The US Centers for Disease Control and Prevention has issued a new health advisory concerning the newest outbreak of Ebola virus illness in the Democratic Republic of Congo. Thirty-seven confirmed circumstances and 19 deaths have been reported as of September 18 throughout this outbreak.
The CDC additionally issued a travel health notice on September 8 for Congo, recommending that vacationers to the affected well being zones keep away from contact with unwell people and monitor themselves for symptoms of Ebola whereas in the outbreak space and for 21 days after leaving.
What is Ebola — what causes it, what are the signs and the way harmful is it? How is the illness unfold? What remedies can be found? Is there a vaccine? And what should people know about this outbreak and why the CDC has issued alerts?
To assist us reply these questions, I spoke with NCS wellness professional Dr. Leana Wen, an emergency doctor and medical affiliate professor on the George Washington University. Wen beforehand served as Baltimore’s well being commissioner.
NCS: What is Ebola, and what causes it?
Dr. Leana Wen: Ebola is a critical sickness with a excessive fatality price in people. The common case fatality price is round 50%, which means 1 in 2 contaminated people will die, in response to the World Health Organization.
Ebola is brought on by a group of viruses which are half of the Orthoebolavirus household. They have been found in 1976 in what’s now Congo. In addition to the Ebola virus, which causes Ebola virus illness, there are additionally the Sudan virus, Bundibugyo virus and Taï Forest virus that may trigger extreme sickness in people.
This new outbreak in Congo is brought on by Ebola virus. It is the sixteenth Ebola illness outbreak reported there since 1976.
NCS: What are the signs of Ebola, and the way quickly do they begin after publicity?
Wen: The incubation interval for Ebola illness is 2 to 21 days, however the common time between publicity and signs is eight to 10 days. Initially, the affected person reveals “dry” signs, resembling fever, joint and muscle complications, extreme headache, and fatigue. These are nonspecific signs that usually result in misdiagnosis with different diseases resembling influenza, malaria or typhoid fever.
Four to 5 days after symptom onset, sufferers can progress to “wet” signs which are attribute of Ebola an infection. Specifically, people might develop gastrointestinal signs resembling belly ache, vomiting and diarrhea; rash; chest ache; in addition to bleeding from the eyes, mouth, nostril and rectum. The illness might progress to organ failure, seizures, mind irritation and loss of life.
NCS: How is Ebola unfold?
Wen: The main manner is person to person. Someone may be contaminated if they arrive in contact with blood or physique fluids from a person who’s sick or has died of Ebola. Objects contaminated with an contaminated individual’s fluids also can unfold the illness. These gadgets embody bedding, utensils, garments and medical tools.
Transmission has additionally been reported by way of sexual contact, particularly by way of semen of those that are contaminated with or have just lately recovered from Ebola illness. In addition, people can contract Ebola from searching, dealing with or consuming contaminated animals resembling bats, monkeys and antelope.
NCS: How are Ebola sufferers handled?
Wen: Patients with Ebola illness are instantly remoted to stop transmission to others. Supportive care is important and contains giving fluids and electrolytes to interchange these misplaced by way of sickness. If blood strain or oxygen ranges fall, intensive care is required to stabilize circulation and respiration. Patients can also want therapy for secondary infections or for issues associated to preexisting situations.
Two treatments are at the moment authorized by the US Food and Drug Administration to deal with Ebola virus illness: a mix of three monoclonal antibodies, and a single monoclonal antibody. In clinical trials, these therapies have been proven to scale back mortality, though the loss of life price stays excessive even with therapy. Because these medicines are expensive and logistically difficult to ship, entry to them is proscribed, notably for sufferers in sub-Saharan Africa, the place most Ebola outbreaks happen.
NCS: Is there a vaccine?
Wen: Yes. The FDA authorized a vaccine, Ervebo, in opposition to Ebola virus illness in 2019. A second vaccine is permitted in Europe however not accessible in the United States.
Ervebo is designed to be used throughout outbreaks as half of a technique referred to as “ring vaccination.” This strategy entails vaccinating people on the highest danger of an infection, resembling these in shut contact with confirmed Ebola sufferers, the contacts of these contacts, and frontline well being care employees. By making a “ring” of safety round circumstances, the objective is to include the unfold of the virus.
According to WHO, an initial 400 doses of Ervebo have already been deployed to 1 of the outbreak hotspots in Congo; further doses are being delivered in the approaching days.
NCS: What else should people know concerning the outbreak? Why is the CDC issuing alerts?
Wen: While Ebola is an epidemic and it’s essential that public well being assets be deployed to assist Congo, this outbreak has not affected the US up to now. As the CDC says, no suspected, possible or confirmed Ebola virus illness circumstances associated to the present outbreak have been reported in the US or exterior Congo. At this time, the danger of unfold to the US is low.
The CDC’s discover for vacationers to Congo recommends avoiding contact with unwell people throughout journey and monitoring for signs till 21 days after leaving the realm. People who develop signs should instantly isolate themselves and name their physician or native well being division.
Issuing a well being advisory alerts clinicians to think about Ebola in sufferers who’ve regarding signs and who’ve just lately traveled to contaminated areas. The advisory additionally offers assets for hospitals, laboratories and public well being departments which may be concerned in treating sufferers, dealing with and testing specimens, or responding to group questions on Ebola.
NCS: Are there different suggestions for the general public now?
Wen: There aren’t any particular suggestions for most people exterior the areas the place Ebola virus is current. For people residing in or visiting affected areas, nonetheless, taking precautions is important. Avoid contact not solely with people who’re unwell but in addition with something which may be contaminated by their physique fluids. In addition, don’t go to any well being care services until you have got an pressing medical want.
Traditional burial practices that contain touching the physique of the deceased should be prevented. Also keep away from bats, monkeys and forest antelope, and don’t enter caves or mines the place bats might reside. Finally, anybody who develops signs should isolate instantly and search medical care.