Prevent Ebola

Ebola hemorrhagic fever (Ebola HF) is a severe and often fatal disease in humans and primates, the precise origin of which remains unclear. Since its discovery in the Ebola River region of the Democratic Republic of Congo in 1976, multiple outbreaks have occurred in western Africa, the most recent beginning in 2014 among several nations in that region. Treatment options are limited at present, so the best way to prevent the transmission and spread of Ebola is to take steps to avoid infection and to isolate and treat the symptoms of the infected. Ebola can be deadly but is usually preventable, and rumors, myths, and fears don't help — sensible measures like those described here can.

Steps

Avoiding Infection

1. Get the facts on how the disease is spread. Ebola can be spread in a number of ways, though primarily via direct contact with patients, specifically the blood and secretions of an infected patient. Contact with objects such as clothing, bedding, and needles have also been linked to the spread of the disease.
   • Ebola requires direct contact to spread, so it cannot be spread through the air, and is unlikely to spread by coughing or sneezing. Mosquitoes and insects are also not known to be carriers.
   • Because the symptoms of Ebola are nonspecific and take time to become severe, the spread of the disease to friends, family, and throughout hospitals is unfortunately common during an outbreak. In a healthcare setting, the reuse of unsterilized needles and the lack of proper hospital clothing has contributed to the spread of the disease near the source.
2. Avoid areas in which infections have been reported and suspected. For now, the disease has only been confirmed in central and West Africa, with isolated cases in the U.S. and Europe among returning healthcare workers and within healthcare facilities where patients are being treated. For the most up-to-date travel warnings and information about potential outbreaks, visit the U.S. Centers for Disease Control and Prevention (CDC) website.
   • In general, you should avoid areas in which the disease has been reported and suspected. If you're already there, try to avoid healthcare facilities, unless you suspect you may be infected. Avoid direct contact with the infected, or anyone you suspect to be infected.
3. Avoid direct contact with infected people. Because the disease is spread primarily via direct contact with infected patients, the best way to avoid infection is to steer clear of people who are already sick. Blood and other bodily secretions from infected patients are linked closely with the spread of the disease – remember that you don't actually have to touch the infected person, you only have to come into contact with his or her blood or secretions on surfaces like clothing or bedding.
   • The remains of infected bodies are still contagious, making it important to handle the deceased with extreme care. Avoid direct contact with bodies and with the bedding and clothing of the deceased.
4. Avoid eating wild-caught bush meat. Researchers suspect that the disease came to humans via animals, probably through the consumption of the meat of primates.
   • If you're in an area where the disease has been reported, avoid purchasing, eating, or handling wild game to stay on the safe side.

Protecting Yourself in an Outbreak

1. Familiarize yourself with Ebola symptoms. Unfortunately, Ebola lacks any obvious, tell-tale symptoms that enable an immediate diagnosis. Since the symptoms are somewhat general, you must use your judgment to determine whether or not your proximity to an outbreak and the symptoms you note might signify the presence of the disease.
   • If you are in proximity to an outbreak, and/or to someone who has been near one, err on the side of caution if you have symptoms.
   • Symptoms normally appear between 2-21 days after exposure, with an average of 8-10 days.
   • Common symptoms of the disease include:
     • Fever
     • Severe headache
     • Fatigue
     • Muscle pain
     • Weakness
     • Diarrhea
     • Vomiting
     • Stomach pain
     • Unexplained bleeding or bruising
2. Wash your hands regularly. Washing your hands regularly and thoroughly with soap and warm water is absolutely essential, especially if you're in the midst of an outbreak.
   • Everyone assumes they wash their hands sufficiently, but there is a proper method to washing hands properly. This is the time to use it.
   • If in a medical setting, you should wash your hands, up to the elbow, before removing your hospital gown and other protective wear, and again after removal is complete.
   • Using alcohol-based hand sanitizers is better than doing nothing, but a good scrubbing with soap and warm water is always preferable.
3. Wear protective medical clothing if you're around infected patients. While it's safest to avoid areas of infection entirely, if you're working as a healthcare provider or volunteer around infected patients, the use of extreme caution is necessary.
   • When the virus first broke out, the CDC recommended that hospital workers use disposable masks, gloves, goggles, and gowns, to be worn at all times around infected patients. After a few cases of Ebola among healthcare workers in the U.S., however, the CDC recommends a Level 4 suit with a protective hood and taped seams for workers around Ebola patients.
   • Proper removal procedures are just as vital as how you put the protective clothing on. Study and follow the most up-to-date recommendations closely and with great care.
   • It's also important to never reuse needles under any circumstances. Discard bedding and clothing that came in direct contact with infected patients. Extreme caution is necessary.
4. Disinfect all medical hardware. Anything that comes into contact with infected patients, or with the bodily fluids of infected patients, needs to be properly discarded or sterilized immediately following use. Disinfectant needs to be used liberally in patients' rooms, and around sleeping areas specifically, to avoid the spread of the infection.
   • There are several acceptable methods for sterilizing medical instruments; make sure that whatever method chosen is followed carefully and completely.
   • To sterilize medical instruments, first rinse them thoroughly immediately following use while wearing protective mask, gloves, and gown. Then follow the sterilization protocol.
   • Operate the sterilizer according to proper procedures and then catalog the instruments and label them sterilized.
5. Isolate the infected, the deceased, and their belongings. If you're working with the infected, the highest level of security needs to be practiced. Isolation practices must extend as well to those who may have died of Ebola, along with the belongings of the living and deceased.
   • Plastic zipper barriers are being employed in some hospitals to minimize the contact that health care professionals have with infected patients, and in most hospitals patients are being quarantined, or separated from the general population to minimize the risk of disease spreading. Direct contact with patients needs to be reduced as much as possible.
   • The bodies of the deceased can still spread the infection, and as such must be handled with as much care as the living. Belongings must also be properly disposed of or disinfected.
6. Monitor your health carefully for twenty-one days after leaving an outbreak zone. If you pass three weeks without displaying any symptoms of Ebola, you are generally considered to be "in the clear."
   • If you display anything resembling Ebola symptoms during this 21-day period, you owe it to yourself, your loved ones, and the public at large to seek medical attention immediately.

Treating and Containing Ebola

1. Seek medical attention immediately if you have possible symptoms and risk of exposure. Remember, time is of the essence, not only to address your symptoms before they become too severe (should you have Ebola), but also to prevent additional spread of the infection.
   • If you have a fever or body aches but have not been near an Ebola outbreak region (or person who visited one), you probably don't have to worry. Likewise, if you've had such exposure risks but have no symptoms, you are unlikely to be infected. It's when both factors (symptoms and risk factors) are present that immediate action needs to be taken.
2. Undergo diagnostic testing if warranted. Diagnosis via symptom is somewhat difficult, because the symptoms are general. If you're experiencing any of the symptoms described in the previous section of the article, however, and you're in an area with reported infections, it's essential that you go to the hospital immediately and have a diagnostic test performed.
   • Depending on the facility and the amount of time since your symptoms appeared, any of the following diagnostic tests may be performed:
     • Antigen-capture enzyme-linked immunosorbent assay (ELISA) testing
     • IgM ELISA (Immunoglobulin M enzyme-linked immunosorbent assay)
     • Polymerase chain reaction (PCR)
     • Virus isolation
3. Contact the Centers for Disease Control (CDC) immediately. If you're in an area of infection and suspect that you may be infected, contact the CDC immediately to report your illness. Keeping the disease contained is essential, meaning that new infections need to be reported as quickly as possible in order to deploy resources and put efficient quarantines into place.
   • The CDC main phone number is 800-232-4636 (CDC-INFO).
   • Outside the U.S., contact the comparable health organization in that nation. Or, contact the World Health Organization (WHO) at + 41 22 791 31 11.
4. Address symptoms as they arise. Although some promising testing has been done, there is currently no vaccine or other "cure" for Ebola, so most of the treatment available involves addressing the specific symptoms and making the patient comfortable. Common symptom treatments include the following:
   • Maintain your electrolytes and stay hydrated. One of the most uncomfortable symptoms of the disease is severe diarrhea and nausea, making it important that you stay hydrated and keep your electrolytes up. Sports drinks can be used for mild dehydration, but IV-drip should be used in serious cases.
   • Monitor your blood pressure and control it if necessary. Rising blood pressure can destabilize a patient, while dropping blood pressure may be a serious sign of infection, making it important to keep your blood pressure under control. Health care workers should therefore keep a close watch on your blood pressure.
   • Breathe in an oxygen-rich environment. Difficulty breathing and chest pains are common in the infected, so oxygen is typically administered to make breathing as easy as possible. If you're struggling to get your breath, talk to a health practitioner immediately and have your oxygen levels checked.
   • Quickly address any symptoms of infection. It's important to communicate openly with the hospital staff and let them know of any discomfort or complications so that they may address your symptoms programmatically. Infections need to be treated locally with antibiotics and addressed swiftly, so be honest about when and where you're feeling pain.
5. Rest and wait. In the end, despite the best efforts of your medical providers, there's not much to be done but to try to ride out the disease. Keep your strength up, stay hydrated, and try to get as much rest as possible.
   • The disease is fatal in roughly 50% of the cases, but patients in good health with strong immune systems can often pull through if swift care is provided and safe recovery practices are followed.
6. Stay abreast of treatment options. Currently, there have been but a few vaccine trials that have shown promise, but scientists are working around the clock to develop effective measures to combat Ebola. Check with the CDC or WHO periodically for more information regarding potential vaccines/cures, and for up-to-date, general information about Ebola.

Tips

• Read the CDC handbook on Ebola precautions. This can be found online in PDF format.
• If you are concerned, do research about Ebola and its history.
• Visit the Centers for Disease Control and the World Health Organization websites. They often publish records of recent outbreaks. Avoid travel to places where Ebola is known to exist.
• Don't panic. Unless you live in an area where outbreaks are common, the odds of you contracting Ebola are minimal.
• Avoid disturbing African cave and jungle habitats as these disturbances are thought to be the main source of Ebola and Marburg virus outbreaks.
• Wash your hands and always wear gloves and masks around people with undiagnosed sickness.
• Other diseases that should be ruled out before a diagnosis of EVD (Ebola Virus Disease) can be made include: malaria, typhoid fever, shigellosis, cholera, leptospirosis, plague, rickettsiosis, relapsing fever, meningitis, hepatitis and other viral hemorrhagic fevers.

Warnings

• Men who have recovered from the disease can still transmit the virus through their semen for up to seven weeks after recovery from the illness.
• If you suspect that you have an un-diagnosed illness, please contact a health professional.
• Go to the ER (emergency room) if your temperature is over 104℉ (40℃), you feel extremely sick, or you are hemorrhaging (bleeding), whether you believe you are at risk for Ebola or not. These can be signs of infection or other serious disease.

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Sources and Citations

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