When the Threat of Ebola Hits Home: What You Really Need to Know

Transmission of EbolaMy home state of Connecticut seemingly had a close brush with the Ebola virus when Yale-New Haven Hospital in New Haven confirmed today that it was treating a quarantined Yale University grad student who was displaying Ebola-like symptoms. The man, recently back from Liberia, had been admitted to the hospital yesterday after developing a fever. It was just reported, however, that the patient’s samples tested negative for the disease, but it’s a perfect time to bring more awareness to this devastating illness.

Yale Patient Displays Ebola-Like Symptoms

The patient was one of three Yale University PhD. researchers who aided the Liberian Ministry of Health on computer systems to monitor the Ebola outbreak in Liberia. The students returned home Oct. 11. The patient and another student tested negative for Ebola in Liberia, but both voluntarily isolated themselves upon their return to the United States.

This new, particularly lethal strain of Ebola began emerging in the West African countries of Guinea, Liberia and Sierra Leone in early 2014 and is considered the largest in history. One person for every two who have contracted Ebola in this outbreak have died, according to the CDC. The World Health Organization (W.H.O.) has identified more than 8,000 cases and 3,800 deaths since March. Only 14 have been treated for Ebola outside West Africa.

When to Seek Help for Symptoms of Ebola

After developing a fever Wednesday, the Yale patient wisely contacted their primary care physician who monitored symptoms and helped to arrange the hospital transport with high precautionary measures. Anyone who has recently traveled in Western Africa and/or who has been in contact with someone with Ebola and is displaying Ebola-like symptoms should contact a health professional and be assessed for symptoms. All who have come in contact with the virus should be identified and isolated from other patients. They should also help identify who else might have had contact with the infection. Direct contact with a deceased Ebola patient should be avoided.

“But if you haven’t come from Liberia, Sierra Leone or Guinea, then you are likely to have just the regular flu,” New Haven City Mayor Tony Harp said in a press conference this afternoon, highlighting the fact that many people with similar symptoms were calling in concerned about their risk of Ebola. “I think it’s really important for people to remember that we are in flu season “

Symptoms of Ebola

Ebola Symptom ProgressionEarly symptoms of the Ebola virus, formally known as Ebola haemorrhagic fever, tend to be non-specific, mimicking other health conditions like the flu. A patient often first experiences fever, fatigue, headache and muscle soreness for a couple days. The patient may shortly develop stomach pain, vomiting and diarrhea, as well as unexplained bruising.

In more than half of Ebola cases, the infection dramatically advances, causing hemorrhage, bleeding under the skin and from the nose, mouth, eyes and anus. If Ebola proves fatal in a patient, he or she typically begins to leak fluid from blood vessels deep in the body, causing a dramatic drop in pressure that leads to organ failure.

These symptoms start presenting between 2 and 21 days after becoming infected. If an exposed person does not develop symptoms after 21 days, the Center for Disease Control and Prevention (CDC) states he or she will not become sick with Ebola.

How Ebola Is and Isn’t Transmitted

Ebola is not an airborne disease. It is transmitted through direct contact with body fluids (like blood, vomit, semen and excrement) of an infected person, objects contaminated with this infected body fluids or through the fluids or infected meat of other primates with the disease. Scientists believe the host animal for Ebola is likely a bat.

If an infected person’s blood or vomit gets into another person’s eyes, nose or mouth, the virus can be transmitted. According to W.H.O., the virus can be passed through semen for up to 7 weeks after recovery from the illness. A reader asked a great question about if Ebola may be transmitted through a sneeze:

Transmission of Ebola

Healthcare Workers at Risk for Contracting Ebola

In this most recent outbreak in West Africa, most new cases occur among those caring for sick relatives or preparing an infected body for burial. Healthcare workers are also at risk for contracting the virus, as it can survive on surfaces, such as latex gloves or hypodermic needles. This is especially likely if the treating medical facility is not properly equipped with or trained to use decontaminate protective gear correctly.

Two of the three confirmed cases of Ebola in the United States occurred in nurses in Texas, who were treating a man with the illness. The CDC announced the country’s first lab-confirmed diagnosis of Ebola on Sept. 30. The patient had traveled from West Africa to Dallas, Texas, showing no symptoms of the virus until four days after arriving in the U.S. He died of the illness on Oct. 8 and his body was cremated.

On Oct. 10, a nurse at Texas Presbyterian Hospital who treated the first, or index, patient reported early symptoms of a low-grade fever and was sent for testing. She was isolated and later was confirmed positive for Ebola. On October 14, a second nurse who cared for the index patient also reported a low-grade fever and was confirmed positive for Ebola on October 15.

The CDC confirms that the second worker flew on a Frontier Airlines flight 1143 from Cleveland to Fort Worth Oct. 13, returning from flight 1142 in the reverse direction on Oct. 10. According to a Frontier Airlines statement, she exhibited no signs of illness on the flight and immediately upon notification from the CDC, the airline removed the aircraft from service and is working closely with CDC to identify and contact customers who traveled on flight 1143.

CDC is asking that all 132 passengers on Frontier Airlines flight 1143, from Cleveland to Dallas/Fort Worth on October 13, landing at 8:16 p.m. CT, call 1-800-CDC-INFO (1-800-232-4636).

Contact Tracing

Stopping the Ebola Outbreak in the U.S.
The CDC sent one team to Dallas to support contact tracing of the first patient and response and as second team to train and assist the hospital in infection control and monitoring of health care workers who had contact with the index patient. The number of contacts—people who had definite exposure to an Ebola patient—has risen in this country to 11. There are an additional 107 possible contacts, including other healthcare workers.

Yale-New Haven Hospital claims to take even greater measures for infectious disease cases than those recommended by the CDC. Patients with Ebola-like symptoms are quarantined from other patients. Staff wears protective gear, such as face shields, gloves and protective suits. Hazmat suits were brought into the hospital on Wednesday to protect some of its workers.

“We feel we are well prepared to handle an event like this,” said D’Aquila. “We have been preparing for the potential of an Ebola patient for weeks, but even before that.” He said the hospital is prepped to be ready at all times with a command center structure, which includes a team that drills and rehearses to prepare for health events like this one.

Connecticut’s Gov. Dannel P. Malloy also issued Thursday afternoon a directive to every hospital in the state to perform a drill within the next week to assure that procedures and Emergency Medical Services (EMS) are up to standard. He announced that the state is taking steps to strengthen the level of preparedness for the Ebola virus by enacting the quarantine and isolation protocols that were authorized under an order he signed last week.

Last week, Malloy declared a public health emergency as a precautionary measure in the event that the state has either a confirmed infection or has confirmed that someone at risk of developing the infection is residing in the state. The order gives the commissioner of the department of public health the authority to quarantine and isolate an individual or a group of individuals whom they reasonably believe has been exposed to the Ebola virus or infected with the Ebola virus.

While precautions were underway at the hospital and in the city of New Haven at the time of today’s conference, Harp said that there was no reason to believe this would turn out to be a confirmed case of Ebola—and fortunately, she was right.

Stopping the Ebola Outbreak

“[T]he report that a Yale student has exhibited symptoms demonstrates why preemptive action is the right approach.  I believe we must go above and beyond what the CDC is recommending,” Malloy said. “I want everyone to know – from the nurses in our emergency rooms to our first responders and our law enforcement personnel – we will provide whatever resources we have at our disposal so that you can do your critically important jobs safely and effectively.”

While no specific treatment is available for Ebola, health providers can do the following for patients:

  • Balance the patient’s fluids and electrolytes, such as the levels of sodium to potassium in the blood
  • Maintain their oxygen status and blood pressure
  • Treat them for any complicating infections

Comments

  1. whitemist says

    I expected a very rational response on this from you and i was not disappointed. The only thing that I have heard is that Ebola is not a virus that survives well out side the body – the 7 days is longer than I heard, but precautions are best anyway…this of course unlike the flu or hepatitis which can survive up to a month on virtually any surface.

    • says

      Thanks, M. Yeah, I was rather shocked by the statement: “According to W.H.O., the virus can be passed through semen for up to 7 weeks after recovery from the illness.” Disposal or decontamination of anything that comes into contact with the virus is so critical. Precautions are important…just as long as we don’t go too overboard from fear of infinitesimally unlikely risks.

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