Medical workers in Guinea moving a dead body. Photo via Flickr user European Commission DG ECHO
It's become a sort of annual ritual for Americans to go wild over the possibility that a new, lethal illness might spread from Africa or Southeast Asia to their own backyard. Ten years ago, SARS was coming for you, and more recently, the Avian (bird) flu had overzealous parents stocking up on post-apocalyptic goodies like powdered milk and canned foods.
The latest dire threat to humanity is actually an oldie: the Ebola Virus, which was first identified after a mysterious fever swept through Zaire (since rechristened the Democratic Republic of the Congo) in 1976. Richard Preston introduced the specter of Ebola to much of the western world with a 1992 New Yorker piece that he subsequently expanded into a best-selling non-fiction thriller, The Hot Zone. The book, inturn, inspired that goofy piece of 90s cinema, Outbreak—though I preferStevenSoderbergh's 2011 film Contagion, which offers a somewhat less sensational take on the same theme.
Ebola sufferers will often bleed from their nose, eyes, and ears, in addition to a host of less bizarre symptoms like vomiting. The current outbreak is the largest in history, with about 700 people already dead in West African countries like Guinea, Liberia, Nigeria and Sierra Leone. Adding to the drama this week was the death of Sierra Leone's top Ebola doctor, along with news that an American traveling to Nigeria got sick and died there. The United Kingdom and Hong Kong are now quarantining passengers from the region, and with reports emerging of aid workers evacuating the West African coast, this is starting to look more and more like a global problem.
To find out just how likely Ebola is to reach our neck of the woods, I called up Dr. Diane Griffin, chair of Molecular Microbiology and Immunology at Johns Hopkins University's Bloomberg School of Public Health. She did her best to talk me down from the ledge.
VICE: What does the Ebola virus look like?
Dr. Diane Griffin: People get very rapidly ill with vomiting, diarrhea, bleeding—it's a hemorrhagic [bloody] fever. I'm not sure that if you lined up a whole bunch of people with different diseases that you could necessarily pick it out. Nobody has been able to figure out how the first person got infected.
What's the mortality rate?
The strain currently causing the outbreak in West Africa is Ebola Zaire, one of the original strains. They vary somewhat in how deadly they are, but this one has about a 70 percent mortality rate.
Is the number of deaths tied to the state of medicine and infrastructure in the country where the virus breaks out, or not really?
We don't know that because all these outbreaks are in Africa. One of the original outbreaks was in a missionary hospital that employed Belgian nuns, and the only way the whole Western world knew about it is that the nuns got evacuated to Belgium. But they still died at the same rate once they got there. It's a good example of the Western world not knowing or caring until their own get involved.
How does Ebola spread?
In contrast to a lot of other infections we worry about, it requires really close contact between the infected person and the uninfected person. The origin for the virus is in bats, and it gets into the human population kind of by accident. It spreads through hospitals—any place where patients are being taken care of. And more importantly, and more difficult to control, is in villages and families who are taking care of sick patients. It spreads within these families, and I gather—I'm not on the frontlines, though I have worked in Africa—I can envision a lot of the problems people encounter with suspicion. Medical workers and health care personnel [in West Africa] are scared and don't come to work. That makes it harder to keep up all these barrier precautions—it's inhibiting to have to be in a gown and mask and gloves and change them all the time.
What makes this outbreak different?
It's very widespread—usually they're quite localized—and they've had a hard time controlling it. The only way to contain the virus is through the isolation of patients and a barrier mechanism for preventing people who've had contact with infected individuals from being exposed to bodily fluids. It's not really unusual for American doctors working in these areas to get infected, though that tends to be what gets it into the press outside of Africa.
Which is sort of perverse.
Right. There's hundreds of cases and this has been going on for months, but all of a sudden in the last two days [people have noticed] because of two things: Americans have been infected, but also this person that flew to Nigeria, so all of a sudden everybody that has an airport is worried. It could move that way to any place just like any other infectious agent. I've heard rumors that they're starting to screen people leaving the area to make sure sick people don't get on airplanes. So that would be a reasonable precaution those countries can take to prevent it from spreading further. And then countries that have planes coming from that region can also screen passengers getting off to identify anybody with a fever or any other kind of illness and rapidly quarantine and then at least determine whether they're infected or not.
Do you think medical personnel would respond the same way to an Ebola outbreak here?
I think there would be much less of a problem in the United States or many other countries where medical personnel have a better understanding both of the precautions that need to be taken and how one gets infected. But the healthcare workers in many of these rural areas are not highly trained, and when they see co-workers and family members and neighbors dying, you can understand that would be a frightening situation.
What kind of precautions are reasonable for people outside of West Africa—and Americans in particular—to be taking? Should they modify their travel plans?
I don't think so, because the random tourist or businessperson or whoever is not going to come into contact with people who are sick—although there have been cases in the cities, which has been one of the problems. If you're going over there to help out in a hospital, then hopefully you know what you're getting into.
It sounds like you're reluctant to press the panic button. Is that your professional ethics talking, or what?
If I were panicked I'd let you know. I just don't think there's any reason for that. There are reasons to pay attention. One of the problems is that West Africa has not really experienced Ebola before, whereas Uganda and a few other countriues have had multiple outbreaks and they're a little more schooled in these control measures.
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