This column, which first ran in our August 21 issue, has been revised and updated by Dr. Crutchfield to run again due to the ongoing Ebola crisis.
Ebola Fever is a viral infection. The virus causes the bleeding (hemorrhage) of internal organs and of the skin. It also causes the infected person to have a fever. It is also known as Ebola Hemorrhagic Fever.
There is no vaccination against it. Ebola Hemorrhagic Fever can kill up to 90 percent of those infected. It is named after the Ebola River, an area where one of the first cases were reported in 1976.
There are several sub-types of the virus. The Zaire sub-type/strain is considered the most deadly. As of this report, since 1976, there have been approximately 6,500 cases of documented Ebola with over 4,000 fatalities.
Currently, countries in West Africa (including Guinea, Sierra Leone and Liberia) are experiencing one of the worst outbreaks of the Ebola virus ever documented with approximately 4,000 deaths at the time this article was written. One projection has an estimate of 50-100,000 fatalities before the epidemic is under control. The World Health Organization calls the Ebola virus “one of the world’s most virulent diseases.”
Fruit bats are probably the natural host for the virus, and they can pass it on to other animals. The human infections are thought to have originated from contact with infected monkeys.
Early symptoms include a sudden fever, general fatigue and weakness, muscle pains, headaches, red eyes, a skin rash with bruise-like blisters, chest pain, difficulty breathing, difficulty swallowing, vomiting, diarrhea and internal bleeding. It can affect internal organs like the kidney and liver and eventually cause death.
One of the common and curious early symptoms is severe hiccups. The symptoms occur anywhere from two to 21 days after infection but most commonly appear eight to 12 days after exposure.
Because the early symptoms are commonly seen in many illnesses, diagnosis can be challenging, and it can often be misdiagnosed as another disease such as malaria, typhoid fever, meningitis, the plague, or even cholera. Ebola can be definitively confirmed by specific laboratory tests.
Although there are experimental medicines to treat Ebola (such as ZMapp, Brincidofovir and Tekmira), none are FDA-approved yet. The World Health Organization has announced that in severe outbreaks it is not unethical to consider using experimental medications.
Currently, the treatment for patients is purely supportive: Maintain good hydration, support normal oxygen and blood pressure levels, treat symptoms, and prevent secondary infection. With early detection and supportive measures such as these, the mortality rate may be decreased to 40 percent or lower.
Ebola is contracted by coming directly into contact with blood, body secretions, or other body fluids from an infected person, or from exposure to a contaminated needle of an infected person. The vast majority of patients with Ebola know exactly where they caught it, from taking care of another person with the disease or who had symptoms such as fever, diarrhea, vomiting, bleeding and hiccups.
The good news is that the virus is sensitive to sanitizing measures such as chlorine and other medical disinfectants, heat treatment and detergents. Currently, there are some promising vaccines under research and development.
The chances of catching it on an airplane are thought to be very low. It is not spread by sneezing or coughing. There needs to be prolonged, frequent, and direct contact with body fluids or blood infected with the virus in order to catch it.
It is important to note: The infected person must be symptomatic in order to transmit the virus. Also, the corpses of persons who have died from Ebola infection can transmit the infection, so those caring for the body must exercise extreme caution and protective measures.
Outbreaks in the past have been controlled, and once an area has gone “infection free” for 42 days (twice the incubation period), the infection is considered to be under control. With the ease of worldwide travel, the challenge for governments, international healthcare organizations, airlines (and other passenger transportation companies), industrial/commercial sanitation and cleaning organizations and medical professionals will be to keep the infection contained and from spreading globally.
If you think you have been exposed to the virus, or to a person with the virus, please contact your physician, local hospital or 911 at once.
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.