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Originally published August 2, 2014 at 2:16 PM | Page modified August 5, 2014 at 4:30 PM

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Bats, superstition play a role as virus spreads in West Africa

Some questions and answers about the current Ebola outbreak.


Los Angeles Times and The New York Times

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As Emory University Hospital in Atlanta begins treating the first of two U.S. citizens who have Ebola, some Americans have expressed fear that the deadly outbreak — which has killed at least 729 people in West Africa and infected more than 1,300 — could spread in the United States. Health officials say there is virtually no danger to the U.S. public. What to know about the virus:

Q: How many people have died in the current outbreak?

A: More than 1,300 people in Guinea, Liberia and Sierra Leone have contracted Ebola since March and at least 729 have died, according to the World Health Organization (WHO), making this the biggest outbreak on record. More than half of those infected have died. Nigeria also reported one probable case: a Liberian man who traveled there and died July 25.

Q: How contagious is the virus?

A: You are not likely to catch Ebola just by being close to someone who has the virus; it is not airborne, like the flu or respiratory viruses such as SARS. Ebola spreads through direct contact with bodily fluids. If an infected person’s blood or vomit gets in another person’s eyes, nose or mouth, the infection may be transmitted. In the current outbreak, most new cases are occurring among people who have been taking care of sick relatives or who have prepared an infected body for burial.

Health-care workers are at high risk, especially if they have not been properly equipped with or trained to use and decontaminate protective gear correctly. The virus can survive on surfaces, so any object contaminated with bodily fluids, such as a latex glove or a hypodermic needle, may spread the disease.

Q: Why has this Ebola outbreak been so difficult to contain?

A: In some parts of West Africa, there is a belief that simply saying “Ebola” aloud makes the disease appear. Such beliefs create major obstacles for physicians from groups such as Doctors Without Borders that are trying to combat the outbreak. Some people blame physicians for the spread of the virus and turn to witch doctors for treatment. Their skepticism is not without a grain of truth: In past outbreaks, hospital staff who did not take thorough precautions became unwitting travel agents for the virus.

Q: What’s the likelihood of a major Ebola outbreak happening in the U.S.?

A: Remote, according to officials from the Centers for Disease Control and Prevention (CDC). If an Ebola patient were to be identified in the U.S., American health systems would quickly identify, isolate and treat the person, along with anyone who may have come into contact with him or her.

The CDC and WHO say it’s very unlikely that U.S. travelers to West Africa could contract the disease, since they would have to come in direct contact with an infected person’s blood, organs or other bodily secretions.

Q: How does the disease progress?

A: Symptoms usually appear eight to 10 days after exposure, according to the CDC. At first, it seems much like the flu: a headache, fever and aches and pains. Sometimes there is also a rash. Diarrhea and vomiting follow. In about half of the cases, Ebola takes a severe turn, causing victims to hemorrhage. They may vomit blood or pass it in urine, or bleed under the skin or from their eyes or mouths. Bleeding is not usually what kills the patient. Rather, blood vessels deep in the body begin leaking fluid, causing blood pressure to plummet so low that the heart, kidneys, liver and other organs begin to fail.

Q: How is the disease treated?

A: There is no vaccine or cure for Ebola, and in past outbreaks the virus has been fatal in 60 to 90 percent of cases. All physicians can do is try to nurse people through the illness, using fluids and medicines to maintain blood pressure, and treat other infections that often strike their weakened bodies. A small percentage of people appear to have an immunity to the Ebola virus.

Q: Where did the disease come from?

A: Ebola was discovered in 1976, and it was once thought to originate in gorillas, because human outbreaks began after people ate gorilla meat. But scientists have since ruled out that theory. Scientists now believe that bats are the natural reservoir for the virus, and that apes and humans catch it from eating food that bats have drooled or defecated on, or by coming in contact with surfaces covered in infected bat droppings and then touching their eyes or mouths.

The current outbreak seems to have started in a village near Guéckédou, Guinea, where bat hunting is common, according to Doctors Without Borders.

Q: Why is the U.S. flying two people known to have Ebola into the country?

A: Evacuation to the U.S. ensures that the two U.S. aid workers will have access to “modern medical facilities and technology” that could save their lives, a White House spokesman said. Dr. Kent Brantly and missionary Nancy Writebol contracted Ebola while working at a Liberian hospital that treated Ebola patients and are in serious condition, according to Christian aid organization Samaritan’s Purse.

Brantly’s wife and two children were living with him in Liberia, and they left for the U.S. just days before he fell ill. They are staying with relatives in Texas. The state Department of Health is monitoring their health and they have shown no signs of the disease, according to a CDC spokesman.

Q: Will other people on the plane be in danger?

A: The patients aren’t on a regular commercial airline. They are transported via a private medical charter plane outfitted with an isolation pod, a portable, tentlike structure that can prevent infected patients from exposing flight crews and other passengers to the deadly virus.

Q: What happens after the two Americans arrive in the U.S.?

A: Emory University Hospital said it will house the two Ebola patients in a state-of-the-art isolation unit on the hospital campus. The facility, one of four in the country, was built in collaboration with the CDC, and is separate from other patient areas.

The unit is outfitted with equipment that provides “an extraordinarily high level” of isolation and ensures that its workers are highly trained in treating Ebola patients, according to a statement from the hospital. The two patients will probably receive an IV drip to help them combat dehydration.

Q: Might I encounter someone with Ebola at an airport?

A: Probably not. All of the affected West African nations have announced plans to screen airport passengers before they leave. That includes taking their temperatures to check for fevers. In the event that a passenger becomes ill on a flight, commercial airlines have received special instructions from the CDC on how to notify the agency and effectively isolate the patient — as well as anyone who may have had contact with that person — on arrival. The CDC has 20 isolation stations at major airports around the country. These are staffed 24/7 and are fully equipped to deal with an Ebola patient.

Q: There’s a conference of African nations in Washington, D.C., this week. Could that bring an infected person to the U.S.?

A: President Obama said Friday that U.S. officials are taking extra precautions in light of the Ebola crisis. Anyone leaving the affected countries will be screened for Ebola before departure and screened again upon arrival in the United States.

The CDC has also said it is working on a “multiagency” approach to ensure that anyone who may fall ill during the conference is given the proper medical care immediately, and is appropriately isolated to contain the threat.



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