Questions and answers about Ebola

WASHINGTON — The Ebola crisis in Africa and the U.S. cases that have occurred have raised a number of questions.

WTOP’s Answer Desk is answering some questions you may have.

How easy would it be for you to get Ebola if someone near you has it?

“The Ebola virus is not easily spread like a cold or influenza,” says Dr. Anthony Fauci, Director of National Institute of Allergy and Infectious Diseases at the National Institutes of Health. “You must come into direct contact with the bodily fluids of a sick person or through exposure to objects that have been contaminated.”

Questions

Answers

Is it risky to take public transit and stand within breathing distance on a bus or train with strangers?

“People with Ebola secrete the virus in their bodily fluids – in their diarrhea, in their vomit when they throw up, in their sputum if they are coughing a great deal,” says Dr. Glenn Wortmann, head of the infectious disease department at Medstar Washington Hospital Center.

But he emphasizes you have to be in direct contact with those bodily fluids to get infected with Ebola. At the point where they are most infectious, Ebola patients aren’t taking public transit – they are in the hospital.

Wortmann says that means “a casual person that’s walking around the subway is really in no danger of catching Ebola from anybody else.”

For airline passengers who want to protect themselves from exposure to Ebola, what measures will the TSA accept? Are passengers allowed to wear gloves and masks as they pass through airport security? TSA employees wear gloves, can passengers?

There is no rule against passengers wearing masks and gloves and a few passengers have been seen wearing them at Dulles International Airport.

But Ebola is not an airborne disease and wearing the mask won’t offer protection.

As for the rubber gloves on TSA screeners, they have nothing to do with Ebola. They wear them largely to protect themselves from dangerous items that could be hidden in bags and also, at this time of year, as a line of defense against the flu.

Do you recommend banning travel to Dallas, Texas?

According to the experts on the panel during our WTOP Town Hall, there is no need to ban travel to Dallas. The experts reiterated that none of the people who’ve had contact with Thomas Eric Duncan, the Liberian man who died from the virus at a Dallas hospital, and who have endured a 21-day quarantine, are showing no signs of Ebola. Only two nurses who had direct contact with the patient and his bodily fluids got sick.

The experts recommend daily precautions as you would take to prevent the flu such as washing hands regularly.

Knowing that Ebola’s arrival in the U.S. was possible, why were the CDC guidelines not updated proactively?

During WTOP’s Ebola Town Hall at the Newseum, our panel of experts all reiterated their support and confidence in the CDC. However the CDC is currently updating its protocols for health workers to make them more stringent and more adaptable to U.S. conditions.

The panel of experts say American health facilities have never faced Ebola patients and there is a learning curve.

How long can the Ebola virus survive on objects like door knobs or table tops?

According to our expert panel at WTOP’s Town Hall on Ebola, the virus can survive on a surface, like a coffee cup or a table, for about 20 minutes. The experts also say no one can give an exact time — but 20 minutes is their best estimate based on scientific data.

How easy would it be for you to get Ebola if someone near you has it?

“The Ebola virus is not easily spread like a cold or influenza,” says Dr. Anthony Fauci, Director of National Institute of Allergy and Infectious Diseases at the National Institutes of Health. “You must come into direct contact with the bodily fluids of a sick person or through exposure to objects that have been contaminated.”

What does direct bodily fluid contact mean?

According to the Centers for Disease Control, the virus has to get in your body through the bodily fluid of an infected person. The fluids that can transfer the virus include blood, saliva, feces, urine, semen, mucus, vomit, sweat, tears and breast milk. The most common entry points on the body are through the mouth, nose, eyes or an open cut or wound.

The virus can also be spread by having contact with items that have been in contact with infected bodily fluids such as soiled clothing and needles.

The World Health Organization says blood, feces and vomit are the most infectious fluids, while the virus is found in saliva mostly once patients are severely ill and the whole live virus has never been culled from sweat.

Read more on how Ebola spreads.

What are the symptoms of Ebola?

The list of symptoms are carried and can include:

  • Fever
  • Vomiting
  • Diarrhea
  • Joint and muscle aches
  • Headaches
  • Sore throat
  • Rash
  • Bleeding from body openings

How long does it take to show symptoms of Ebola?

The incubation period for Ebola is 2-21 days.

How long does the Ebola virus stay alive outside of the body?

Once the bodily fluid Ebola is in dries, the virus should only survive a few hours. But, if the fluids are still wet, the virus can stay viable for several days.

Can I get Ebola if someone with it coughs or sneezes?

Since Ebola is not an airborne disease, some of those droplets that come out of that person’s mouth when they cough or sneeze would have to either happen to land in your eye, nose, mouth or an open wound.

However, if those droplets land on a handrail and you touch them, you could transfer them when you rub your eyes or put your hand to your lips or touch a cut on your body.

What if I touch a bench or handrail that someone with Ebola sweated on?

The Ebola virus can be spread through sweat. If the sweat is still wet, the virus can be viable for quite some time. Once the sweat dries, the virus may still be alive for a several hours.

How can I kill the virus?

Hospital-grade disinfectant and household bleach products can destroy the virus.

What happens after someone gets Ebola and recovers, can they still spread the virus?

Once a person recovers from Ebola, they can no longer spread it through most bodily fluids, with one exception. The virus will stay active in semen for as long as three months, so those who have had Ebola are advised to use condoms or abstain from sex for at least that long.

Is there a cure for Ebola?

At this time there is no known cure for Ebola, and typically is fatal in more than 50 percent of those who are infected.

Where is there more information about Ebola?

The Centers for Disease Control and Prevention has created a fact sheet about Ebola.

What do I need to know about air travel?

International passengers are being screened by Customs and Border Protection agents stationed at New York’s Kennedy, Newark Liberty, Washington’s Dulles, Chicago’s O’Hare and Hartsfield-Jackson Atlanta airports.

There are no nonstop flights to the U.S. from Liberia, Sierra Leone or Guinea, the three countries hardest hit by Ebola.

Read more about the airport screenings.

How do you calm kids who are frightened about Ebola?

David Kaplan, head of the American Counseling Association, says, “Don’t let them watch TV or stay on the Internet or do social media endlessly talking about it.”

He says children probably need a little extra reassurance, both at home and at school. Kaplan says most kids are going to be just fine.

“There are going to be a few where their anxiety is going to interfere in their school work and they are having difficulty with this and that it is the job of the school counselor to identify that group of kids and help them.”

Are NIH workers working with Nina Pham checking their own temperatures?

Dr. Glenn Wortmann, who heads the infectious disease department at MedStar Washington Hospital Center, says self-monitoring begins with the very first exposure to an Ebola patient, and continues for weeks.

“Health care workers who take care of patients infected with Ebola are required to monitor their temperature twice a day for the next 21 days after their last exposure to the patient. Should they develop a fever, they would come in for evaluation at which time a blood test to detect Ebola would be performed,” Wortmann says.

What happens to all that medical waste created when hospitals treat someone with Ebola?

The Centers for Disease Control and Prevention has established guidelines for dealing with medical waste.

Dr. Glenn Wortmann, head of the infectious disease department at MedStar Washington Hospital Center,says “within a patient’s room, waste is carefully placed into a red plastic bag.”

When that bag gets to be half full, it is sealed, disinfected on the outside and placed inside a second bag. The process repeats itself as that second bag is placed inside a third one.

“That triple-sealed bag is then processed for destruction within the hospital,” Wortmann says.

He explains that under the CDC guidelines it can be incinerated on site, or sterilized in a special pressure chamber called an autoclave.

Who is covering the costs of monitoring and isolating health workers and others exposed to someone with Ebola?

The practice of quarantining people exposed to dangerous infectious diseases has been around for a long time.

Larry Gostin, head of the O’Neill Institute for National and Global Health Law at Georgetown University, says quarantines “are used by the government and paid by the government but it is well worth the cost. The ultimate outcome is to try to protect the public’s health.”

“When we are thinking about the common good and health of all the people in the United States, it is right that the community – through the taxpayer – pay for these services because ultimately, they will save suffering and preserve life,” Gostin says.

When a person with Ebola urinates, defecates or vomits into a toilet, the Ebola virus gets into the water system. Is WSSC treating our water supply for the Ebola virus? Is our water supply safe to drink and use?

Kellog Schwab, a professor at the Johns Hopkins Bloomberg School of Public Health and director of its Water Institute says, “Our multi-barrier treatment process allows the drinking water utilities to treat water to reduce micro- organisms, including viruses, that might be present.”

Schwab says the waste water system removes other possible contaminants, “And in general Ebola virus doesn’t hold up well once it is exposed to the environment and can degrade relatively quickly.”

Another listener wanted to know if it is risky to dip fingers in holy water in church because someone with Ebola might have touched the water first. Schwab says the risk is extremely low, noting once again that the virus breaks up quickly when exposed to the environment.

What are examples of successful past responses to epidemics by the U.S. government and how does the response to Ebola differ?

The industrialization of the 1800s and the accompanying migration to America’s cities led to outbreaks of several disease that we associate today with developing countries: Yellow fever, malaria and cholera.

Jesse Bump, an associate professor of international health at Georgetown University, says, “The U.S was able to defeat those problems on its own soil because both the government and the citizens took them seriously.”

“That is yet to happen in West Africa, although Ebola is deadly serious, the U.S. has yet to become fully engaged (in that region).”

What is the typical time of infection before someone in Africa has received treatment? Is the 70 percent mortality rate related to late treatment over there? Would faster, more rigorous treatment in the U.S. translate to a lower death rate?

There is no data that tells us just how long those infected with Ebola in West Africa delay getting treatment. But, Dr. William Blattner, an infectious disease expert with extensive African experience, says in many instances people seek care from a traditional healer before heading to a hospital or clinic.

Blattner, the associate director of the Institute of Human Virology at the University of Maryland School of Medicine, says many patients arrive at a medical facility severely dehydrated with a fluid and electrolyte imbalance that can put them in an irreversible downward spiral.

He says faster, more rigorous treatment certainly could result in improved survival. But at the same time, he notes many of the West Africans who get Ebola are already in poor health from bouts of malaria and other diseases, and that fact also contributes to the high death rate.

WTOP’s Michelle Murillo, Paula Wolfson, Darci Marchese and the Associated Press contributed to this story. Follow @WTOP on Twitter and WTOP on Facebook.

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