The worst recorded outbreak of the virulent Ebola virus has killed more than 700 people in West Africa, including more than 60 health care workers, and is believed to have infected 1,300 more people since it began in March.
So far, the outbreak has been confined to Guinea, Liberia and Sierra Leone. The U.S. Centers for Disease Control has issued a Level 3 travel warning advising people to avoid nonessential travel to those countries.
Dr. Dino Rumoro, head of the Rush Department of Emergency Medicine, sees little danger to the U.S. from Ebola. He explained why in the following interview.
Q: Are you worried about it Ebola coming here?
Rumoro: There are a lot of diseases that cause us a lot of concern. In the ‘80s, when we saw the emergence of HIV and AIDS, that made us very nervous as well, and we learned how to deal with it. Our experience dealing with other infectious diseases makes us prepared for this disease. This is a disease that we know about in the scientific community, but it’s not native to the United States.
Q: How is Ebola spread?
Rumoro: The key thing to remember with Ebola is that it’s not an airborne virus, so we’re not worried about it being transmitted through the air. We’re worried about contact with bodily fluids like blood, vomit and diarrhea. If those fluids enter another person’s eyes, nose, or mouth, an infection could occur.
Q: Who’s at risk for Ebola?
Rumoro: Anyone who comes in direct contact with body fluids of an infected person is at risk. Health care workers are at higher risk, just because they’re getting in close contact with body fluids. A close family member who may be caring for a patient is at even higher risk than a health care worker, because they don’t have the personal protection we use. Family members, if they’re cleaning up the diarrhea or the blood, they think, ‘it’s part of my job,’ and may ignore the need to protect themselves.
While Ebola is a highly dangerous and infectious disease, we can control it by using blood and body fluid precautions. We want to protect ourselves from any types of secretion. All we really need to do it is wear a face mask with an eye shield, wear gloves, gowns, and boot covers, and we need to wash our hands frequently.
There’s reason to exercise caution, but with the proper equipment, if you follow the rules you’ll be safe. The problem they have in the third world countries is they don’t have the personal protective equipment we have.
Q: Could someone from Africa bring the virus to the U.S.?
Rumoro: Because of global travel, someone could come here and not have symptoms, and two weeks later they could develop symptoms. Because we’re an international community, we have to be aware of it, but it’s not something that should cause panic.
Q: Why not?
Rumoro: With a disease like Ebola, there’s less concern here because of the type of equipment we have and because we have advance notice that it’s out there. Public health is tracking who’s coming here.
If we saw a case pop up in the United States, it would be similar to how we were made aware of the MERS (Middle East Respiratory Syndrome) case that was identified in Indiana, and we were able to control that. We have a very good public health infrastructure. They were able to identify that, isolate it, treat it, I think the same thing would happen.
Q: Ebola is fatal between 60 and 90 percent of the time. What can be done to treat it?
Rumoro: The standard of care is support. Meaning, you’re going to treat the symptoms. One of the end stages is cardiovascular collapse. The blood pressure drops, the patient starts going into cardiac arrest.
Ultimately though, the source of that collapse is the virus, there is no treatment for the virus. So it would be supportive care at this point. We would try to ease the discomfort, try to keep the blood pressure maintained. It appears that the people who die of Ebola virus don’t mount the same immunologic response as the ones who live through it. If you get them through some of those rough points, maybe you give them enough time for a reactive response and they can fight the virus off.