August 14, 2014

Ten Things to Know About Ebola

KANSAS CITY, Kan., Aug. 14, 2014 /PRNewswire/ -- The current Ebola Virus Disease (EVD) is the deadliest on record but it is important to understand key elements of this virus.

Lee Norman, MD, chief medical officer for The University of Kansas Hospital offers these 10 things to know about Ebola:

    1. Cases Are Out-Migrating From Africa: This is happening due to the fact
       that infected or ill people are traveling out of those countries in
       Africa with Ebola outbreaks.  Cases found outside of Africa may likely go
       up as the number of people leaving outbreak areas increases when
       aid-workers and others return to their home countries.
    2. No Cases of Human-to-Human Transmission Outside of Africa: There has been
       no human-to-human or other transmission to humans outside of Africa.
    3. Ebola Is Not Transmitted By Air, Only Via Bodily Secretions: Ebola is not
       respiratory, so it is not transmitted through coughing or breathing.
       These infections are occurring because of people who are exposed to
       bodily fluids of infected individuals.
    4. Ebola Is Not The Most Infectious Disease: As infectious diseases go,
       Ebola virus isn't inherently the most infectious nor is it the least
       infective from person-to-person.  Measles and chickenpox, for example,
       are easier to spread.  So are influenza and MERS.
    5. High Mortality Rates Due to Geography: The mortality rate is quite high
       in Africa Ebola cases, partly because of the chaos, instability, and
       unrest of the governments there, and very directly related to the fact
       that their access to standard treatment supplies (IV solution, tubing,
       syringes, and protective equipment) is not universally available. Ebola
       cases identified and treated in westernized nations, and those with
       modern infection control practices, will have a much lower rate than
       those seen in most African regions.
    6. Likelihood of Breakouts In Areas Outside of Africa: Meticulous infection
       control practices in modern hospitals will make it more unlikely that
       human-to-human transmission will occur in these settings.  While
       expensive and advanced bio-containment units provide the highest level of
       infection control, it is unlikely that these units will be widespread
       throughout the world.
    7. No Approved Immunizations and Treatments: There are no approved
       immunizations to prevent Ebola virus infection. There are no approved
       treatments for Ebola virus infection.  There are experimental antibody
       treatments, as well as an antiviral medication not approved for Ebola. 
       But whether either or both are safe or effective for widespread use is
       not known. "Compassionate use" or "experimental use" of the above
       treatments is tempting, because no targeted, specific "conventional
       treatment" exists.  But widely adopting experimental, unproven
       medications as "the new conventional therapy" has its own difficulties:
       Is it safe?  Is it effective?  Is it costly?  Are there unanticipated
       "down-sides" to using them? A WHO ethics panel has given the go-ahead for
       this, something it has never done before.
    8. How Animals Play a Role: The non-human vectors that can harbor Ebola
       virus (fruit bats, non-human primates) are widespread in areas far
       removed from Africa.  As such, it bears watching whether those vectors
       begin to harbor the virus.  The WHO has an excellent map showing the
       parts of the world with these vectors.
    9. Alert Levels: The WHO and CDC both recently increased their respective
       alert levels. State and local health departments throughout the U.S. and
       world will certainly seek guidance as to the adoption of best "local
       practices" to guide hospital and care providers. The guidance by the CDC
       as to how to manage exposed individuals and those who might be incubating
       the infection are quite specific and helpful.  They will certainly change
       as time goes on.
    10. What We Don't Know About Ebola: There are things unknown about Ebola. 
        For example:
        a. Can a person have had a low-level infection and not know they ever
           had it?  Probably, based on serum testing.
        b. Does a person who has had it and survived develop lifelong immunity? 
           That is unknown at this point.  The various strains of Ebola are
           enough different antigenically that there may not be cross-immunity.
        c. Is there such a thing as a "chronic carrier state" in humans where a
           person can shed the virus and be infectious for a long period of
           time, even when they themselves have no illness or symptoms? That is
           also unknown at this point.

The University of Kansas Hospital is the region's premier academic medical center, providing a full range of care. The hospital is affiliated with the University of Kansas Schools of Medicine, Nursing and Health Professions, and their various leading-edge research projects. The constantly growing facility contains 699 staffed beds (plus 24 bassinets) and serves more than 28,000 inpatients annually. All 12 of its medical and surgical specialty areas are ranked nationally by the U.S. News & World Report "Best Hospital" lists, including Cancer (#29), Cardiology & Heart Surgery (#21), Diabetes & Endocrinology (#20), Ear, Nose & Throat (#17), Gastroenterology and GI Surgery (#24), Geriatrics (#16), Nephrology (#33), Neurology & Neurosurgery (#12), Pulmonology (#12), Gynecology (#38), Orthopedics (#33), and Urology (#36). The cancer program is part of The University of Kansas Cancer Center, a National Cancer Institute designated program. The hospital has received Magnet nursing designation, reflecting the quality of care throughout the hospital, an honor awarded to only 6.6 percent of the hospitals nationwide. The hospital also houses the region's only burn center, the area's only nationally accredited Level I Trauma Center and the area's only Advanced Comprehensive Stroke Center recognized by the Joint Commission. For more information, visit


SOURCE The University of Kansas Hospital