Two U.S. citizens are being treated for Ebola in Liberia and the country shut some border crossings, as the worst outbreak of the disease on record spread to Nigeria, Africa’s most populous nation and largest economy.
Kent Brantly, the medical director of the Samaritan’s Purse Ebola center in the Liberian capital Monrovia, is in isolation and receiving treatment, the Boone, North Carolina-based charity said in a statement on its website yesterday. Nancy Writebol, who was helping the team treating patients at the center, has also tested positive for Ebola, the group said.
Ebola, which has no known cure or treatment and leads to death in as many as 90 percent of those who get it, has killed more than 660 people in four West African nations since March, the worst outbreak since the virus was first reported in what is now the Democratic Republic of Congo in 1976. Nigeria reported its first case last week after an infected Liberian man landed in Lagos, Africa’s largest city.
“He could have gone anywhere” on a flight, said Ben Neuman, a virologist at the University of Reading in the U.K. “As this epidemic goes on, this sort of thing is eventually probably going to happen.”
Still, the chances of the virus spreading by air travel outside of Africa is small, Neuman said.
“If you look at the numbers, there are probably about 300 people who are currently infected with Ebola virus, and most of those would be too ill to sit up or walk,” Neuman said by phone today. “So the odds are small, but it is something that needs to be watched.”
Only one case has ever been reported of an Ebola infection being exported outside Africa, according to David Heymann, a professor at the London School of Hygiene and Tropical Medicine. In 1994, in a 34-year-old Swiss woman was infected in Ivory Coast while performing an autopsy on a dead chimpanzee. She was repatriated to Switzerland and recovered without infecting anyone else.
Liberia shut all minor border crossings to contain the virus, AllAfrica.com reported, citing a government statement. The country plans to establish testing centers at major entry points that remain open, including Roberts International Airport, James Spriggs Payne Airport, Foya Crossing, Bo Waterside Crossing, and Ganta Crossing, according to AllAfrica.com.
Nigeria’s Arik Air is suspending flights to Monrovia in Liberia and the Sierra Leone capital of Freetown because of the Ebola outbreak, ThisDay newspaper reported, citing a statement from the airline.
Ebola virus is transmitted to people through the blood and other secretions of wild animals, such as chimpanzees, gorillas and bats, according to the World Health Organization. Humans spread it to each other through contact with bodily fluids of infected people. It causes fever, diarrhea and vomiting, and can lead to bleeding from the eyes, ears and nose.
The virus isn’t transmitted through the air, and can only be transmitted in sweat by patients who are in the late stages of the disease, so there’s no risk the passenger in Nigeria infected other travelers on the plane unless he vomited or they somehow came into contact with his bodily secretions, Neuman said.
“You wouldn’t expect to catch it even if you’re sitting next to someone,” he said. “If they’re well enough to get on the plane, they should be well enough not to infect you, probably.”
Medical staff are at the highest risk of contracting the virus through bodily secretions such as blood and sweat because of their proximity to patients.
Gloves & Gowns
Health workers attending to the patient should have been wearing gloves, gowns and face visors to prevent contact between the patient’s bodily fluids and their own mucus membranes, such as the eyes, mouth, nose and ears, said Heymann, who has studied Ebola since the 1976 outbreak.
“People who have been in contact should be under fever surveillance, they should have their temperature taken twice a day and if they became febrile they should be immediately isolated,” Heymann said by phone from London yesterday.
A confirmatory test from the Nigerian case is being sent to Dakar in Senegal, said Tarik Jasarevic, a WHO spokesman. The Geneva-based WHO is sending disease-trackers to Lagos, including a specialist in burial practices to make sure the risk of further transmission is limited, he said.
“Every time there is an infection in a new location it is a serious development, but the principle remains the same,” Jasarevic said by phone from Sierra Leone. “You have to identify this person, test them, identify the contacts and follow them for 21 days.”
Denial and Hostility
Denial the disease exists, hostility to medical workers, a lack of medical supplies and below-standard hygiene are complicating efforts to contain the spread of the disease. In Sierra Leone, victims’ families have attacked doctors, while in neighboring Liberia the husband of a victim tried to burn the hospital down where his wife died.
A top Liberian doctor, Samuel Brisbane, died yesterday after treating Ebola patients, the country’s Ministry of Health said today. The physician in charge of Ebola treatment in Sierra Leone, Sheik Umar Khan, contracted the virus last week.
“There should never be any false security with Ebola, everybody should be on the alert no matter where they are,” Heymann said.