Wednesday, October 15, 2014

My concerns with Ebola

With a second case of Ebola transmission in the US, fears of a major outbreak are increasing.  A lot of information is being thrown out there about the way it can or cannot be transmitted.  We are told over and over it can only be spread through body fluids, but are often not given details about what this means.  While the list of body fluids Ebola lives in is long, its presence in mucus and saliva are the two that primarily make it communicable.  A person who has direct contact with the saliva or mucus of an infected and symptomatic individual can contract Ebola, but there are several caveats concerning that.  Ebola can't penetrate the skin, so the infected mucus or saliva would have to come into contact with someone's mouth, nose, etc. to enter the body.  For example, if you shook the hand of an infected individual, they could only pass it to you if their hand had a bodily fluid such as mucus or saliva on it, something that is unfortunately a real possibility.  After that, you would only become infected if you touched your hand to your mouth or nose before washing it, or if the virus found a way to enter through a cut or abrasion.

It gets trickier when trying to determine whether or not someone could catch Ebola from a contaminated surface.  I've read that the virus can't survive long outside the body, but it appears "not long" is still a few hours.  In this case the rules of transmission would be if you touch a contaminated surface a few hours after it became contaminated, you could become infected if the virus then came into contact with your mouth, nose, skin wound, etc.

There has been much discussion about the possibility of Ebola becoming airborne with many doctors and scientists saying it is possible.  While it wouldn't be impossible for it to happen it would seem to me that it is improbable.  The virus would have to make a steady series of mutations to become airborne, a series that I find it unlikely to make in a short time frame.

The greater danger with Ebola isn't that it will make the huge leap to become airborne, but that smaller mutations will cause slight alterations that could greatly enhance its infectivity or decrease our chances to detect it.  A single mutation that allowed it to survive outside the body for a significantly longer period of time would be trouble.  It would also be trouble if a mutation altered its symptoms in a manner that made it harder for doctors to recognize.  For example, this article mentions that not everyone who contracted Ebola gets a high fever that would serve as a flag for it.  The lack of a high temperature in this small percentage of patients most likely is due just to variance in physiology and not an alteration in the virus itself.  However, if an alteration in the virus would allow it to infect individuals without causing a significantly high temperature, at least for some time after a person becomes contagious, it would make it much more difficult for us to detect.

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