Last week a 40-year-old man who was infected with the Ebola virus flew to Lagos, Nigeria, from Liberia, stopping over in Ghana and changing planes in Togo—coming into contact with countless people along the way. This man, whose sister had died from Ebola, began exhibiting symptoms aboard the flight to Nigeria, was hospitalized after landing and died while in quarantine.
Although the World Health Organization has been managing Ebola outbreaks since the 1970s, the largest outbreak in history recently occurred in West Africa. Since March, 1,201 cases and 672 deaths have occurred in Guinea, Liberia and Sierra Leone. Between July 21 and 23 alone, 108 new cases and 12 deaths were reported in the three nations. And two American health care workers working in Liberia are now battling the disease.
As the international public health community scrambles to contain the virus, here’s what you need to know:
What is the Ebola virus?
The Ebola virus is a contagious and often deadly disease transmitted by direct contact with the blood, bodily fluids and bodily tissues of animals and people with the disease through broken skin or mucous membranes. The disease’s death rate runs as high as 90 percent, although the current outbreak is closer to 60 percent, according to the Centers for Disease Control and Prevention, which held a press briefing on Monday to address the current crisis.
The virus can incubate between two and 21 days from infection to the time symptoms appear. Initial symptoms—which include sudden fever, intense weakness, headache, muscle aches and sore throat—are similar to those of other diseases, including cholera, malaria, meningitis and typhoid fever. Vomiting, diarrhea, rash, impaired kidney and liver functioning, and in some cases internal and external bleeding follow. The virus is not contagious until the symptoms appear.
How contagious is it?
Unlike the flu and tuberculosis, the Ebola virus does not travel through air.
“Transmission requires close contact,” says Dr. Diane Griffin, chair of the department of molecular microbiology and immunology at Johns Hopkins Bloomberg School of Public Health. The fact that the virus is transmitted through bodily secretions—think saliva, blood, vomit, urine, stools and semen—makes it unlikely that it will spread in public settings. Another possible mode of transmission is through needles and other items contaminated with bodily fluids, according to the CDC.
“Family members and health care workers treating the sick are at greatest risk,” Griffin says.
Then why all the panic?
Now that one of the world’s most dangerous viruses has traveled from remote rural villages to Lagos—whose population the New York Times estimates at 21 million, making it not only the largest city on the African continent but also one of the largest in the world—fears are escalating that it will explode throughout West Africa. On Monday, Liberia took the uncommon step of closing most of its borders.
The CDC says it’s “very unlikely” that the disease will make it to the United States; however, officials here are taking the precaution of educating health care workers in the event that someone with the virus arrives on U.S. shores.
Should you cancel your trip to West Africa or tell your relatives not to come?
The CDC has upgraded its travel notices for Guinea, Liberia and Sierra Leone to a Level 3 warning, recommending that U.S. citizens “avoid nonessential travel”—both to protect themselves from possible exposure to the virus and to allow the respective governments to respond to the outbreak. “If you’re traveling on business, you’re probably pretty safe,” says Griffin. “The risks would come from any need for medical treatment that would potentially put you in contact with infected individuals, so postponing travel would probably be advisable.”
If you do happen to be traveling in or from West Africa, don’t be surprised if you are asked questions about your health or handed a flier stating that travelers are required to report any illness at the airport so that public health workers can isolate the sick to limit their exposure to others.
“If people are sick, they will probably not be allowed on the plane,” says Griffin, “but it’s a long flight. In the Nigeria case the person got sick on the flight—it was not recognized beforehand. It’s also possible that there will be more monitoring of flights coming from West Africa.”
Visiting family? The chances that you’ll encounter the virus are remote. Still, “it’s critical to avoid being exposed to ill people,” Griffin says. “For most people, unless they are going to a village or are visiting family or are medical personnel, they’re not at much risk.”
Going on a medical missionary trip? “Be schooled and observant of all of the precautions required of people who interact with patients,” Griffin says.
The chances of the virus making it to the U.S. are low, according to the CDC, which notes that there are few direct flights from West Africa to the U.S. However, if family arrives from the continent feeling sick, “hightail it to a medical facility,” warns Griffin. “Getting them to medical treatment is important.”
Editor’s note: This article has been updated to clarify Ebola’s contagiousness as a virus spread through direct, rather than airborne, contact, as well as to reflect additional travel guidance from the CDC.
Philadelphia-based writer Hilary Beard is co-author of Promises Kept: Raising Black Boys to Succeed in School and in Life and Health First! The Black Woman’s Wellness Guide, which won a 2013 NAACP Image Award. Follow her on Twitter and Facebook.
Philadelphia-based writer Hilary Beard is co-author of Promises Kept: Raising Black Boys to Succeed in School and in Life and Health First! The Black Woman’s Wellness Guide, both of which have won an NAACP Image Award. Follow her on Twitter and Facebook.