Dr. Diane Weems knew the virus was on their minds, so the acting director of the East Central Health District just launched into it at last week’s meeting of the Richmond County Board of Health.
“OK, does anyone have questions about Ebola?” she asked board members.
The lethal outbreak in Africa has prompted a lot of unneeded fear even among health care workers who might not understand that it takes more than casual contact to cause an infection, she said.
Augusta and Georgia have faced far bigger public health threats in the past and will likely face worse in the future, experts said.
The problem with the outbreak in West Africa, where nearly 2,000 people have been infected and more than 1,000 people have died, is that unlike past outbreaks in self-contained rural villages, this one is occurring in more populated areas, Weems said. These countries also lack a good public health infrastructure and health workers might not be taking common infection control procedures, such as wearing gloves, she said.
“We know it is not passed through the air, like a cold or like the flu,” Weems said. “It’s by infected body fluids. Health care workers who are not using good infection control, not wearing gloves, are disproportionately being impacted there, in those communities.”
In the U.S., that would not happen. “Here, we know how to protect ourselves,” Weems said.
That is the difference between Ebola and a far more contagious respiratory virus that killed hundreds of people in 2003 called severe acute respiratory syndrome, or SARS, said Dr. Keith Woeltje, a professor of infectious diseases at Washington University in St. Louis and the former hospital epidemiologist at Georgia Regents Medical Center. He helped handle a suspected SARS case that came to the hospital that year.
“He had a travel history (to an outbreak area) and came in with respiratory symptoms,” he said. “We alerted the emergency department to screen people with appropriate symptoms to screen them for a travel history. He had been appropriately screened and was immediately put into isolation.”
That is what hospitals are being advised to do with travelers from those areas of West Africa who show up with a fever. In Georgia, the points of entry would be through Hartsfield-Jackson Atlanta International Airport, where there is a quarantine station for patients with fever who arrive from those areas, and the ports in Savannah and Brunswick, where crewmen from those areas with a fever would also be screened, said Weems, who is also Coastal Health District director in Savannah.
There is a clear difference in risk of contracting the disease even from those who are actually infected, Woeltje said.
“SARS is actually way more contagious than Ebola,” he said. “The people who have gotten Ebola really have had direct contact with blood and body fluids. So casual contact is really unlikely to spread Ebola.”
Think of sitting next to someone with either infection, Woeltje said.
“If you are sitting in a waiting room with somebody, you could have gotten SARS but you are not going to get Ebola,” he said.
Unlike a cold or flu, where the person is contagious a couple of days before symptoms show up, patients with Ebola don’t become contagious until they start showing symptoms, Weems said.
The flu is actually worse than Ebola in terms of its contagiousness and the damage it causes every year, Woeltje said.
“In terms of deaths, every year the flu season causes way more deaths worldwide than Ebola does,” he said. “And we have a vaccine for it, which granted is not perfect. But it’s still effective and we can’t get people to take the vaccine.”
In terms of emerging diseases threatening U.S. health, there are probably bigger threats, Weems said.
“(Mosquito control) would tell you we have more to worry about with chikungunya,” a mosquito-borne virus that causes terrible joint pain and can persist for years, she said.
“There is a concern that chikungunya will start to spread in the U.S. like West Nile (virus) did,” Woeltje said.
But those don’t cast the terrifying specter that Ebola does at the moment, even if the more mundane things are far more likely to be a threat to U.S. health, he said.
“People are not good assessors of risk, really,” Woeltje said.