On September 30, 2014, the Centers for Disease Control and Prevention (CDC) and the Texas Health Department confirmed the first case of Ebola in the United States. While the thought of this virus, which has claimed more than 3,000 lives in West Africa according to World Health Organization (WHO), is alarming, Dr. Tom Frieden, M.D., M.P.H, Director of the CDC, is confident that the strength of the United States healthcare system will help in preventing the virus threatening our communities.
Let’s take a closer look at Ebola and address what you should know about this virus.
What is Ebola and what are its symptoms?
Ebola, previously known as Ebola hemorrhagic fever, is a rare and deadly disease caused by infection with one of the Ebola virus strains. Ebola can cause disease in humans and non-human primates (monkeys, gorillas, and chimpanzees). The virus is transmitted by direct contact with the blood, body fluids and/or tissues of infected animals or people.
Symptoms may appear anywhere from two to 21 days after exposure to Ebola, but the average is eight to 10 days. Initial signs and symptoms are nonspecific, but may include fever, chills, muscle pain, and malaise. Yet, the most common signs and symptoms are fever, anorexia and asthenia/weakness. Patients may develop a diffuse erythematous maculopapular rash by day 5 to 7 (usually involving the face, neck, trunk, and arms) that can desquamate.
Recovery from Ebola depends on the patient’s immune response. People who recover from Ebola infection develop antibodies that last for at least 10 years.1
Are there preventative measures that can be taken against Ebola?
At this time, there isn’t a vaccine for Ebola, but two potential vaccines are undergoing human safety testing. Currently, raising awareness of Ebola risk factors and practicing infection prevention measures are the best ways to reduce illness and deaths from Ebola.
On September 16, 2014, WHO’s Medical Officer, Dr. Sergey Eremin, delivered a presentation about key measures for prevention and control of the disease. One preventative measure that Dr. Eremin highlighted was the use of alcohol-based hand sanitizer as the preferred means for routine hand hygiene when hands are not visibly soiled. In his presentation, the alcohol-based hand sanitizer was recommended as faster, more effective and better tolerated by hands than washing with soap and water.
How is Ebola treated?
Supportive care, rehydration with oral or intravenous fluids and treatment of specific symptoms improves survival. There is not yet a proven treatment available for Ebola. At this time, a range of potential treatments, including blood products, immune therapies and drug therapies, are being evaluated.
Can the disease spread in the United States?
In a statement released by the CDC on Sept. 30th, the organization indicated that it knows how to reduce Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person and further isolation of contacts if they develop symptoms.
If I work in healthcare, what are preventative measures I can take?
WHO recommends that healthcare workers follow Standard Precautions in Health Care, basic infection control precautions, published by WHO, to reduce the risk of transmission of bloodborne and other pathogens. In addition to providing precautionary measures such as the use of personal protective equipment, the importance of hand hygiene in healthcare is emphasized. Included in the precautions:
- Clean your hands by rubbing them with an alcohol-based formulation, as the preferred means for routine hygienic hand antisepsis when hands are not visibly soiled
- Wash your hands with soap (bland or antimicrobial) and water when hands are visibly dirty or visibly soiled with blood or other body fluids or after using the toilet
- Ensure availability of handwashing facilities with clean running water
- Ensure availability of hand hygiene products (clean water, soap, single use clean towels, alcohol-based hand rub) - alcohol-based hand rubs should ideally be available at the point of care
The Standard Precautions also provide guidance on when hand hygiene is important:
- Before and after any direct patient contact and between patients, whether or not gloves are worn
- Immediately after gloves are removed
- Before handling an invasive device
- After touching blood, body fluids, secretions, excretions, non-intact skin and contaminated items, even if gloves are worn
- During patient care, when moving from a contaminated to a clean body site of the patient
- After contact with inanimate objects in the immediate vicinity of the patient
Is there any guidance for the safe management of patients with Ebola in U.S. hospitals?
The CDC has issued several documents to help U.S. hospitals dealing with Ebola and infected patients with this virus.
This is a constantly changing situation. For the most up-to-date information, please refer to these websites for reference.
World Health Organization:
Centers for Disease Control and Prevention (CDC):