The sign above warns people in West Africa: Attention Ebola!, Don’t Touch Anyone, Don’t Manipulate Objects, The Animals You’ll Find Dead in the Forest
Last week a dear friend and neighbor called to ask about her chances of contracting the Ebola virus if she was traveling back from West Africa on an airplane. She had no intention of taking a flight to anywhere in Africa but it bothered her that she had no idea what to do if she ever encountered this situation while traveling abroad. She had heard me talk about living with the threat of Ebola while traveling through East and Central Africa and felt that the media in the United States had not told the American public the entire truth. After I answered her questions and told her what steps she could take to keep herself safe she felt somewhat better and more in control of her life. Then she begged me to write this post in order to educate anyone else who felt as she did. So this one is for you Diane, I truly hope the information I’ve included in this post helps save lives one day. I have meticulously researched and referenced all of the factual information presented in the post and matched it to that cited by the World Health Organization as well as the Center for Disease Control. I have also included direct links to each of these web pages so my followers can check out this information for themselves.
So what have I learned about Ebola during my summers in East and Central Africa and what do I do to keep myself safe? First, out of all the diseases one can catch in East Africa, like AIDS, Malaria, Yellow Fever, Blackwater Fever, Tuberculosis and hundreds of parasitic illnesses – it’s Ebola that terrifies my African friends and colleagues the most. “ Three Days,” ( the time they believe it takes the virus to kill them) they whisper after I ask about Ebola then either make the sign of the cross over themselves repeatedly or shake their heads back and forth in absolute dread. When travelers meet on back roads throughout the bush, its news about Ebola they ask for first and the name, itself has the power to turn a cheerful, laughing Ugandan into a silent, nervous wreck. But knowledge is power and so there are certain things you can do to protect yourself against bringing this virus into your body and infecting you with the disease.
Ebola has been classified as a virus and as such there are a few things you need to remember about this virus in particular when traveling that can keep you safe. A person can only spread Ebola if they are in the active symptoms stage. That means they are either running a high fever, vomiting, experiencing diarrhea, severe headaches, muscle pain, weakness, abdominal pain, or unexplained bleeding around or from any opening in their body. And they don’t have to have all of these symptoms – one is enough. But these symptoms also describe other illnesses such as influenza so a blood sample must be taken and examined by a laboratory to confirm whether it’s actually Ebola or not. This makes the disease very difficult to detect and confirm especially in rural districts where lab reports are not readily available and by the time competent medical staffers have been called in an entire village could be infected. Doctors have determined that there is a definite incubation period between 2 to 21 days (time between becoming infected and the actual onset of the physical symptoms) but it is not the same length of time in all patients so this has caused a lot of confusion in the past. How would I even suspect I had the disease if I didn’t show any symptoms until 21 days later? By then most people who had come in contact with Ebola would feel they were free from the disease. Plane travel from Africa to the United States usually takes two separate flights and between twelve to sixteen hours depending on the European airport selected for the second flight. Hypothetically I could travel through the first flight symptom-free but develop stage one symptoms like a high fever during the second flight. That means I could become contagious while in-flight and have no idea what’s happening to me. And now you’re sitting next to me. So what can you do to protect yourself?
A person demonstrating active stage one symptoms of Ebola can transmit the virus through all of his/her bodily fluids like sweat, mucus, tears, saliva, urine, feces, and blood. You infect yourself when you come in contact with my Ebola-rich body fluids and bring them into you own body through any open cut/wound or bring your contaminated fingers to your eyes, nose, or mouth. So I advise when on an airplane where there is reason to suspect Ebola that you wear a surgical mask and either sunglasses that thoroughly surround/cover your eyes or clear glasses that do the same thing. You may not look like the sexiest person in Coach or Business Class but you’ll go a long way in protecting yourself from this debilitating disease. Before you hit the airport remember to examine your body closely especially any exposed areas like hands and feet making sure that all cuts, no matter how tiny- even hangnails have been thoroughly covered up by Band-Aids or adhesive strips. Make sure to bring extra ones with you and if you have a deep wound on your hand I would wear a pair of gloves while traveling. Make sure to pack these things in a carry-on bag when leaving the US for any country in Africa- you’ll never know when you’ll need them. Remember, “ an ounce of prevention is worth a pound of cure.”
I heard a newsman on television say that you can’t catch the Ebola virus from a sneeze. Wrong, wrong, inexcusably wrong!!! Technically you can’t catch the virus from airborne particles released through your nose during a sneeze but when people sneeze they usually release some saliva from their mouths as well. Think about your last hearty sneeze- I know I do and I bet you do too. That means that saliva from an infected person’s mouth could be sprayed out onto your hands, shoulder, head, lap, or even food depending on how close he/she was when the sneeze occurred. If a person with active symptoms sneezes on you, spits on you, vomits on you, bleeds on you, or you come in contact with his/her urine or feces you’d better have any wounds covered up and your eyes, nose, and mouth covered too or you’re at risk for infecting yourself with the virus.
Now this virus can live for hours outside its host’s body so carry disposable wipes soaked in bleach with you and use them to wipe down the tray in front of you, both metal side arms; then give the cloth seat a quick swipe too before sitting down. Wipe down any earphones and touch screens before using them as well. I always take a large African scarf with me and wrap myself up in it during the flight. No airplane pillows or blankets for me. Using the bathroom can be especially dangerous if you have bleeding hemorrhoids or any other open wounds in that area of your body. Make sure to take your bleach wipes with you and make a thorough swipe of the toilet seat before sitting down. Wash your hands well with plenty of soap and make sure to wipe your hands with fresh wipes before and after using the toilette and sink. When eating your meal watch what the people on either side of you are doing. If for some reason they sneeze on your food leave it alone!!! It’s better to go hungry than sicken yourself with Ebola. And watch where you put your hands. Do not put them anywhere near your eyes, nose, or mouth without wiping them off with bleach wipes first. Once you arrive home take all clothes off immediately and throw them in the washing machine. If you have worn a suit or “dry clean only” garments place them on a hanger and put them outside in the sunlight for a day or two. Other things that can kill the virus once it’s outside of its host- hand soap, detergent, hand sanitizers, heat, and alcohol- the kind you drink as well as rubbing alcohol and hydrogen- peroxide. Remember people who tend to sick Ebola patients can be infected by handling bedding, clothes, cups, dishes, or utensils so they must take the proper precautions as they minister to them. Following these steps may make you feel embarrassed at first- even look like you suffer from Obsessive Compulsive Disorder but who cares? Would you rather be pretty or dead? Adults traveling with children will have a more difficult time enforcing many of these protocols but remember they work and have been designed to save you and your family members from a terribly painful illness you might not survive.
Stage two of the disease according to one friend, “is a journey into hell and back”. The infected person suffers from extreme bouts of vomiting and diarrhea, agonizing rashes, and gradually his/her liver as well as the kidneys slowly shut down. There’s lots of bleeding from every orifice in the body and much more pain. The very old and the very young succumb first as well as anyone in poor health at the onset of the disease. Many East Africans will tell you that anyone who catches Ebola dies but WHO maintains that the average fatality rate is more like 50 %. It all depends on the general health of the person at the onset of the disease. And according to the CDC, those people who do manage to survive develop personal antibodies that remain in their blood stream and protect them from further infection from Ebola for up to 10 years; although scientists are not sure if these survivors are immune to the four other species of Ebola or mutations of each strain as well. There is no cure or vaccine for Ebola at the moment although blood transfusions and a serum called Z-Mapp was used on the doctors who became infected with Ebola in West Africa but is still in the experimental stage.
And now the most crucial fact in preventing epidemics like the one that occurred in West Africa. People can fully recover from the Ebola virus and still remain infectious (that means they can still infect others) as long as their blood and/or other body fluids including semen and breast milk contain the Ebola virus. Men who have recovered from the disease and demonstrate no symptoms whatsoever can still transmit the virus to others in their semen for up to 7 weeks after recovery. Doctors who have been treating male patients in West Africa who survived Ebola are advising them to abstain from all forms of sex for 30 days and to wear condoms after that. According to Mother Jones, in one 2000 study a woman who recovered from Ebola still had the virus in her breast milk weeks after she made a full recovery and her infant eventually died from the disease. It is not clear if she transmitted the virus to her infant and more research needs to be conducted before scientists can establish a direct cause –effect relationship between breast milk and the transmission of the virus.
As of October 24, 2014 five countries located in West Africa have had outbreaks of Ebola Hemorrhagic Virus in the past several months: Guinea, Liberia, Nigeria, Sierra Leone, and Senegal. Of these, Nigeria and Senegal have been classified by the World Health Organization (WHO, 2014) as “Ebola –Free” with no new reported cases of this disease for six weeks in a row. This was the largest and most complex outbreak of Ebola ever recorded with more deaths than all other outbreaks combined. To show you how contagious this virus can be according to the CDC the first case in West Africa was confirmed in March of 2014. It started in Guinea then was spread by land to Sierra Leone, after that one traveler was responsible for spreading the virus by airplane to Liberia, then one traveler spread it to Nigeria by land, and one traveler spread it to Senegal by land. It seems that the world’s attention was focused exclusively on West Africa when in fact there had also been an outbreak of Ebola in Central Africa, in Lokolia, south of Equateur Province in the northwestern region of the Democratic Republic of the Congo (DRC) as of September, 2014 with a confirmed tally of 68 cases of Ebola and 41 deaths. But Ebola outbreaks have occurred in the past in the DRC, Uganda, South Sudan, and Gabon.
According to historical data on Ebola supplied by the Center for Disease Control (CDC, 2014) the Democratic Republic of the Congo has experienced 7 outbreaks of Ebola in the last 38 years- more than any other country in the world and the Congo Basin has been identified by scientists as the source of several major pandemics. As far back as 1976 the first recorded cases of Ebola came out of the Congo Basin in the DRC, the second largest tropical rain forest in the world. What’s more, it is now believed that Human Immunodeficiency Virus (HIV) emerged from the same rain forest sometime in the late 1920’s after that virus crossed from chimpanzee into human blood streams.
This has also made the doctors serving the populace of the DRC some of the most knowledgeable “ Ebola Doctors” in the world. And one of the very best is the virologist and professor Dr. Jean- Jacques Muyembe Tamfum, who heads the Institut National de Recherche Biomedicale, at The University of Kinshasa in the DRC’s capital city of Kinshasa. It was Dr. Tamfum who identified the Ebola virus 38 years ago. According to Dr. Tamfum, “Ebola is the most dangerous virus in the world at this time classified as a ‘level four’ virus and there are more just like it out there.”
Five species of the virus have been identified so far: Zaire, Bundibugyo, Sudan, Reston, and Tai Forest. And each of these has the ability to mutate. The most recent outbreak of Ebola in West Africa has been attributed to a mutation of the Zaire species which according to the CDC is the most deadly strain.
According to Jonna Mazet, global director of the US Agency for International Development (USAID) “Predict Program,” a five year project charged with identifying viruses before they become a threat and building a global database to store this information, “most of the global epidemics in the world originated in these same forest ecosystems. The three areas in the world currently classified as “Virus Hot Spots,” the Amazon Basin in South America, the Congo Basin in Central Africa, and Southeast Asia- all three have the heat, the water, and the tree cover to act as pathogen incubators. According to the latest version of the Thorndike- Barnhart Dictionary- a pathogen is “any infectious agent that can produce illness in its host and can appear in the form of viruses, bacteria, fungi, and other micro-organisms.” The medical community at large knows by now that viruses mutate easily enough inside their host, some can live outside of their host for hours on end, and all are not easily treated. Mazet goes on to say,” In the last five years we have detected over 800 viruses globally and 540 of these viruses have never been seen before. Many could be just as deadly as Ebola.” This means that a good 68% of these new viruses have the potential to be as destructive to humans and animals as Ebola and AIDS have been. Scientists have also determined that 60% of the emerging diseases that infect humans worldwide are “crossovers” that originally came from animals, especially wild ones.
An estimated 270 species of animals and 40 million people call the Congo Basin home. In a country identified by the United Nations Human Development Index as 186 out of a total of 187 countries (only Niger was given a lower score) it has the poorest quality of life in the entire world. Locals around the Basin eke out a living from the forest each day or literally die of starvation. As I discussed before in my blog on Ebola after the Ugandan outbreak of 2012 while traveling through the infected area of Uganda near the DRC/ Uganda border, primates such as monkeys and apes can catch Ebola just like humans who are also primates. Because Gorillas share 95% of their genetic code with humans it is extremely easy for the virus to cross over between the two causing prolonged outbreaks of the disease. Contrary to Americans’ preferences for red meat, the Congolese will hunt and eat wildlife in any form they find it. Animals such as bats, monkeys, chimpanzees, forest antelope, and porcupines are caught and sold in outdoor markets as fresh or cooked meat and eaten by a community that truly enjoys this cuisine. Unfortunately, these are the same animals that have been identified as the culprits responsible for spreading the Ebola virus in the Congo Basin especially into hunters who handle the infected blood, bodily fluids, and feces of the wounded or dead animals before they’re cooked. The CDC currently believes that it is a species of fruit bat living in the Congo Basin that’s primarily responsible for holding the Ebola virus in its blood stream between outbreaks.
Jonna Mazet warns that the Congo Basin is home to millions of viruses and many of them could be far more virulent than Ebola or HIV. As the rain forest in the Congo Basin is being destroyed to accommodate a growing population of Congolese citizens they in turn are coming in contact with new and deadlier microorganisms like never before and who knows what the repercussions will be for the global community at large? And for those who doubt me! In 2009 a new virus was discovered in Mangala, a small village deep within the Congo Basin’s rain forest. Three people had been stricken with a mysterious fever that suddenly spiked and began to vomit up blood. Two of the patients died within three days of demonstrating active symptoms and the third survived the disease going on to develop preventive antibodies in his blood stream. It was first thought that they had contracted the Zaire species of Ebola virus but then it was confirmed through laboratory tests that the villagers had become infected by a totally new virus. It was eventually named the Bas- Congo Virus and there have been no reported cases of the Bas- Congo Virus since. Virologists finally determined that it had been spread by insects.
Voyons ce que demain nous, mes amis!
Kat Nickerson Kingston, RI USA