Do I need to worry about Ebola?

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So it has finally happened. As I write, the news is breaking that the first case of Ebola has been identified in the UK as a result of the crisis in Africa this year. We do not know currently how ill the patient is, and of course our thoughts and prayers are with them and their family as they are with the countless individuals elsewhere in the world affected in the same way – meanwhile, a timely look at all things Ebola seems in order.

The first, and most important, thing to say about Ebola is that it is actually quite difficult to catch. Ebola is one of the so-called haemorrhagic fevers and on average 50% of people who catch it die as a result. However, thankfully Ebola is not ‘airborne’, that is it has never yet been transmitted from one person (or any other species, primates can also catch Ebola) to another through the air in the same way as a cold or flu is; to have a chance of picking up this virus you need direct contact with the body fluids of another person who has been infected with it and who is currently experiencing symptoms. Symptoms of Ebola can develop anything from 2 to 21 days after the person involved has contact with the virus, and in the time between the infection and the onset of the symptoms the risk of the virus being transmitted to another person is extremely low. For this reason, the health profession has been advised to ask anyone with symptoms that may represent Ebola infection (more of which next) if they have travelled to a high risk area in the last three weeks – after this, it is almost certain that the symptoms are caused by something else.

The symptoms of Ebola are vague enough, in the early stages at least, that they can easily be diagnosed as something else; they include fever, chills, muscle pains, headache, sore throat, rash (so just like flu so far then), nausea, vomiting or diarrhoea, but in the later stages it generally becomes fairly obvious that this is not just straightforward man flu and requires expert treatment in hospital. The current advice is that if you have been to Guinea, Liberia or Sierra Leone in the last three weeks and develop any of these symptoms then please stay at home and phone either 999 or 111 to explain that you may have had contact with Ebola.

The people who are most likely to contract Ebola are those who are caring for patients who currently have the disease, either in their capacity as healthcare/laboratory workers, or family members. For healthcare workers, infection control measures are extremely important including protective clothing involving face masks, goggles, gowns and gloves, disinfecting medical equipment carefully and, thankfully, hand washing is very effective. If you are not a healthcare worker or a relative of someone who has recently returned from an affected country with the symptoms, then your risk of having Ebola are currently very low in the UK.

If a health care professional suspects Ebola (and we’ve all been sent the relevant information!) then the virus can be easily found in blood or other body fluids in a laboratory test.

Sadly there is no vaccine or antiviral treatment that is specific to curing Ebola, although in the wake of the crisis this year experimental interventions have been tried with varying degrees of apparent success. The most important management is to isolate the patient to prevent spread, and so-called ‘supportive’ measures – plenty of oxygen, lots of fluid through a drip, drugs to keep blood pressure normal and generally monitoring as many aspects of the patients health as possible and doing whatever it takes to keep those things as normal as possible while the patient’s own immune system hopefully sorts out the virus.

Currently as individuals we can only be aware of the situations in which it is possible to catch Ebola and be responsible in informing healthcare professionals if we believe we are personally affected. As a nation we are screening people travelling to the UK from affected countries by checking their temperature and asking for a brief health questionnaire to be completed. In the wider context, we can do whatever possible to support the healthcare systems in the affected countries to limit the spread both there and internationally.
In summary, Ebola is a very unpleasant disease but is thankfully pretty difficult to catch, and once we are aware of who is likely to have it then it becomes relatively easy to make a diagnosis. Experimental treatments are having some success and a lot of research is ongoing with the hope of good treatments being available in the future. If you have any concerns about your own risk of Ebola then please stay at home (!) and telephone either 111, 999, NHS Direct or your GP. The risk of Ebola in the UK remains extremely low and it is almost certain that they will be able to reassure you.


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