Monday, October 20, 2014

Why you shouldn't worry about Ebola

Everyone and their mother is worried about Ebola right now. They shouldn't be. Writing this post to lay down some facts and let a few of my more hysterically inclined friends sleep easier at night.

My Credentials

Hi! My name's Matt and I have a Master's degree from the University of Michigan School of Public Health for Hospital and Molecular Epidemiology. That means I dedicated 2 years of my life learning about the math and biology behind diseases like Ebola, and was competent enough to pass all my exams and graduate. Being taught by infectious disease experts means I know a little more about diseases and how they spread compared to your friend Larry on facebook. Wanted to share some knowledge so you know how to protect yourself and impress your friends at the cool kid parties with your newfound Ebola wisdom.

Ebola basics

First off, everything you could ever want to know about Ebola can be found on the CDC website. Most of what I'm going to say is copy/pasted from there. For me, I understand a virus better once I break down how it works at a micro level. Check out this great video which explains the inner workings of Ebola:

(Skip to ~1:43 if you don't want to watch the entire video)

Let's simplify that a little further. Think of your body's cells like exclusive nightclubs. They have bouncers standing guard (glycoprotein receptors) at the entrances to make sure only VIPs can enter. The Ebola virus has a bunch of fake IDs (glycoproteins) that it uses to trick your cells' bouncers into letting it get inside the club. Once it's in there, the Ebola virus shoots out its RNA (viral blueprints) and hijacks your cell's replication machinery to create more Ebola viruses (Punches out the bartender and starts making drinks? I'm done with this metaphor...). Ebola specifically targets your liver cells, cells lining blood vessels, and certain cells in the immune system. So when immune cells go to fight the virus on blood vessels, they will often get infected and compromised into virus factories. This is one of the reasons that the virus has such a long incubation period (time it takes to show symptoms), since your immune cells can take 2-21 days (7-8 days is the average amount of time) before they can raise the alarms and start responding to the virus in force.

Your immune system work has to work extra hard against Ebola.

Symptoms and Transmission

Ebola causes the following symptoms once it has had time to incubate:

  • Fever
  • Severe headache
  • Muscle pain
  • Weakness
  • Diarrhea
  • Vomiting
  • Abdominal (stomach) pain
  • Unexplained hemorrhage (bleeding or bruising)
The virus is often hard to spot since most of these symptoms are shared by common viruses like influenza (the flu). This similarity to other diseases leads health officials to worry about hysteria. However, unlike the flu which can spread a few days before symptoms, Ebola is not contagious until symptoms present themselves, and you can only get Ebola by exposing your mucous membranes (eyes, mouth, nose, genitals, open cuts, etc.) to an infected person's bodily fluids. Here's a quick video created by some of my former teachers explaining how Ebola spreads from person to person:

The U of M Epidemiology team has prepared more videos like the above which can be found here.
(If you're curious)


Kind of mean, but the right way to think about Ebola.

So to sum up, don't come in contact with the bodily fluids of an Ebola-infected individual. Here's every way the disease can be transmitted, copy/pasted from the CDC:

When an infection does occur in humans, the virus can be spread in several ways to others. Ebola is spread through direct contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with...
  • Blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
  • Objects (like needles and syringes) that have been contaminated with the virus
  • Infected animals
  • Once someone recovers from Ebola, they can no longer spread the virus. However, Ebola virus has been found in semen for up to 3 months. Abstinence from sex (including oral sex) is recommended for at least 3 months. If abstinence is not possible, condoms may help prevent the spread of disease.

So Why Is Ebola So Scary?

Once you get Ebola, it's a very nasty disease with a very high mortality rate. Looking at past outbreaks, on average ~50% of infected persons die. At the same time, you should consider that the disease has never been in the United States until a month ago, and that medical care in Africa is DRAMATICALLY worse than what we have in America. The CDC is also aggressively tracking and controlling the spread of the virus to nip it in the bud before it can grow out of hand.

Hans Rosling is correct that we need to spend our resources stopping the spread of Ebola before it snowballs out of control. This is why the world is infuriated by the incompetence of the healthcare workers handling the first US Ebola patient. One of them even took a plane trip after exposing herself, endangering the lives of 132 other passengers (the CDC has isolated these people and is closely monitoring them). These are the kinds of mistakes that will allow the disease to spread, and they must be eliminated.

We can't be too mad at the Texas healthcare workers though. The disease has never before been on US soil and you would be hard pressed to find anyone who routinely recognizes and treats Ebola patients. An honest mistake was made during the initial triage. But any mistake that leads to anal bleeding is a painful lesson to learn.

All eyes are on Ebola now.
Thankfully, all known cases of Ebola are being closely tracked and monitored. Any contact or at risk individual is being closely watched as well. Now that we're aware of the disease, the threat is isolated, and proper precautions are in place to ensure that the disease will not spread beyond Texas. Only 3 people are infected so far, and hopefully no one else will contract the disease.

If you want to avoid Ebola, avoid contact with infected bodily fluids. Infected persons should be easy to spot since they are probably bedridden and bleeding out of every orifice. If you're sick, avoid contacting other people so you don't spread the disease. It's that simple.

I'm not worried about Ebola, and you shouldn't worry either.

Have a question? Leave me a comment below or ask me on twitter. Feel free to share this if you feel others will benefit from some Ebola truth.

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