How NOT to catch Ebola!

Okay folks, for those of you that just want the facts and not the details, here’s the one secret to avoid catching ebola… don’t touch someone with Ebola!  Done.  Pretty simple, ehh?  You may ask “But Doc G, how the heck will I know if someone has Ebola or not?”  Fair question.  For simplicity’s sake, signs of Ebola infection fall into two categories, early and late.

Some of the early signs of Ebola include…

  • fever
  • muscle pains
  • fatigue
  • headache
  • sore throat

These symptoms can take up to 21 days to show up after being exposed.  People in the early stage are probably not that infective because they are not shedding the virus like they will in the later stage.  Getting infected from someone with Ebola exposure but without signs of infection, would be unlikely.  Intimate contact with their body fluids is needed to pass infection, and even then they’d likely have to be showing late symptoms.  And let’s be real here, when was the last time you came in contact with a stranger’s body fluids?  If you have, well that’s your own personal business.  Who am I to judge?

Signs of a late infection include…

  • vomiting
  • diarrhea (often bloody)
  • rash
  • bleeding from eyes, nose or gums
  • prostration (too weak to get out of bed)
  • death

Do these signs fit anyone you’ve seen lately?  At the local fast food eatery?  The Mega-low-mart?  At the airport?  Hmm… probably not.  So far, the only folks at risk of getting Ebola in the U.S. (and pretty much everywhere) are family members and healthcare workers.  No strangers getting it off a bowling ball, airplane lavatory seat, cruise ship door knob or anything like that.  And here’s the kicker… only 1 out of 9 people infected with Ebola in the U.S. has died, and that one person arguably died because he didn’t get proper care in time.

Which leads me to a brief discussion about case fatality rate. The case fatality rate is basically the number of people who die from a disease, divided by the number of persons infected, expressed as a percentage.  The ebola case fatality rate ranges from 50 to 90% for different outbreaks since ebola was first encountered in 1976, meaning that 50 to 90% of infected persons die.  That’s pretty scary!  However, what most folks don’t consider is that those are the rates for very poor countries in Africa that have nearly non-existent healthcare systems, with something like one doctor per several hundred thousands of people.  Looking at the few U.S. cases gives us a case fatality rate of 11%  (1 death divided by 9 total cases).  Of course 9 cases is not statistically significant, but it’s a good indicator.

The low case fatality here in the U.S. and in other developed countries reflects two things.  First, the relative easy availability of good medical care here.  Second, people die from Ebola due to organ failure, something that apparently can be fixed by good supportive care (intravenous fluids, blood transfusion, drugs to keep your blood pressure up, etc.), things that are readily available in developed countries.


The United States and West Africa, as compared to three historical Ebola outbreaks.

African data courtesy of the WHO and the CDC.

  Dead     Infected     Case Fatality  

United States, 2014

1

9

11%

West Africa, 2014*

4,960

13,268

37%

Democratic Republic of the Congo, 2007

187

267

71%

Uganda, 2000

224

425

53%

Democratic Republic of the Congo, 1976

280

318

88%

*Data as of 11/04/2014, for Guinea, Sierra Leone, and Liberia.  Case fatality rate for current West African outbreak is not final, because the outbreak is ongoing and as more people die the case fatality rate goes up.  Under-reporting of numbers of infections and deaths is almost certain.


In summary…

The intent of this post is not to downplay the current Ebola outbreak, but merely to provide some perspective.  Ebola is deadly.  Especially if you’re not fortunate enough to be born in the United States or any other developed nation.  However, the hype and the hysteria that seems to grip some folks here is overblown.  You are way more likely to die in a car accident or from influenza (the flu), than you are from Ebola.

What can you do?

So what can we do about all this?  I wouldn’t worry about catching Ebola so much as about helping those in need.  Beyond doing good for Africa, you are doing good for the U.S., because the more effort put into containing and controlling Ebola in West Africa, the less likely we will be fighting it here.

Doc G has donated money to the following two outstanding charities.  I favor them because they are on the front lines and most of the money donated goes into field operations, and not cushy leather chairs for their executives…

Doctor’s Without Borders – provides field medical care, medical staff, field hospitals and so on.  One of the best humanitarian medical organizations around.

OxFam America – usually working to provide clean water, food, education and other services in developing countries — now providing protective gear and hospital supplies to the ebola affected countries.

Medical Volunteers

The United States Agency for International Development (USAID) is coordinating recruitment of medical volunteers from the U.S.  Of course, you could always volunteer with Doctor’s Without Borders (above) if you were so inclined.



Next post…

If you look at the numbers in the table above you can see that this outbreak is much bigger than any previous outbreak.  So the question is why.  How did this come to pass?  What factors are in play?  And of course, does climate change play a role in this mess?

I hope to tackle these questions in my next post… so please stay tuned!

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