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Outbreak turns Ebola into a moving target

I have been contemplating how to address the topic of Ebola in the context of the La Plata Health Watch.

The fact of the matter is that the current pace of the outbreak makes it something of a moving target. Anything I might compose one day may be old news the next.

Nevertheless, the current outbreak of Ebola cannot be ignored and merits consideration here. With all of the many sources of Ebola-related information, I think it wise to consider the facts as they now stand.

Ebola is a viral illness first identified in the 1970s in central Africa. Since that time, there have been intermittent outbreaks isolated to that region, which have all been quickly contained.

The current outbreak in West Africa began in Guinea in late 2013 and has now spread to multiple other countries. Hardest hit are the three African nations of Guinea, Sierra Leone and Liberia. Smaller outbreaks in Nigeria, Senegal and Spain appear to have been controlled. Meanwhile, the U.S. is now the seventh country to report transmission of the disease. More on that in a moment.

Ebola is a serious viral illness that infects multiple organ systems. Reports from the current outbreak put death rates in the 50 to 70 percent range. There are no known effective treatments, although experimental treatments have been tried recently with uncertain effects.

There is no available vaccine, although a vaccine is currently completing Phase 2 clinical trials, which is one step away from larger trials of effectiveness in humans planned in spring 2015. If the vaccine proves safe and effective, it could qualify for approval and production for general use after that, although widespread availability would likely be delayed for some time thereafter.

The virus appears to be transmitted only through bodily fluids from an infected person or corpse. Infectious bodily fluids include saliva, sweat, feces, urine, blood, vomit, semen, breast milk or other fluids. It also can be transmitted from objects infected with the virus.

Symptoms of Ebola are nonspecific (meaning, they are initially similar to other less serious viral illnesses) and include fever, headache, diarrhea, vomiting, stomach pain, muscle pain and weakness. Unexplained bleeding or bruising also may occur.

While there are no known effective treatments for Ebola, supportive therapy can be beneficial, and several patients have fully recovered from the disease in U.S. hospitals. While most of these were flown from West Africa for treatment, a single patient was diagnosed in Dallas in September, having recently arrived from Liberia. As of this writing, two nurses providing care for that patient, who is now deceased, have developed the disease and are in isolation while being treated.

Also as of this writing, sustained person-to-person spread has not been documented in the U.S., and public health officials have indicated confidence in stopping the isolated outbreak in Dallas.

This outbreak is being taken very seriously by public health experts. The ultimate goal is to control the outbreak at its source in West Africa.

Dr. Matthew A. Clark is a board-certified physician practicing at the Ute Mountain Ute Health Center in Towaoc.



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