Oregon health officials: Ebola risk here ‘low’
The Oregon Health Authority on Thursday released a series of questions and answers regarding the recent Ebola outbreak and steps taken to prevent it from reaching the state – or dealing with it, if it does — while seeking to reassure that the risk of the deadly disease being contracted in Oregon is low.
Here is the full document:
OREGON HEALTH AUTHORITY EBOLA Q&A
August 2014
What concerns, if any, do we have about Ebola reaching Oregon? For example, how worried are state health officials about an infected person coming in on a flight here, the issue of air travel and the spread of Ebola being something that came up in West Africa with this new outbreak (http://www.oregonlive.com/today/index.ssf/2014/07/death_in_nigera_shows_that_ebo.html).
Ebola is a serious, often deadly illness. We are following the situation in West Africa closely, and are ready to respond in the unlikely event that a person ill with Ebola infection arrives in Oregon. That said, the risk of Ebola disease here in Oregon is low. There are no direct flights from the affected areas to Oregon airports, so the chance of a person with Ebola arriving here is small. Even so, we are sharing information with the public health and medical communities so we will be ready to get ill persons into proper care and prevent infection of others.
State and local health authorities are in contact with the CDC Quarantine Station, which will be immediately notified if any ill travelers arrive at the airport. There are emergency plans in place at Portland International Airport and Seattle-Tacoma International Airport to deal with just this sort of situation. Those working at airports play an important role in keeping potentially imported illnesses like Ebola in check: By knowing what to do and who to call when a traveler presents with unusual illness, airport personnel help recognize and contain illnesses so they don’t have a chance to spread.
As a precaution, CDC urges U.S. residents to avoid nonessential travel to Sierra Leone, Guinea and Liberia because of an unprecedented outbreak of Ebola in those countries.
How much of a concern is it for Ebola to come into Oregon by air travel as opposed to other illnesses that have arrived here? Example: The unvaccinated infant who visited the Philippines and brought back measles from earlier this year,http://www.oregonlive.com/health/index.ssf/2014/03/rare_measles_case_diagnosed_in.html.
In Oregon, the risk of contracting Ebola is low. Clearly, it is a serious illness, and we are taking steps to contain the illness and prevent its spread in the unlikely event a person ill with Ebola should travel here.
Spread of Ebola virus requires direct contact with the blood or secretions of an ill, infected person, either by touching the ill person or a surface recently contaminated by his or her bodily fluids. Because of this, it is much harder to catch Ebola infection than, say, measles or tuberculosis, which can be spread through the air. People traveling to Ebola-affected areas can protect themselves by educating themselves about Ebola virus disease, and using gowns, gloves, masks, and frequent hand washing when caring for a person suspected to be ill or have died from Ebola.
This lessens the risk of spread of illness in a community, and also allows properly protected health care workers to care for patients with Ebola with minimal risk to themselves.
What plans do we have in place for dealing with or preventing Ebola from entering and spreading in Oregon? What plans do we have for infectious diseases in general, and does Ebola differ?
Because Ebola is a serious illness, health officials want to stop the outbreak, to protect Oregonians and people living in the affected countries. The best way to stop this outbreak is to put the necessary measures in place at the source of infection. Teams from CDC and the World Health Organization are working with affected countries to do this.
The Oregon Health Authority and county health departments are monitoring the Ebola outbreak in West Africa and coordinating with other government agencies, including the CDC, to ensure the health and safety of Oregonians. State and local health officials participate in the Epidemic Information Exchange (Epi-X) network, which allows health officials to securely share information with other health departments and the CDC. Information sharing is critical to early detection of disease, identification of vectors and reservoirs of diseases, and routes of disease transmission.
OHA has a team of trained clinicians and epidemiologists, or “disease sleuths,” that is monitoring health threats across the state. In the event of any infectious or foodborne illness disease outbreak, the state health department works with the local health authority to identify the cause of the outbreak, control the spread of the disease, and ensure the health and safety of the community.
People can protect themselves by educating themselves about Ebola virus disease, and using gowns, gloves, masks, and frequent hand washing when caring for a person suspected to be ill or have died from Ebola.
OHA has the legal authority to issue isolation and quarantine procedures. The Oregon Bench Book outlines emergency and nonemergency quarantine and isolation procedures. Isolation is a strategy regularly used in care of ill, contagious patients to prevent spread of illness to health care workers and others. Quarantine involves separating people exposed to a contagious illness from others to prevent unnecessary contact until it is certain they are not infected. Quarantine would only be used if there is known exposure to a serious illness, and the quarantine is believed to be necessary to prevent the spread of illness more broadly in the community (ORS 433.121).
Testing for Ebola infection is available at CDC.
How much should folks worry here in Oregon about Ebola spreading here? How low or high is the risk (compared to other health risks, say from the flu, smoking, heart disease, car accidents)?
In Oregon, the risk of contracting Ebola is low. The disease carrier appears to be fruit bats, which don’t live in Oregon.
Oregonians are much more likely to become ill with vomiting and diarrhea due to norovirus from not washing their hands or influenza from not being vaccinated than ever being at risk for getting Ebola virus disease.
Nonetheless, we have taken steps to be ready. We are sharing information with the public health and medical communities so any ill person suspected of having Ebola infection will get prompt, proper care, the correct diagnosis can be made quickly and all necessary steps will be taken to prevent infection in others.
If folks are apt to worry, what can they do individually to protect themselves? Hand washing? Other tips?
As a precaution, CDC urges U.S. residents to avoid nonessential travel to Sierra Leone, Guinea and Liberia because of an unprecedented outbreak of Ebola.
People who do visit an area where Ebola infections are occurring can protect themselves by avoiding direct contact with the blood or secretions of people who are ill. Those caring for an ill friend or family member should use impermeable gloves, a protective gown, a surgical mask and eye protection, and wash their hands regularly to prevent infection, The bottom line: Illness among family members and health care workers is consistently tied to failure to follow these essential steps.
Ebola and other infectious diseases can seem scary and unknown, but CDC and WHO has lots of resources available about the virus. Learning the facts about the disease can help people understand the unprecedented outbreak that is occurring in West Africa. Fortunately for those who live in the U.S., there has been no human Ebola outbreak in on U.S. soil. Further, most Ebola outbreaks have occurred in Central and West Africa. Unfortunately, these outbreaks are linked to the limited or absent use of effective infection control practices by clinics and hospitals, or by those caring for ill people.
For more information, please see the World Health Organization Ebola Fact Sheet: http://www.who.int/mediacentre/factsheets/fs103/en/.
What else should Oregonians know about Ebola, the risk, and keeping safe/healthy?
The risk of Ebola disease in Oregon is low. Nonetheless, Oregon Health Authority and the entire Oregon health system continue to monitor this and other illnesses that could affect the public’s health. We have plans in place to recognize these illnesses, diagnose and treat them promptly, and prevent their spread in our communities.
In 1990, four people in the U.S. who worked with infected monkeys developed antibodies suggesting they were exposed to Reston ebolavirus. None of them became ill.
In 1996, the Ebola-Reston virus was again introduced into a quarantine facility in Texas by monkeys imported from the Philippines. No humans were infected.
When naming Ebola viruses, the first part of the name is typically the country in which that strain of Ebola virus was first discovered, then the species.
Example:
Zaire ebolavirus
Reston ebolavirus
Side question: How has the mortality from Ebola changed? I’ve seen current mortality figures at 60 percent, and I recall it was much higher years ago when I was reading about it in “The Hot Zone.” Has the mortality truly gotten lower? Why? Is it we have a better understanding of the virus and how to treat it, or are less lethal strains evolving (which I recall can happen over time because it’s often better for a microbe over evolutionary time not to wipe out its hosts/host species, or so the hypothesis went that I learned about as a biology student)?
The virulence of specific viruses can change over time, based on the characteristics of the virus and the persons they infect (hosts). The last outbreak of Zaire ebolavirus (the same strain circulating in West Africa) was in 2008 and 2009 in the Democratic Republic of the Congo, and had a case fatality rate (the percentage of ill persons who died) of 47 percent. In the current outbreak, the case fatality rate is about 55 percent. As you note, mortality rates in prior outbreaks with this strain have been much higher. It is difficult to say how much of the decrease in mortality is due to a change in the virus, the host, or how much it reflects early treatment and containment efforts.
References
Oregon Bench Book: http://public.health.oregon.gov/DiseasesConditions/CommunicableDisease/ReportingCommunicableDisease/Documents/benchbook.pdf
CDC Interim Guidance for Managing Patients with Suspected Viral Hemorrhagic Fever in U.S. Hospitals: http://www.cdc.gov/vhf/ebola/pdf/vhf-interim-guidance.pdf
CDC Travel Advisories
http://wwwnc.cdc.gov/travel/notices
CDC Outbreak of Ebola in Guinea, Liberia, and Sierra Leone
http://www.cdc.gov/vhf/ebola/outbreaks/guinea/index.html
CDC Ebola homepage
