 8, 2014 -- An outbreak of Ebola virus that has claimed hundreds of lives in West Africa is triggering concerns in the United States, particularly after two American aid workers stricken with Ebola were brought back for treatment.
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WebMD asked the CDC for answers to some questions about the virus, its treatment, and how it spreads.
Q: What is the risk to the general public of bringing the two infected Americans back to this country?
A: The risk is very low both for the general public as well as for patients being treated in the same hospital. The arrival of these two humanitarian workers was carefully planned and prepared for. They are in strict isolation and their care is being closely monitored. We are confident everything is being done by the hospital for their well-being and for the safety and well-being of those treating them.
Q: What do you tell people who are afraid of Ebola and want to do everything they can to stay safe?
A: The greatest risk to Americans at this point is in traveling to one of the affected countries: Liberia, Guinea, or Sierra Leone. [Note: Nigeria has since been added to the list of affected countries.] CDC is advising that until further notice, people should not travel to these countries unless it is absolutely necessary. Here in the United States, there is no current risk for Ebola virus in either the community or in health care facilities.
Q: How do doctors treat someone with Ebola, given there's no vaccine or cure?
A: Because there is no approved treatment or vaccine for Ebola virus, doctors treat suspected patients with supportive care, including balancing the patient's fluids and electrolytes, maintaining their oxygen status and blood pressure, and treating them for any complicating infections. Media reports also suggest a new experimental therapy was given the two American health care workers with Ebola. The treatment was arranged not by CDC but through a private company and [aid agency] Samaritan's Purse. For more information on experimental treatments and vaccines for Ebola, see this link.
Q: We've been told that the disease is not easily spread. Yet two American health care workers, who we presume would have been taking all the regular precautions, came down with the disease, as have other health care workers in Africa. Can you speak to possible transmission in these cases?
A: First, from everything we have seen to date, Ebola only spreads from sick people -- not from people who've been exposed to the disease but haven't yet become sick. Being sick can typically include having a fever, headache, body aches and difficulty moving, diarrhea, vomiting, and stomach pain.
You get Ebola virus when you touch the vomit, blood, spit, sweat, urine, or stool of someone who is sick with the virus.
We may never know exactly how these two patients were exposed to the Ebola virus. Their infections and those of other health care workers is a sobering reminder that healthcare-acquired transmission is often a significant factor in Ebola outbreaks. Isolation and strict infection control procedures in health care settings are critical to prevent spread of the disease. This is true of any infectious disease.
Q: How is the Ebola virus killed?
A: Ebola is a fragile virus and is readily killed by soap and water, bleach, or other products such as hospital-grade quaternary ammonium or phenolic products. That's why proper cleaning of contaminated surfaces is so important. Health care workers who clean contaminated surfaces should wear personal protective equipment such as gloves, gowns, eye protection and a face mask.
Q: What does the U.S. health care system offer in terms of better care?
A: Survival of Ebola virus infection depends largely on early and aggressive supportive care…
In addition, for the protection of those around them, each patient should be isolated in their own room, including a private bathroom, with the door kept closed. Medical equipment should be used just for that patient, health care workers should wear protective clothing, and a log should be maintained of all who enter the patient's room. Visitors should be avoided, or limited. Many of these conditions are not always possible to maintain in the African health care settings.
Q: Is an Ebola outbreak likely in the U.S.? If not, why not? What precautions are being taken against the spread of the virus in the U.S.?
A: The standard, rigorous infection control procedures used in major hospitals in the United States will prevent spread of Ebola.
In the past decade, the United States has had five imported cases of hemorrhagic fevers -- one of Marburg and four of Lassa, both viruses that are similar to Ebola. Each time, the American public health system identified the cases and through thorough infection control procedures prevented any one else from becoming ill.
The best way to protect Americans is to stop the outbreak in West Africa.
We know how to control Ebola. Previous outbreaks of Ebola virus disease have been contained by patient isolation, rigorous use of infection control measures in hospitals, intensive and thorough tracing of those who came into contact with the patients, and community education.
CDC, the World Health Organization, and our partners are committing to deliver a surge of resources and expertise to help end this outbreak. Far too many lives have been lost already. We have a difficult road ahead, which will take many months, but we must redouble our efforts to bring this terrible outbreak under control.
SOURCE: Centers for Disease Control and Prevention.
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