Expert: Disease poses little threat here

By Nick DukeOctober 14, 2014

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Health-care workers put on personal protective equipment before going into the hot zone at Island Clinic in Monrovia, Liberia, Sept. 22. As the U.S. helps to combat the spread of Ebola virus in Africa, Fort Benning's chief of preventative medicine sa... (Photo Credit: U.S. Army) VIEW ORIGINAL

FORT BENNING, Ga., (Oct. 15, 2014) -- With the Ebola outbreak in West Africa garnering worldwide media attention, some have expressed concern the disease could find its way to the U.S., perhaps even to Fort Benning.

However, Lt. Col. Daniel Bigley, chief of preventative medicine for MEDDAC, said the disease is unlikely to take hold here.

"I would have to say that the likelihood we're actually going to have to treat an Ebola patient, let alone an Ebola outbreak or Ebola epidemic, is very low," Bigley said. "The reason I say that is if you go back over the last 20 years, we've had approximately five patient zeros (initial patients in the population) for viral hemorrhagic fevers that are very much like the Ebola viral disease. Those five patient zeros never propagated the disease. Not only was there no outbreak, but there was no epidemic. Hundreds of people were interviewed in a contact investigation for each of those patient zeros. None of them ever propagated an outbreak or an epidemic and in fact, none of them ever propagated the disease to another person. We have better medical technology and better communication technology, so the likelihood that this will propagate to even one person is very low."

While Bigley said there is not much cause for concern, he also said health officials are taking the proper precautions in the event a confirmed case of Ebola does reach the region.

"Just because a threat level is low doesn't mean we're dismissing it," he said. "We certainly have a lot of heightened awareness. ... I wouldn't say there's a panic with any of the local, state or federal medical agencies across the U.S. There's a heightened level of preparation and suspicion. It's not a suspicion that involves some kind of worry that we're facing impending doom. We're trying to get ahead of things as much as we can so that we have a very alacrity-driven, resource-driven, time-sensitive response for even one patient."

According to an Installation Management Command information paper, Ebola hemorrhagic fever is one of numerous viral hemorrhagic fevers. It is a severe, often fatal disease in humans and nonhuman primates such as monkeys, gorillas and chimpanzees.

Ebola HF is caused by infection with a virus suspected to be transmitted from infected bats, rodents or monkeys. The first Ebola virus species was discovered in 1976 in what is now the Democratic Republic of the Congo near the Ebola River. Since then, outbreaks have appeared sporadically.

Ebola may be transmitted by direct contact with an individual who is experiencing symptoms of Ebola infection. It may also be transmitted through blood or secretions of an infected person or exposure to objects such as needles that have been contaminated with infected secretions.

"People get Ebola virus from dealing with people who have active bleeding Ebola or people who have already died from Ebola and their tissues are being handled," Bigley said. "We're really not going to see that in the U.S. ... Folks in West Africa were coming into contact with bodily fluids. When you develop something like bloody vomiting or bloody bowel movements and you're in very compressed areas that don't have public sanitation, running water, toilets, toilet paper or sinks for hand washing, it is very easy to propagate the virus from person to person."

Some common misconceptions about the virus, he said, are that it can be spread through the air, food, water or insect bites.

"Ebola virus isn't spread through coughing and sneezing," he said. "It isn't like the influenza virus - it's not going to be something where you'll see people coughing and sneezing and the virus suddenly spreads to hundreds of people. It also isn't spread through food.

"Amoebas and parasites are what you get through water when you drink from a well on a camping trip or from pond water. Ebola virus doesn't live in water, so you're not going to see it in municipal water systems in the U.S. You're not going to see it in well water in the U.S. ... Also, this isn't like when a tick bites you and gives you Lyme disease or a mosquito bites you and gives you malaria. It's just not spread that way."

When infection occurs, symptoms usually begin abruptly. Symptoms include fever above 101.5 degrees, headaches, joint and muscle aches, weakness, diarrhea, vomiting, stomach pain, lack of appetite and abnormal bleeding. Symptoms

may appear anywhere from two to 21 days after exposure to Ebola virus, though eight to 10 days is most common.

Bigley said 21 days after exposure, the chances of developing the disease are practically nonexistent.

"If someone is concerned about developing Ebola or if they have a travel history to West Africa or have come in contact with someone they believe to be an active Ebola patient, two to 21 days is the active incubation period," he said. "If 21 days ago you came across someone you thought might have active Ebola virus and you're not symptomatic, the chances that you're going to develop Ebola virus or hemorrhagic fever are so negligible that they would be less than one-millionth of a percent."

Bigley said there are systems in place to track any potential patients with a recent travel history, and that early reporting is key for anyone who might be symptomatic.

"The earlier we catch symptoms, and it starts with people saying that they have flu-like symptoms and a travel history, we start to isolate those patients and treat them with supportive care," he said. "There's no vaccine for it and no specific antiviral medication for it. That supportive care is typically in the form of IV fluid, antivomiting medication to prevent dehydration and antidiarrheal medications. Those types of supportive medications, when administered early, will help to abate any kind of dehydration."

Standard sanitation procedures, such as hand washing or alcohol-based sanitizers, can kill the virus, as can common household cleaners, he said.

Bigley encouraged anyone who wants to stay updated on the Ebola outbreak to check the Center for Disease Control and Prevention's website, www.cdc.gov, for regular updates.

"It's very evidence-based, empirical, time-sensitive and very heavily peer-reviewed by some of the best virologists, microbiologists, infectious disease physicians, public health officials and preventative medicine officials we have in the world," he said.

Facebook town hall

When: 6-7:30 p.m. Oct. 22.

Where: www.facebook.com/FortBenningGarrison.

Topics: Fort Benning's role in Operation United Assistance (Ebola response), new Martin Army Community Hospital, life on Fort Benning, relocation, schools, Family programs.