Safety Ebola: What You Need to Know By UPMC, October 13, 2014 Updated 10/24/2014 On Oct. 23, 2014, Craig Spencer, MD, became the first person in New York City to test positive for Ebola. Spencer recently returned from Guinea where he treated those afflicted with the Ebola virus. He is currently in isolation at Bellevue Hospital Center in New York. Three people who were confirmed to have been in contact with Spencer are also isolated for observation. Representatives from the Centers for Disease Control and Prevention were sent to NYC on Thursday and will confirm the test results. On the worldwide stage, the European Union (EU) met at a summit on October 24 and planned to contribute to aid to fight the spread of Ebola in West Africa. The organization pledged $1 billion Euros (roughly 1.26 billion USD), in addition to the 600 million Euros (approximately $7.6 million USD) pledged by the European Commission. According to the World Health Organization, nearly a million doses of an Ebola vaccine could be available by the middle of 2015. Clinical trials are expected to begin on five other Ebola vaccines in January 2015 in the hopes of helping to stem the outbreak. Updated 10/23/2014 Beginning Wednesday, Oct, 22, 2014, the Department of Homeland Security (DHS) declared that all international travelers coming from Liberia, Guinea, and Sierra Leone be given a health screening at one of five major U.S. airports. Travelers coming from these countries, which have been most heavily impacted by the Ebola outbreak, must make a stop at either Chicago’s O’Hare International Airport, New York’s John F. Kennedy International Airport, Newark Liberty International Airport, Washington Dulles International Airport, or Hartsfield-Jackson Atlanta International Airport. These major hubs will serve as checkpoints where these travelers will undergo testing for Ebola, complete an interview, and have their temperature checked. In addition these travelers will be closely monitored for 21 days by public health officials through daily check-ins. The travel restriction was instituted as a result of demand from bi-partisan lawmakers on both sides of the aisle. Secretary of Homeland Security Jeh Johnson said, “We are continually evaluating whether additional restrictions or added screening and precautionary measures are necessary to protect the American people and will act accordingly. On October 20, health care providers at Emory University Hospital declared a patient Ebola-free after she tested positive for the disease on September 9 and was admitted to the hospital. The patient was one of four treated for the disease by experts at Emory. One patient was cleared to leave on August 19 and another on August 21. The fourth patient was admitted on October 15 and remains in the hospital. Updated 10/21/2014 Thomas Eric Duncan became the first casualty of the disease on U.S. soil. Duncan was exposed to the disease in Liberia before returning to the U.S. He died in a Dallas hospital on October 8, 2014, after being treated for the disease. By the time Duncan began an experimental treatment, his case of Ebola was too far advanced to respond. A deeper look at Duncan’s case shows that it is actually harder to catch Ebola than most Americans may believe. Sunday, October 19 marked the completion of the 21-day incubation period that health officials observed, monitoring individuals who Duncan had been in close contact with since his return to the U.S. October 20 marks a full month since he took several flights from Monrovia, the capital city of Liberia. To date, and as expected since he was not contagious at the time, no one on Duncan’s flight has fallen ill. Duncan’s family and fiancé – whom he lived with while he was experiencing the symptoms of Ebola,such as sweats, a fever, and vomiting – have not shown signs of the disease either and have been declared free of the virus. In addition to Duncan’s family having been given a clean bill of health, a Texas health worker who was traveling aboard a cruise ship in the Caribbean also tested negative for the disease. Once she and her husband had been tested for Ebola, they were given clearance to drive home. The remaining 4,000 vacationers on the ship were also allowed to leave a few hours after pulling back into port. Amesh Adalja, MD, an infectious disease specialist at UPMC and a senior associate at the UPMC Center for Health Security, says the risk of it spreading in the U.S. is very low because it can only be transmitted under specific conditions. “Ebola is a deadly disease, it’s a scary disease, but it’s not very contagious. It doesn’t spread through the air; it only spreads through intimate contact with blood or body fluids,” says Dr. Adalja. “It is far less contagious than the flu — a respiratory virus easily spread by sneezing and coughing. Also, Ebola is only contagious when a person has symptoms. With the flu, a person is contagious the day before symptoms appear.” Although the risk of Ebola spreading is low, the Centers for Disease Control and Prevention (CDC) and other agencies have taken steps to prevent that from happening in this country. That includes increased airport screenings before and after entering the United States from Ebola-affected countries. In addition, the CDC has issued Level 3 travel warnings urging U.S. residents to avoid nonessential travel to Guinea, Liberia, and Sierra Leone in West Africa. The West African nations of Nigeria and Senegal have recently been declared Ebola-free. The country has not registered any new cases of Ebola in 41 days. Protocols also have been established to ensure health care facilities are prepared to properly detect and handle the disease. UPMC facilities are ready, says Dr. Adalja. Each hospital in our system has comprehensive and detailed action plans in place. “We know how to stop the spread of Ebola. But it’s crucial for hospitals to prepare in advance,” he says. “UPMC has easily accessible protocols from the moment a patient arrives in the Emergency Department through their hospital stay — how we screen that person, how we isolate that person, how we test for it, who we communicate with — it’s all laid out.” About the 2014 Epidemic According to the CDC, the 2014 outbreak is the largest in history and the first documented appearance in West Africa. About half the people who contracted the virus have died. In the U.S., the Texas patient who had recently traveled from Liberia died on Oct. 8. Ebola Facts A person infected with Ebola is not contagious until symptoms appear. Symptoms of Ebola may appear anywhere from two to 21 days after exposure, but the average is eight to 10 days. Early symptoms include: o Fever (higher than 101.5° F) o Headache o Diarrhea o Vomiting o Stomach pain o Muscle pain o Unexplained bleeding or bruising How Ebola Spreads Ebola is spread through direct contact with: Blood and body fluids (urine, feces, saliva, vomit, sweat, and semen) from a person sick with the disease; and Items contaminated by blood or body fluids from an infected patient, like needles, medical equipment, clothing, or bedding. Are You at Risk? If you’ve traveled to an area with an outbreak, or had close contact with someone sick with the disease, you may be at risk. The CDC recommends that you: Check for signs and symptoms for 21 days. Take your temperature every morning and evening. Call your doctor — even if you do not have symptoms — to evaluate your exposure level and consult with public health authorities to determine if any actions are needed. Continue normal activities, including going to work, while you are symptom-free. If You Get Sick after Travel to an At-Risk Area Get medical care immediately if you develop a fever (higher than 101.5° F). Alert your doctor about your recent travel to West Africa, or contact with a person sick with Ebola, and symptoms before you go to a doctor’s office or emergency department. Calling ahead will help the doctor or emergency department care for you — and protect others.