Hamptons Wellness:EBOLA FEAR, What you need to know

Ebola is a rare and deadly infectious disease that is characterized by the following signs and symptoms: fever, severe headache, muscle pain, weakness, diarrhea, vomiting, abdominal pain and unexplained hemorrhage (bleeding or bruising). Symptoms may appear anywhere between 2-21 days after an exposure to the virus. People DO recover from Ebola but it is dependent on early identification and good supportive clinical care. The mortality rate is anywhere from 40-80%.

Ebola was first identified in the Democratic Republic of the Congo in 1976 near the Ebola river. Although it is unknown what the natural hosts of the virus is, it is believed to be animal borne. It is believed that when humans ate bat or bush meat (a delicacy in some parts of the Congo and Liberia), the Ebola virus was acquired in humans.

Ebola is spread through direct contact. It is highly contagious! Ebola enters the body through what is called a 'Portal of Entry,' broken skin, mucous membranes in the eyes, ears nose or mouth with contaminated blood or body fluids including but not limited to urine, saliva, sweat, feces, vomit, breast milk and semen. The human body remains contaminated even after death. This is why it is imperative to dispose of the dead host properly, sometimes by cremation or burial in a specially sealed coffin.

The persons most at risk for getting infected are the family members caring for the sick, healthcare workers and people preparing and disposing the dead. Improper disposal or sterilization of contaminated material increases the risk for transmission of the virus. It is very important to note that even after recovery from Ebola where an individual is no longer infectious, Ebola virus has been found in semen for up to 3 months. Abstinence or the use of condoms will help prevent the spread of the disease. Pets may harbor the virus and they must be tested to insure they are virus free. Animals that are infected will unfortunately have to be euthanized.

The individuals most at risk for exposure are persons who have recently traveled to the western part of Africa. Healthcare workers involved in the recent cases inTexas are obviously at risk. But a word of caution. This disease is a now a world traveler. Ebola has appeared in Africa, Spain and the United States in this most recent outbreak. From a public health position, people everywhere in the United States should expect the possibility of outbreak in their community some tie in the future. It is important that our population not panic! Past outbreaks in Africa have been contained although the components of this current situation is much more problematic and dangerous. The disease spread from a rural area in Africa to the urban city. Dense populations, myths and denial has contributed to the spread in Africa. The use of 'home remedies and refusal to self-identify has made this outbreak much more difficult to contain. Ebola has always been a death sentence and the stigma attached to families with infected relatives is a powerful deterrent to seeking care. Suspicion of the government has made the task of identification and treatment very difficult (if this sounds familiar just think of the Swine Flu during the Nixon administration).

What do we do here and now? This would be a very good time to reinforce the techniques for preventing the spread of illnesses in our own backdoor. Hand-washing is the single most important aspect of reducing the spread of disease and illness. Parents should be teaching their children, schools should be teaching their students and employers should mandate in-service training for all employees about using good hand-washing techniques. ALL public buildings with bathrooms should have  signs illustrating hand-washing techniques. Local governments should have public service announcements about hand-washing. These interventions are that important. The next step is more difficult. We must begin to become disciplined about keeping our hands away from our faces, especially our eyes, nose, mouth and ears. This is an unnatural act and must be made into a habit. Again, practice will make perfect. This is less about preventing Ebola as it is about preventing the Flu (influenza season is beginning soon!), reducing the risk of the common cold. Parents must insist that their children wash their hands upon coming home and before each meal. Schools must have ample supplies of hand sanitizers and liquid soap in appropriate dispensers in bathrooms and around their schools (bar soap is a great source of spreading infection). I am not a great proponent of antibacterial soaps because I feel regular soap and friction from hand washing with good technique will remove most germs. The removal of door knobs (an great source of infection) and the use of swinging doors should be proposed.
If children are sick, keep them at home. If an employee is sick, do not pressure them to come to work. This only exposes more people to their germs. Ebola can be contained but it will take a more coordinated response to the epidemic in Africa than has been presented. I am astute enough to know that because this epidemic occurred in Africa as opposed to Europe, the world's response was muted and slow. In this global, interconnected community that we are all a part, it is more important than ever to know that we are all neighbors now. What happens in my backyard is sure to affect you. I hope that we don't get to the point that we have to close borders and restrict passage. People who are restricted in their travel WILL find a way to get out. By keeping borders open and travel regulated, the path of least restriction allows us to identify travelers who are at risk and by extension, a risk to others. 

We must remember that everyone in the 1980's did not know anyone who had AIDS except if they were a part of the Gay and Lesbian community, inner city Blacks or IV drug abusers. AIDS was not a problem for the greater unaffected population. In the 21st century, we have ALL been touched by the AIDS catastrophe. We as a society fell asleep at the switch because it was the 'OTHERS' who were affected. Well, this is about all of us now! If we fail again through the lack of moral imperative and political will to act aggressively to combat this disease now, I shudder to think what the results will be this time. We must not make this mistake again.