Ebola Virus Ripples Felt Here

Published 4:29 pm Thursday, October 30, 2014

PRINCE EDWARD —Ebola is a potentially deadly virus hammering several West African nations.

The ripple effects are being felt in the U.S. as well.

“I think we have to take it very seriously,” said Piedmont Health District Director Dr. Alexander Samuel. “This is not something that we will relax about. So long as there are Ebola cases in West Africa, there’s potential for it to…come overseas. We as a public health system…really maintain a heightened level…for all sorts of diseases. This one will be added to that list as a matter of course now.”

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The Herald recently sat down with Dr. Samuel to discuss the topic that is abuzz in the national news.

“What I am not so concerned about is an outbreak of Ebola virus disease in the United States—certainly including Virginia—just by virtue of the fact of our…advanced public health response system and the assets that could be brought very quickly to bear from both state and federal agencies.”

Risk Factors

Dr. Samuel highlighted several areas including risk factors: you can only get Ebola by direct contact with bodily fluids from someone who is sick with Ebola, direct contact with an item, which he offered is mostly in the health care setting such as needles used to treat an individual exposed to bodily fluids, or be exposed to animals that carry Ebola virus.

“In this country, fortunately, we don’t have that sort of situation. Right now, all we know about with regard to those animals are species of monkeys and certain species of bats that reside in Africa,” Dr. Samuel said.

There has been no evidence of Ebola being transferred through domestic animals common in the U.S., including cats and dogs, according to Dr. Samuel.

He noted, “You cannot get Ebola by airborne transmission, waterborne transmission—through the water—or through food, again assuming people eat food consistent with cultural practices here in the United States…the issue that’s going on in West Africa is eating so called bush meat and this would include some of the animals I mentioned earlier that could potentially harbor the virus.”

Currently, there are only three countries that the CDC and the World Health Organization considers at risk for Ebola: Liberia, Guinea and Sierra Leone (in West Africa). So, understandably, travel history is important as well as evaluating symptoms consistent with Ebola, which include fever, vomiting, diarrhea, extreme muscle aches, headaches and hemorrhaging through the nose, mouth and even eyes.

“The other kind of category of individual that we would consider at potential risk as we screen would be somebody who has had contact with an individual who has been sick with Ebola,” Dr. Samuel cited.

Those most at risk include those with the travel history and those caring for known Ebola virus disease patients.

The average person who can deny the risk factors, is “really not at risk of being potentially exposed to Ebola disease.”

Few Cases

There have been few cases in the U.S., though concern runs high. Dr. Samuel also noted last week that we had just made it through the 21 days of quarantine for the close contacts of the individual who died with Ebola in Dallas. It is good news, but Dr. Samuel offered that it kind of re-enforces the notion that it’s through direct contact with bodily fluids of someone who is sick with the disease.

In West Africa, the fatality rate runs at about 70 percent for those contracting Ebola. There are a lot of things that are specific to the area that feed into the high fatality percentage, including a very poor health system and seeing patients in the later stages of the disease.

Given our robust public health system “where we are able to identify individuals at points where we can intervene using our very advanced health care system, individuals with Ebola virus disease, hopefully will be…managed appropriately in isolated settings with people who are equipped and trained to…manage the spread of disease to themselves,” Dr. Samuel said.

Dr. Samuel noted that the public health system worked hard to do contact investigation in Dallas. It’s something “we are well equipped to do,” he cited, noting they do it all the time with other diseases. That means locating those who have had direct or concerning contact with individuals who have a disease. Parallel situations, he offered would be such things as tuberculosis, measles, mumps and pertussis.

“…In a case like Ebola we would…with help…from the CDC in this situation, do extensive contact investigations, find out who had high risk contact with an individual who has the disease and then take actions to—based on the type of contact—monitor them closely for symptoms or, if necessarily, quarantine, which is what happened in that situation in Dallas with many of the very close contacts of that individual,” Dr. Samuel said.

Where Things Are Now

Dr. Samuel noted, “…Right now we are at a point where health care institutions and public health systems are responding, I think, appropriately—pretty much getting our plans activated, in place and refined, which will probably be an on-going process as planning works…So, we’re continually monitoring as a public health institution for potential cases or…appearances of disease that…could mimic it or…resemble it in some way shape or form that require some sort of further evaluation.”

He added, “We have had nothing to date that we have had to explore in depth in this health district…We are working certainly with the hospital and other health care providers closely with regard to ways to evaluate patients that they might be seeing. We’re engaged in that. We’re also supporting testing for Ebola, which is only being done at hospitals by virtue of…potential risks…that come with bodily fluid exposure. And so…that has to be done carefully in a very controlled environment and testing is mediated through the Virginia Department of Health as well as the CDC.”