I started researching Ebola yesterday, when I realized I needed a refresher course to answer some of my own questions about the disease. For example:
Why are so many people getting Ebola so quickly? It’s spread by body fluids like HIV is, so why does it spread so much more quickly and effectively?
It turns out that many more body fluids are MUCH more infectious with Ebola than with HIV. Ebola can be spread (even through microscopic droplets) in saliva, blood, tears, vomit, feces, semen, vaginal secretions (there is some dispute among official sources as to whether sweat can spread the disease).
In this helpful taxonomy from the Journal of Infectious Diseases: Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites, the authors explain,
“We found EBOV to be shed in a wide variety of bodily fluids during the acute phase of illness, including saliva, breast milk, stool, and tears. In most cases, the infected bodily fluid was not visibly contaminated by blood. Of particular concern is the frequent presence of EBOV in saliva early during the course of disease, where it could be transmitted to others through intimate contact and from sharing food, especially given the custom, in many parts of Africa, of eating with the hands from a common plate.”
Unlike with HIV and many other bloodborne pathogens, casual contact such as sharing a meal with someone infected with Ebola is a seriously risky activity!
In addition, it can take up to 3 weeks for symptoms to appear! Even after symptoms begin, people can be ambulatory and highly infectious. Funeral rites for Ebola victims in West Africa also often bring families and communities into close (even direct) contact with deceased victims, whose bodies can still easily transmit the virus to others.
According to this World Health Organization report released yesterday (4/14/14), 168 cases of Ebola have been confirmed in West Africa, and 108 people have died from the disease.
As Sanjay Gupta explains in this video, a turning point in the outbreak’s trajectory was when the virus spread into Guinea’s capitol, Conakry, from outlying, rural areas where the outbreak began. People had been fleeing outlying villages in an attempt to avoid the virus, and someone infected inadvertently brought Ebola with them on the journey to the densely-populated city of almost 2 million people. The outbreak has spread across national borders in West Africa to Liberia, and cases are being tested in Mali.
HealthMap is an excellent (if also slightly terrifying) way to keep up with the geographic reach/distribution of all verified disease outbreaks globally, including Ebola:
U of M-affiliated readers can access GIDEON, which provides the full history of Ebola outbreaks globally clinical and diagnostic information, pictures, and even allows you to compare the disease to any others you might be interested in. For example:
For everyone living and traveling in West Africa right now, and for the brave, dedicated health workers on the front lines: stay safe!