According to the WHO as of 5th September 2014, there have been 2105 deaths from Ebola (probable, confirmed and suspected), in 4 countries, Sierra Lone, Nigeria, Liberia and Guinea.
Ebola is caused by any one of the 5 species of “Ebolavirus” which is a filovirus. Local travellers have taken the ebola virus from the outbreak areas to new locations (the 2 health workers in the States who were treated with experimental drugs) but the virus cannot “hitch a ride via air travel”. (quote from Prof Rick Speare in the Medical Observer). The ebola virus is transmitted by direct contact with the case and their fluids – eg. Sweat, blood, vomit, diarrhoea. Any secretion contains virus. Entry is via mucous membranes or broken skin. Virus secretion is low early in the disease but increases as the disease progresses, thus hospitalised patients are a major risk. Thus health care workers are at great risk, particularly those who have direct contact with the patient or the bodies of the infected.
Media outlets such as News Corp have been publishing stories claiming that “Ebola is a flight away” and questioning why Aussie airports are not employing thermal scanners to detect passengers with fever. But infectious disease experts have stated that ebola virus disease was highly unlikely to enter Australia and that the reporting in the media may be a distraction from more dangerous threats such as malaria. Australia has up to 800 cases of malaria a year and only this year have had 300+ cases of measles mostly imported from returned travellers. Travellers, and also doctors should be aware and think of the possibility, but I do not think we need to be alarmed.
EVD presents with sudden onset of fever, malaise, myalgia, headache and URTI Sx- often diagnosed as suspected dengue. In some outbreaks joint pains can be common (so another arbovirus chikungunya could be a differential – and in parts of Aust this is how Ross River Virus presents). This is then followed by vomiting, diarrhoea, maculopapular rash, and at times renal and liver failure and bleeding (haemorrhagic diathesis). Case fatality is always high 50 – 90% although it seems this current outbreak mortality rate is lower than previous outbreaks.
Just last week there was sensational media reporting in QLD and nationally regarding a possible case of ebola in a man arrested in the GC which was later reported to be negative later that night after negative testing. See the article below for more information.
DR. Deb Mitchell
Alice Springs Family Medical Centre