Aug. 11, 2014 -- WebMD hosted an online chat on Thursday, Aug. 7, with an expert panel to answer reader questions about the Ebola virus outbreak.
The panel included:
Amesh A. Adalja, MD, an infectious disease doctor at the University of Pittsburgh Medical Center and a member of the U.S. government's National Disaster Medical System that was deployed to Haiti in 2010.
Thomas W. Geisbert, PhD, a professor of microbiology and immunology at the University of Texas Medical Branch, who's been studying the Ebola virus since 1988.
Robert Glatter, MD, an emergency medicine doctor at Lenox Hill Hospital who serves on the editorial board for Medscape.
Michael Smith, MD, the chief medical editor at WebMD.
Here are some of the questions that were top of mind for WebMD readers.
Question: How are health care workers getting infected with the virus, even though they are wearing proper equipment and following recommended procedures? Do you think the majority of infected health care workers that have access to proper personal protective equipment (PPE) are infected while doffing the PPE and making mistakes due to heat/exhaustion, or that they are being exposed outside of the isolation wards?
Adalja: Ebola is contracted solely by contact with blood and bodily fluids. When treating patients that may have Ebola, donning the appropriate personal protective equipment (gloves, gowns, masks, eye protection) can prevent this from occurring. Also, avoiding exposure to bodily fluids of those who are deceased is crucial. However, in resource-poor settings, even gloves may not be available, and health care providers often take care of individuals without full protection, placing themselves at heightened risk.
Reports from the field have stated that personal protective equipment (PPE) is scarce, and there have been calls for donations of equipment. There also is a concern that PPE may not work optimally in the weather conditions in West Africa. … It must be emphasized that the health infrastructure in these nations is poor and very conducive to lapses in infection control (even when PPE is available).
Question: Are there any precautions one can take while travelling on a flight in case a fellow passenger has been exposed to Ebola?
Glatter: It is unlikely to transmit the Ebola virus by just casual contact on an airplane. The virus is spread by close and direct, intimate contact. That said, I would wash my hands thoroughly, and avoid touching my eyes, nose, or mouth. The virus is not known to have sustained airborne or droplet transmission [Editor’s Note: The virus is not spread through the air or through droplets – for example, if someone coughs or sneezes near you], and is much less contagious than the measles or influenza. If you do use a restroom, make sure you thoroughly clean your hands after touching any surfaces in the restroom, and remember not to touch your mouth, nose, or eyes.
Question: What can kill the Ebola virus on surfaces?
Adalja: Ordinary hospital environmental cleaning substances can inactivate the Ebola virus. Bleach (10%), hospital grade phenol, and hospital grade quaternary ammonium compounds can be used. Similarly, ordinary cleaning agents on airplanes can be used.
Question: Why is the U.S. not making the ZMapp (an experimental serum given to two American patients) available to the West African nations, knowing that they are the worst hit? The drug has not been approved, but it’s been tested on the U.S. citizens, (so) why not give it to the people that need it before it becomes a world epidemic?
Geisbert: The issue regarding making ZMapp available to West African nations is quite complicated. There have been no phase I clinical trials yet, and ZMapp has not been approved by the FDA for use in humans in the U.S. Licensure can be a fairly long process. It could of course be approved for compassionate use by the FDA for use in the U.S. Things get really complex when you talk about using it in outbreak settings in other countries like in West Africa. For one thing, the involved countries would need to make a request from the companies. The other issue is that it would take some time to make enough ZMapp to handle an outbreak of this size.
Question: Can birds or insects carry the virus to different regions, or is infection exclusive to human beings only?
Smith: Outbreaks of Ebola happen when a person is infected by contact with an infected animal. Bats are known to be one of the animals that can transmit the infection. But you have to come in contact with body fluids or tissues from the animal. Once a person is infected with Ebola from an animal, they can then transmit the infection to other humans, and that's how an outbreak starts. At this point we don't think insects serve as a source of Ebola.