Fact not Fear – Dr. Escott Answers questions about Ebola

http://www.khou.com/story/news/health/2014/10/16/highlights-from-factsnotfear-facebook-qa-on-ebola/17385729/

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Three medical professionals joined us at KHOU 11 Thursday for a Facebook Q&A that allowed viewers to ask and receive factual answers from knowledgeable professionals about Ebola.

Those professionals were:

– Dr. Richard Bradley with the UT Health Science Center at Houston

– Dr. Mark Escott with the Baylor College of Medicine and the Montgomery County Hospital District, and a doctor who recent traveled to West Africa with a team from the Baylor College of Medicine

– Kathy Barton with the Houston Health and Human Services Department

Here are the highlights:

If someone sneezes or coughs and expels mucus or saliva, wouldn’t that make it airborne?

Richard Bradley: We call this kind of transmission (sneezing) to be droplet, not airborne transmission. The mucus droplets from a sneeze can travel a pretty good distance, but will fall to the surface below them. They don’t float in the air. If that happened, we would be just as concerned about the flu virus floating in the air — which doesn’t happen.

What are some symptoms that should alert you to go to a hospital as soon as possible?

Mark Escott: If you do not have a history of travel to the areas with active disease spread or contact with bodily fluids of someone who is sick from that area, you should be concerned about other things. The chance of casual transmission in the community from touching a doorknob for instance is approaching zero. This is based on case history going back many years.

Can the Ebola virus be transmitted by money if the person was sick with fever?

Mark Escott: It is theoretically possible but unlikely that someone who is that sick would be out spending money in the community. However, money is dirty. It is a good idea to wash your hands or hand sanitize after handling money.

Why not lockdown the borders until we get a handle on this Ebola?

Kathy Barton: It is important to ensure that medical personnel and supplies can move in and out of the affected West African countries easily. It protects us more here if we can provide better health services in West Africa.

How many people can be isolated in the five facilities that the CDC claims to be Ebola ready? In other words, how many people with Ebola will overwhelm our health care system?

Mark Escott: My understanding is at this stage there are 19 beds at the five facilities. This seems like a small number, but it is the exact number of cases that Nigeria saw. They have nowhere near the healthcare infrastructure of the United States. We are unlikely to see more than a few at a time.

When can we expect a vaccine? When can we expect a medicine to treat this? Blood transfusions: What blood types can receive the transfusions with Ebola antibodies?

Mark Escott: It seems unlikely that we will have an effective vaccine during this outbreak. There are multiple drug trials in progress, but again it is unlikely that it will be helpful for this outbreak. Regarding part three, I do not have the information available regarding the availability of the blood transfusions from those who have recovered. Obviously this is a promising avenue for treatment.

Can it be transmitted via mosquitoes?

Richard Bradley: To the best of my knowledge, Ebola doesn’t infect mosquitoes, and hasn’t been implicated as a vector. Ebola has been found in bats and non-human primates.

How does someone wearing a safety outfit get the virus while someone who didn’t wear anything not catch it?

Kathy Barton: Mr. Duncan, the initial patient from West Africa, entered the US before he had any symptoms of infection. Our nation’s knowledge and understanding of the disease is evolving as we work in this country and West Africa to contain the outbreak. Travel advisories have been issued to the three West African countries with infection: Liberia, Guinea and Sierra Leone.

Do you think that the outbreak will increase rapidly?

Richard Bradley: I am hoping that it won’t and I’m ready if it does. We are always at some risk of epidemics — influenza is probably a bigger risk, but we can respond to an Ebola outbreak if it happens.

Can you contract Ebola more than once?

Richard Bradley: People who survive develop antibodies to Ebola. That *should* provide immunity to Ebola — at least to that strain (e.g. Ebola Zaire). I don’t know how long the immunity lasts for. As long as you have antibodies, you should not be able to get infected again.

Why are the nurses and doctors not being sprayed with the sterile spray after leaving the isolation unit like the doctors across the borders?

Mark Escott: Spraying the suits may lead to increased possibility of contamination due to the presence of additional fluid. In West Africa, where they are treating multiple patients at one site, it is more practical to sanitize the suits between patients rather than repeated application and removal of personal protection equipment.

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