The US Centers for Disease Control and Prevention has issued a new health advisory about 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 ought to people find out about this outbreak and why the CDC has issued alerts?
To assist us reply these questions, I spoke with NCS wellness skilled Dr. Leana Wen, an emergency doctor and medical affiliate professor at 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 severe sickness with a excessive fatality charge in people. The common case fatality charge is round 50%, which means 1 in 2 contaminated people will die, in keeping with the World Health Organization.
Ebola is attributable to a group of viruses which are a part 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 attributable to 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, corresponding to fever, joint and muscle complications, extreme headache, and fatigue. These are nonspecific signs that always result in misdiagnosis with different sicknesses corresponding to 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 corresponding to stomach 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 approach is person to person. Someone will 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 particular person’s fluids may unfold the illness. These gadgets embody bedding, utensils, garments and medical tools.
Transmission has additionally been reported by sexual contact, particularly by semen of those that are contaminated with or have not too long ago recovered from Ebola illness. In addition, people can contract Ebola from looking, dealing with or consuming contaminated animals corresponding to bats, monkeys and antelope.
NCS: How are Ebola sufferers handled?
Wen: Patients with Ebola illness are instantly remoted to forestall transmission to others. Supportive care is important and contains giving fluids and electrolytes to switch these misplaced by sickness. If blood stress or oxygen ranges fall, intensive care is required to stabilize circulation and respiratory. Patients may want therapy for secondary infections or for issues associated to preexisting situations.
Two treatments are at the moment permitted by the US Food and Drug Administration to deal with Ebola virus illness: a mixture of three monoclonal antibodies, and a single monoclonal antibody. In clinical trials, these therapies have been proven to cut back mortality, though the loss of life charge 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 permitted a vaccine, Ervebo, in opposition to Ebola virus illness in 2019. A second vaccine is allowed in Europe however not out there in the United States.
Ervebo is designed for use throughout outbreaks as a part of a technique referred to as “ring vaccination.” This method includes vaccinating people at the highest threat of an infection, corresponding to these in shut contact with confirmed Ebola sufferers, the contacts of these contacts, and frontline well being care employees. By creating a “ring” of safety round circumstances, the objective is to comprise the unfold of the virus.
According to WHO, an initial 400 doses of Ervebo have already been deployed to one in every of the outbreak hotspots in Congo; extra doses are being delivered in the coming days.
NCS: What else ought to people find out about the outbreak? Why is the CDC issuing alerts?
Wen: While Ebola is a lethal illness and it’s essential that public well being sources be deployed to assist Congo, this outbreak has not affected the US thus far. 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 outdoors Congo. At this time, the threat 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 space. 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 not too long ago traveled to contaminated areas. The advisory additionally gives sources 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 public now?
Wen: There are not any particular suggestions for the common public outdoors the areas the place Ebola virus is current. For people dwelling in or visiting affected areas, nevertheless, 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’ve an pressing medical want.
Traditional burial practices that contain touching the physique of the deceased must be prevented. Also keep away from bats, monkeys and forest antelope, and don’t enter caves or mines the place bats might stay. Finally, anybody who develops signs ought to isolate instantly and search medical care.