What does ‘direct contact’ mean? The truth about Ebola transmission

[mystery-ak]

http://www.foxnews.com/health/2014/10/03/what-does-direct-contact-mean-truth-about-ebola-transmission/

What does ‘direct contact’ mean? The truth about Ebola transmission
Published October 03, 2014
FoxNews.com

In light of the first diagnosis of Ebola in the U.S. earlier this week, concerns over whether the disease will spread— and by what means— still linger.

The family of the Ebola patient Thomas Eric Duncan has been quarantined in the Dallas apartment he was visiting before being admitted to an area hospital. Fifty people who came in contact with Duncan since his arrival in the U.S. on Sept. 20 are being monitored, the Centers for Disease Control and Prevention (CDC) confirmed Friday.

The CDC said in a release Friday that it has recorded 10 "possible" Ebola cases nationwide. Of those, 17 have resulted in blood tests.

Ten people in Texas are now being considered “high-risk” and will be monitored daily for 21 days, the incubation period for Ebola. Ebola symptoms typically appear between eight and 10 days after infection, according to the CDC.

People who are infected with Ebola are not contagious until they become ill, Dr. Beth P. Bell, director of the National Center for Emerging and Zoonotic Infectious Diseases at the CDC, said during a press conference Friday.

When patients are infected, “the next steps are basically threefold,” said Dr. Thomas Frieden, director of the CDC, in a press conference on Tuesday. “First, to care for the patient … to provide the most effective care possible as safely as possible to keep to an absolute minimum the likelihood or possibility that anyone would become affected, and second, to maximize the chances that the patient might recover.”

The third and possibly most daunting step, which the CDC has been working with Texas health officials on since Monday, is identifying and monitoring anyone who may have come in contact with the patient.

Initial symptoms of Ebola include fever, fatigue, muscle pain, headache and sore throat, according to the World Health Organization (WHO). The disease is transmitted only through direct contact with bodily fluids from a person who has exhibited symptoms.

Direct contact occurs when bodily fluids— such as blood, saliva, mucus, vomit, urine or feces— from an infected person, dead or alive, have touched another person’s eyes, nose, mouth or an open cut, wound or abrasion, according to the CDC.

Ebola is not spread by water or directly by food, nor is it transmitted by air like respiratory illnesses such as measles and chickenpox. Coughing and sneezing aren’t common symptoms of Ebola, but if a symptomatic patient coughs or sneezes, and the saliva or mucous comes in contact with another person’s eyes, nose or mouth, these fluids may transmit the disease.

Medical workers pictured in hoods and respirators are wearing those items for precautionary purposes and not out of necessity, Dr. Jeffrey Duchin, chief of communicable disease epidemiology & immunization of public health in Seattle and King County, Wash., told FoxNews.com. Face masks are part of infectious disease control protocols, to avoid splashes and droplets, but masks that filter air are necessary for airborne illnesses, which Ebola is not.

When someone recovers from Ebola, they can no longer spread that specific species of the virus, according to the CDC. People who recover from Ebola develop antibodies that last for at least 10 years, research shows.

Nonetheless, Ebola has been found in semen for up to three months after the person recovers. The CDC advises that those who become infected abstain from sex or use condoms for three months after they recover.

Ebola can live outside of the body — on surfaces like countertops or doorknobs, for example — for several hours. In bodily fluids like blood, on the other hand, the virus can survive outside of the body for several days at room temperature.

According to the World Health Organization (WHO), health-care workers without proper personal protection equipment, or who aren't trained in infection prevention and control, are most at risk of contracting Ebola.

During the press conference Friday, Texas health officials declined to disclose the number of hospital workers who may be at risk after having contact with Duncan before his isolation.

Although scientists haven’t yet identified the natural host of the virus, researchers believe the first-ever patient contracted the disease through contact with an animal infected with Ebola. In West Africa, Ebola may have spread as a result of handling animals hunted for food, or by contact with infected bats.

According to the CDC, Ebola can be killed with hospital-grade disinfectants, including household bleach.

[Fishrrman]

From the article:
[[ Medical workers pictured in hoods and respirators are wearing those items for precautionary purposes and not out of necessity, Dr. Jeffrey Duchin, chief of communicable disease epidemiology & immunization of public health in Seattle and King County, Wash., told FoxNews.com. Face masks are part of infectious disease control protocols, to avoid splashes and droplets, but masks that filter air are necessary for airborne illnesses, which Ebola is not. ]]

Once again, I'm going to put up an excerpt from Richard Preston's "The Hot Zone".
Judge for yourself (from the experience of people who dealt with an outbreak of Ebola in a monkey-storage warehouse in Reston, Virginia in 1989):
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General Russell's office occupied a corner of a low-slung Second World War barracks that had been recently plastered with stucco into a hopeless effort to make it look new. It had a view of the legs of Fort Detrick's water tower. Consequently, the general never opened his curtains. The visitors sat on a couch and hairs, and the general settled behind his desk. He was a medical doctor who had hunted viruses in Southeast Asia. He was in his late fifties, a tall man with hair thinning on top and gray at the temples, lined cheeks, a long jaw, pale blue eyes that gave him a look of intensity, and a booming, deep voice.

C.J. Peters handed the general a folder containing the photographs of the life form in the monkey house.

General Russell stared, "Holy shit," he said. He drew a breath.

"Man. That's filovirus. Who the hell took this picture?" He flipped to the next one.

"These were done by my microscopist, Tom Geisbert," Jahrling said.

"It could be Ebola. The tests are showing positive for Ebola Zair."

C.J. then gave an overview of the situation, telling the general about the monkeys in Reston, and finishing with these words: "I'd say we have a major pucker factor about the virus in those monkeys."

"Well, how certain are you that it's Ebola?" General Russell asked. "I'm wondering if this could be Marburg."

Jahrling explained why he didn't think it was Marburg. He had done his test twice, he said, and both times the samples were positive to the Mayinga strain of Ebola Zaire. As he spoke to the general, he was very careful to say that test did not in itself prove that the virus was Ebola Zaire. It showed only that is was closely related to Ebola Zaire.

It might be Ebola, or it might be something else-something new and different.

C.J. said, "We have to be very concerned and very puckered if it is of the same ilk as Ebola."

They had to be very puckered, Russell agreed. "We have a natural emergency on our hands," he said. "This is an infectious threat of major consequences." He remarked that this type of virus had never been seen before in the United States, and it was right outside Washington. "What the hell are we going to do about it?" he said. Then he asked them if there was any evidence that the virus could travel through air. That was a crucial question.

There was evidence, horrifying but incomplete, that Ebola could travel through the air. Nancy Jaax described the incident in which her two healthy monkeys had died of presumably airborne Ebola in the weeks after the bloody-glove incident, in 1983. There was more evidence, and she described that, too. In 1986, Gene Johnson had infected monkeys with Ebola and Marburg by letting them breathe it into their lungs, and she had been the pathologist for that experiment. All of the monkeys exposed to airborne virus had died except for one monkey, which managed to survive Marburg. The virus, therefore, could infect the lungs on contact.

Furthermore, the lethal dose was fairly small: as small as five hundred infectious virus particles. That many particles of airborne Ebola could easily hatch out of a single cell. A tiny amount of airborne Ebola could nuke a building full of people if it got into the airconditioning system.

The stuff could be like plutonium. The stuff could be worse than plutonium because it could replicate.

C.J. said, "We know it's infectious by air, but we don't know how infectious."

Russell turned to Jaax and asked, "Has this been published? Did you publish it?"

"No, sir," she said.
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What do you think?
Whom would you trust?