Ebola - Who's at risk?
“I’m about to go to Africa. Should I be worried about Ebola?”
It’s a question we’ve been asked a lot lately from people heading to West Africa or other countries in the region.
The quick answer is ‘no’: Even for those intending to stay long term the risk of infection with Ebola virus disease (EVD) is extremely low.
Because, ever since Ebola was first detected in 1975 in Sudan and the Democratic Republic of Congo, those who have caught the disease had been in close contact with an infected person displaying symptoms of severe illness, or with an infected animal.
How Ebola is transmitted.
Researchers believe the virus is zoonotic (transmitted from an animal to a human) with bats the likely reservoir. There are 5 subtypes and four have been found in animals in Africa.
Ebola can only be passed from person to person through direct contact with the blood or other bodily fluids (e.g. saliva, urine, semen) from infected people or animals – dead or alive.
EVD is not an air-borne virus like influenza or measles. And, unlike flu and measles, Ebola survives only a short time on hard surfaces. Measles and flu are much more infectious than Ebola.
It’s worth noting that even people who have recovered can pass on the virus through unprotected sexual contact for up to seven weeks.
For all of those reasons, most people visiting West Africa are not likely to be at risk. Those who could potentially be exposed might include:
People visiting family or relatives in a region/s where an outbreak is occurring and who will be staying in family homes for an extended period.
Healthcare workers based in hospitals or other facilities in areas where (1) outbreaks are occurring, or (2) where the sick are being taken for treatment
How Ebola is NOT transmitted
Despite what you may hear, you cannot catch Ebola from:
Casual contact with people in public places - even from an infected person, unless they are exhibiting symptoms.
Handling everyday items like money or groceries
Swimming in a pool
Much is yet to be learned about the transmission of Ebola. Hence there are few established primary prevention measures. Outbreaks over the last 20 years have been managed by isolation of cases and barrier nursing. The challenge at the moment is being able to implement the isolation of cases in situations where there is a lack of services and trust.
At a personal level, reduce the risk of Ebola infection by:
Avoiding direct contact with blood or bodily fluids, or with objects possibly contaminated with them.
Avoid close contact with wild animals – some wild animals can carry the virus. (Don’t eat ‘bush meat’.)
Avoiding unprotected sex.
The latest on Ebola in West Africa
In its recent update (31 July 2014) the World Health Organisation has reported a total of 122 new cases of Ebola virus disease (EVD) between 24 and 27th July 2014: These are laboratory-confirmed and those suspected to be EVD. There were 56 deaths reported from the three main outbreak countries of Guinea, Liberia and Sierra Leone and 1 from Nigeria - a 40 year old male who travelled by plane from Liberia. He was symptomatic during travel and there was a stop in Togo and Ghana. This case is a concern and contact tracing through national authorities is proceeding on all people who may have been in contact en route to Lagos.
The current report brings the total to 1323 cases and 719 deaths. 775 cases have been confirmed as Ebola and the rest either probable or suspected. Most of the new cases have been reported from Liberia (80) and Guinea (33).
Both cases and deaths are more than double any previous EVD outbreak, making it the largest and most deadly ever.
However, at this time the WHO’s advice remains: “The WHO does not recommend that any travel or trade restrictions be applied to Guinea, Liberia, Sierra Leone, or Mali based on the current information available for this event”.
Read more on Ebola from the WHO and CDC