By Rita Rubin
WebMD Health News
Amid increasing concerns about the Ebola virus in the U.S., WebMD spoke with infectious disease specialist William Schaffner, MD, chair of the department of preventive medicine at the Vanderbilt University School of Medicine, about misconceptions fueling those fears.
Q: Is there any reason for Americans to panic over Ebola?
A: Absolutely not. The epidemic of anxiety is in many ways as real and even more disturbing … than the actual Ebola risk, which, of course, is exceedingly small. The psychologists tell us that when something is new, mysterious, fierce, as is Ebola — if it is difficult to understand, and if the average person feels they are out of control…that turns out to be very troublesome. That introduces this sense of anxiety.
A lot of people are saying this shouldn’t be happening. It’s 2014, why is this happening? They simply don’t comprehend that this sort of infection can still occur in the world … or in their proximity. They feel anxious or even offended about Ebola.
Q: How does the Ebola virus spread?
A: You can’t acquire the infection easily. The person has to be sick, and then you have to touch their bodily fluid. This is not spread by coughing and sneezing. Once you realize it’s not spread that way, you don’t worry about it.
Even when the person becomes sick initially, they’re still not highly infectious. People who cared for (Thomas Eric) Duncan in the ER (on his first visit to a Dallas hospital) didn’t know he had Ebola. They’re at the end of the incubation period, and none of them have gotten sick yet. That speaks to the fact that early on he’s not that infectious to others. There were a lot of people who were very close to him in the ER.
The worse the illness, the more hazardous the patient is. That’s why health-care workers are particularly at risk. As the illness progresses, there’s simply more virus in the body. The illness is often characterized by voluminous diarrhea and vomiting, and that … is very hazardous. The health care workers spend more time with the patient. You put those things together, and you get increasing risk.
Q: Are the people who flew with the Dallas nurse hours before her symptoms appeared at any risk?
A: She didn’t have a temperature elevation that could be defined as fever. My conclusion is that the people on that plane, their risk is zero. They had no contact with her blood or body fluids. They’re going to be put on surveillance to address their anxiety. They’re going to be educated. But their risk, if any, is minuscule. I wouldn’t lose a minute’s worth of sleep if I were sitting next to her.
Thousands of people have traveled from West Africa to Europe to the United States and other parts of the world since the outbreak began. And all we have is one person (Duncan) who has come down with Ebola disease.
Q: Should we be more worried about other infectious diseases, such as the flu?
A: We have three patients who were diagnosed (in the U.S.) with Ebola in this outbreak. One has died. This is a new mysterious frightening disease over which people think they have no control. Let’s contrast that with influenza. Influenza, on average, causes over 200,000 hospitalizations and 3,000 to more than 40,000 deaths each year. But influenza is old hat, and people have a measure of control: “I could get vaccinated, I’ll avoid people who are coughing and sneezing, I’ll wash my hands frequently.” It’s an old and very familiar phenomenon.
I’m more anxious about influenza than I am about Ebola. I wish everybody who’s anxious about Ebola would please go out and get their flu vaccine, if they haven’t already.
Q: Realistically, what can people do to protect themselves against Ebola?
A: Obviously, we want people to remain interested and educated, but not anxious. Ebola is not going to show up in their neighborhood this evening.