Since the first outbreak of Ebola in Guinea in March, the virus has been spreading across western Africa.
As of Monday, four other countries outside of Guinea have had outbreaks: Sierra Leone, Liberia, Lagos and Nigeria. Friday morning the World Health Organization declared an international health emergency.
According to the CDC, “Ebola hemorrhagic fever is a severe, often fatal disease in humans and nonhuman primates, such as monkeys, gorillas and chimpanzees.” Just how the virus is transmitted to the first person in an outbreak is unknown, but researchers hypothesize that it is from an infected animal. The incubation period in humans is usually eight-10 days, but can be as few as two days or as many as 21..
McMahan said it is believed it might have been spread through the bite of a fruit bat, but no one really knows. Because no one knows the reservoir for the disease, it is difficult to predict where it could pop up in the future. Currently the outbreak is being spread person to person through direct contact with blood or secretions of the infected person and exposure to objects, like needles, that have been contaminated.
“As an outbreak progresses, sometimes people are afraid, for punitive reasons, that bad things will happen to them, (so) they tend to become more secretive,” McMahan said.
McMahan said that in order to stop the spread of the disease, the bodies of victims need to be cremated. In some of the areas of the outbreak, this practice has not been followed, inadvertently infecting more people.
McMahan said she has been sending out public heath memo to area doctors' offices in Allen County. McMahan said she has just finished her third on the Ebola virus. The CDC has listed evaluation recommendations for dealing with the virus, and how to collect a sample safely for testing. McMahan said it is critical that the nurse get a history of where that person has been in the last six months. That helps to narrow down what the person could be suffering from. Once a sample has been collected the Fort Wayne-Allen County Health Department would transport the specimen to the lab at the Indiana State Department of Health for testing.
“So many of these things have an incubation period. Three weeks out you may not think it's related to your trip and you don't tell the doctor,” McMahan said.
McMahan said at the early stage of the disease it is difficult to diagnosis Ebola, as the symptoms are similar to a lot of other serious viruses. Early diagnoses are critical in the survival of the patient. Symptoms of the disease include a fever greater than 101.5, severe headache, muscle pain, vomiting, diarrhea, abdominal pain or an unexplained hemorrhage.
If testing is indicated, local and state health officials need to be contacted. Should the patient prove to be infected, they will need to need to be hospitalized in isolation. There are recommended standards and procedures for this set up by the CDC. McMahan said the hospitals in Fort Wayne have the ability to do this. people with whom the patient had been in contact for the past 21 days will need to be assessed as to what risk they face.
“If they are at a high level of risk and have a fever, they will be tested. If they don't have a fever, they will be quarantined,” McMahan said.
The infected countries already have travel precautions, now they are doing some screening of people who are leaving these countries. Should the outbreak worsen, McMahan said there could be restrictions placed on people to keep them from leaving.
“Things could ramp up,” McMahan said.
McMahan said the disease is not airborne, so if there was someone traveling on a plane with an infected subject, and has no physical contact with the patient, they should be at low risk to develop the disease. Currently McMahan said unless someone has a fever, when getting off a plane from an infected country, U.S. officials are not testing. So far they have tested five people; none tested positive.
“I have a lot of confidence in the CDC. I feel like they have a wonderful communication system. I think they are pretty good at letting us know what the threat is and getting the information out there. They have the appropriate level of concern. I feel pretty good, especially with so much warning, we should be able to do well should anyone be identified here,” McMahan said.
Currently there is no cure for Ebola or a proven vaccine, although several are currently being worked on.
McMahan said she recommends that anyone planning a trip abroad to either come to the Health Department's travel clinic, where they can provide the information and vaccinations for the country they are traveling to, or go to the CDC website and look up the country. The website will tell them what vaccinations they need and they can also find current postings for any disease-related restriction in that area.