A patient being treated at a Dallas hospital is the first person to be diagnosed with Ebola in the United States. Now that the first case has been reported, what does this all mean for the rest of the country, and what types of precautions should Americans take? Now more than ever, the population of the United States – the “melting pot” of all nations – is a mix of societies, cultures, beliefs, and attitudes that impact the health-care community.
Because of this “cultural gumbo”, few would argue that protection from infectious and communicable diseases is one of the health issues of greatest concern, and controversy.
Why not close down air travel to people coming from Ebola-infected countries, you ask?
Ebola can only be contracted through direct contact with a sick person’s bodily fluids. That means saliva, feces, urine, blood, vomit or semen. It isn’t transmitted through the air, so you are more likely to catch a cold on a flight than Ebola.
Even before this first U.S. Ebola case, four in 10 adults were concerned about the possibility of a large-scale outbreak of the disease in America. The concern is probably fueled in part by a widespread lack of knowledge about Ebola: Nearly 70 percent of Americans incorrectly believe the virus spreads “easily,” and a third of Americans believe (incorrectly) that there is an effective treatment for Ebola. Twenty-six percent of Americans are concerned that they or one of their loved ones will get Ebola within the next year. 
Can you catch Ebola from a blanket or a pillow that an infected person used days ago? What about from a doorknob in his apartment? How infectious, exactly, is this deadly virus?
These kinds of questions are naturally going through everyone’s mind as news bulletins tell of an Ebola patient in Dallas and another patient with “Ebola-like” symptoms at Howard University Hospital in Washington.
Just for the record, this is how to get Ebola: Come into direct contact with the bodily fluids of a person who is infected with the virus and already symptomatic. Ebola doesn’t travel through the air. A person in Washington, D.C., can’t catch Ebola from an Ebola-infected person in Dallas without going there and coming into direct contact with the patient’s bodily fluids.
Then, there is the Enterovirus D68, which is attacking children.
The virus, which began spreading rapidly across the U.S., and has led to severe respiratory infections and is believed to be directly responsible for a 4-year old child’s death, recently confirmed by New Jersey health officials. In that instance, the child died in his sleep after going to bed without any symptoms.
“Enterovirus” is the name given to a range of more than 100 viruses, which often cause nothing worse than a bad summer cold. The viruses cause between 10-15 million infections a year in the U.S., with a peak of infections toward the end of summer and beginning of fall. So, technically speaking, the worse of it should be behind us.
Fears of Enterovirus D68, and what it could mean for children are spreading nearly as quickly as the respiratory illness itself, with more than 500 cases confirmed across 42 states, according to the Centers for Disease Control and Prevention (CDC).
While there is no treatment for Enterovirus D68, some patients require treatment for specific symptoms. In severe cases a patient may require hospitalization.
The Enterovirus germ was first identified in 1962 and, like Ebola, has caused clusters of illness before. Because it’s not routinely tested for, it may have spread widely in previous years without being identified.
Infectious disease was the leading cause of death in children 100 years ago, with diphtheria, measles, scarlet fever and pertussis accounting for most of them. Today the leading causes of death in children less than five years of age are accidents, genetic abnormalities, developmental disorders, sudden infant death syndrome and cancer.
So, what are we to do? Antibiotics do not work on a virus, and remember, we’re dealing with viral infections.
This strain of Enterovirus spreads much like the common cold, which means that frequently washing your hands can lower your odds of getting sick. If you have to cough, observe proper hygiene and cough into a tissue (which you then dispose) or your upper sleeve – not your hands.
There is no vaccine for either disease. Enterovirus 68 has no vaccine. The Ebola vaccine is experimental. There are currently no FDA approved vaccines for Ebola. The NIH’s National Institute of Allergy and Infectious Diseases is working on developing an Ebola vaccine.
Vaccine development is a long, complex process, often lasting 10-15 years. Several companies are now working on finding vaccines for these infections. Although vaccines can normally take years to reach the market, researchers could rush the approval under an emergency use authorization.
Assuming that the day will come when a vaccine is approved, and available, for these diseases, there will be another problem waiting in the wings: The fear and suspicion widely held among large segments of the Unites States population.
In the U.S., vaccines have reduced or eliminated many infectious diseases that once routinely killed or harmed many infants, children, and adults. However, the viruses and bacteria that cause vaccine-preventable disease and death still exist and can be passed on to people who are not protected by vaccines.
Now that vaccines have virtually eliminated many once-feared diseases, the possibility of vaccine side effects or adverse reactions loom larger in some people’s minds than the diseases that vaccines prevent.
In the meantime, there’s the question of what happens if you get infected and survive.
Any patient who survives a severe viral infection could have damage to their kidneys, liver and heart, as well as long-term fertility issues. So if an Ebola patient survives, you can only imagine some of the long-term consequences he or she may face. As more patients survive and recover from this disease, we might begin to get a better idea on some of these issues. Any time a patient survives a significant viral infection, the autoimmune responses that the patient undergoes could have secondary consequences on the rest of the body— particularly in areas that are quite sensitive to immunological reactions and inflammation, like the joints and eyes.
The general complaint by many of these patients is chronic body pain and severe joint pain— called arthralgia. In many cases, patients develop complications of the eyes resulting in a condition called uveitis. The condition causes patients to experience swelling and irritation of the uvea, the middle layer of the eye, which provides most of the blood supply to the retina. Symptoms can include blurred vision, floating spots in the vision, eye pain, redness and sensitivity to light. Most attacks of anterior uveitis— inflammation in the front of the eye— go away in a few days to weeks with proper treatment, but relapses are common. However, inflammation related to posterior uveitis— affecting the back part of the uvea— could last for months or years and may cause permanent vision damage, even with treatment.
In many of these cases, the patient would require anti-inflammatories, as well as steroid therapies. After we look at the thousands of patients that are now being afflicted with Ebola, we’ll get a better picture of what the long-term consequences of this terrible virus will be.
One thing’s for certain for many of these patients – they may survive, but they’ll never be the same.
Experts say the best way to prevent transmission of Enteroviruses or Ebola is to:
Remember, I’m not a doctor. I just sound like one.
Take good care of yourself and live the best life possible!
