Doctors worldwide should be prepared to identify Ebola virus infection in hospitals and emergency rooms, and isolate patients if necessary, infectious disease specialists recommend. However, concerns that Ebola will spread beyond West Africa to Europe and North America are unfounded because of the way Ebola is transmitted and because of highly developed hospital infection control practices, they say.
A description of the virus, the current outbreak and recommendations for management of infected patients appear today in the Annals of Internal Medicine
The lead author is Carlos del Rio, MD, chair of the Hubert Department of Global Health at Emory's Rollins School of Public Health and professor of medicine (infectious diseases) at Emory University School of Medicine.
Co-authors, all at Emory University School of Medicine, are Aneesh Mehta, MD, assistant professor of medicine (infectious diseases), G. Marshall Lyon, MD, associate professor of medicine (infectious diseases), Jeannette Guarner, MD, professor of pathology and laboratory medicine. Lyon and Mehta are part of the team caring for two Ebola patients now at Emory University Hospital.
The authors review the history and ecology of the current Ebola outbreak in West Africa, the symptoms and pathology of Ebola infection, effective infection control measures and the development of experimental treatments.
The current outbreak is the largest ever and presents an "unprecedented" challenge to West African countries primarily because of their fragile health care infrastructure there, the authors write.
Public concern has grown over the possibility that Ebola can spread, via international air travel, beyond West Africa to places like Europe and North America. The authors compare the current wave of public concern about Ebola to the recent appearance of the mosquito-borne virus Chikungunya in the United States.
"Such concerns are unfounded as Ebola, unlike Chikungunya, is not transmitted by a vector [ie, mosquitos] and, while highly infectious, is only acquired by direct contact with infected secretions," they write. "Even if cases are imported, the likelihood of further transmission beyond the index patient is close to zero as hospital infection control practices in existence in hospitals in developed countries are a very effective barrier."
"However, clinics, hospitals and emergency rooms worldwide should be prepared to immediately isolate any patient who has a recent history (< 3 weeks) of travel to West Africa and presents with compatible signs and symptoms."
It is important for the general public and in particular for healthcare workers to stay abreast of information that is, fortunately, readily accessible on reliable Web sites from the Centers for Disease Control and Prevention Centers for Disease Control and Prevention and the World Health Organization (www.who.int and www.afro.who.int).