Ebola
Questions
and Answers
Maryland Department of Health and Mental Hygiene
Updated June 19, 2015
General Information
What is Ebola virus disease?
Ebola
virus disease is a severe, often fatal, viral disease. Currently, there are Ebola
outbreaks in two Western African nations. For the most current information regarding Ebola and outbreaks
caused by Ebola, visit http://www.cdc.gov/vhf/ebola/.
What are the symptoms of Ebola virus
disease?
Ebola
virus disease symptoms usually include fever. Other symptoms may include
headache, diarrhea, vomiting, weakness, joint and muscle aches, stomach pain,
lack of appetite and bleeding. The symptoms can be similar to other, more
common, infections. Symptoms appear 2-21 days after exposure to the virus, but
most commonly occur 8-10 days after exposure.
How is Ebola spread?
Individuals
who do not have a fever are not contagious and cannot transmit the disease to
another person. The Ebola virus is transmitted through direct contact with the
blood or body fluids of an infected person with symptoms or through exposure to
objects (such as needles) that have been contaminated with infected body
fluids. Transmission can also occur from directly handling bats, rodents or
primates in areas where Ebola occurs.
How Ebola is Spread
Who is at risk for Ebola?
Individuals
who have recently been in a country with
known Ebola, and who also have:
- Contact with blood or
other body fluids of a patient or dead body known to have or suspected to have Ebola,
or
- Direct handling of
bats, rodents or primates.
If someone has symptoms of Ebola virus disease and a possible
exposure, that person should see a
health care provider.
What is the treatment for Ebola?
There is no specific
treatment for Ebola; treatment is limited to close monitoring and supportive
care in a hospital. For information about experimental treatments, visit the
Centers for Disease Control and Prevention (CDC) website at http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/qa-experimental-treatments.html.
Ebola
and Maryland
What is the risk of Ebola in Maryland?
Currently,
the risk of acquiring Ebola in Maryland is extremely low. If a case is
identified, there are established infection control guidelines to prevent
transmission.
What is the Department of Health and
Mental Hygiene (DHMH) doing?
DHMH has established
standards to respond to reports of infectious diseases in Maryland and to
prevent their transmission. Health care providers are required by law to report
any cases of illness that might pose a risk to public health. These include
Ebola virus disease, MERS-CoV, measles, polio, tuberculosis, pandemic influenza
and about 100 other diseases.
DHMH works in
partnership with the CDC, other states, organizations and programs as part of
the planning process for response to outbreaks of illness. Maryland is part of
the Emerging Infections Program, a national resource for surveillance,
prevention and control of emerging infectious diseases. Hospitals throughout
Maryland are skilled in surveillance and infection control procedures.
All-hazards public health emergency planning has established partnerships among
health care and emergency response agencies.
DHMH has taken these
steps:
1. Surveillance/Disease
Reporting –Ebola is a reportable condition. Providers and labs are required
to report all suspected cases immediately.
2. 24/7
Possible Case Investigation and Response – DHMH and local health
departments have a 24/7 system to respond to and investigate possible Ebola
cases and to monitor that appropriate isolation is in place while an assessment
is underway.
3. Provision
of Infection Prevention Guidance to Health Care Providers – Guidance,
including how to properly isolate a suspected patient and appropriate use personal
protective equipment for health care workers and others has been disseminated
to:
·
hospital emergency departments;
·
hospital infection prevention
officials;
·
nursing homes/long-term care
facilities;
·
clinical laboratories; and
·
general health care providers
4. Development
of Ebola Lab Testing Capacity – DHMH Laboratories Administration has the
capacity to test for Ebola.
5. Coordination/Communication
with other States and CDC – DHMH participates in regular Ebola-related
calls and webinars with other states and with CDC (including the Dulles/BWI CDC
Quarantine Station) to ensure up-to-date and coordinated responses.
Where can I get the most up-to-date
information on Ebola?
For
more EVD information, visit: http://www.cdc.gov/vhf/ebola/. To learn about
the current Ebola situation in Maryland and links to Maryland guidance and fact
sheets, visit dhmh.maryland.gov/ebola.
Ebola and the Outbreak in West Africa
How do I protect myself against
Ebola?
If you must travel to an area
affected by the Ebola outbreak, protect yourself by doing the following:
- Wash hands frequently or use an alcohol-based hand
sanitizer.
- Avoid contact with blood and body fluids of any person,
particularly someone who is sick.
- Do not handle items that may have come in contact with
an infected person’s blood or body fluids.
- Do not touch the body of someone who has died from
Ebola.
- Do not touch bats and nonhuman primates or their blood
and fluids and do not touch or eat raw meat prepared from these animals.
- Avoid hospitals in West Africa where Ebola patients are
being treated. The U.S. Embassy or consulate is often able to provide
advice on medical facilities.
- Seek medical care immediately if you develop fever
(temperature of 100.4°F/ 38°C) and any of the other following symptoms:
headache, muscle pain, diarrhea, vomiting, stomach pain, or unexplained
bruising or bleeding.
- Limit your contact with other people until and when
you go to the doctor. Do not travel anywhere else besides a health care
facility.
What is CDC doing in the U.S. about the
outbreak in West Africa?
CDC has activated its Emergency
Operations Center (EOC) to help coordinate technical assistance and control
activities with partners. CDC has deployed several teams of public health
experts to the West Africa region and plans to send additional public health
experts to the affected countries to expand current response activities.
If an ill traveler arrives in the
U.S., CDC has protocols in place to protect against further spread of disease.
These protocols include having airline crew notify CDC of ill travelers on a
plane before arrival, evaluation of ill travelers, and isolation and transport
to a medical facility if needed. CDC, along with Customs & Border Patrol,
has also provided guidance to airlines for managing ill passengers and crew and
for disinfecting aircraft. CDC has issued a Health Alert Notice reminding U.S.
health care workers about the importance of taking steps to prevent the spread
of this virus, how to test and isolate patients with suspected cases, and how
to protect themselves from infection.
Can hospitals in the United States care for an Ebola
patient?
Any U.S. hospital that is following CDC’s
infection control recommendations and can isolate a patient in their own room
with a private bathroom is capable of safely managing a patient with Ebola. For
more information on infection control in health care settings, visit http://www.cdc.gov/vhf/ebola/hcp/infection-prevention-and-control-recommendations.html.
Ebola
and Travel
What
is being done to prevent ill travelers in West Africa from getting on a plane?
In West Africa
CDC’s Division of Global Migration
and Quarantine (DGMQ) is working with airlines, airports, and ministries of
health to provide technical assistance for the development of exit screening
and travel restrictions in the affected areas. This includes:
- Assessing the ability of Ebola-affected countries and
airports to conduct exit screening,
- Assisting with development of exit screening protocols,
- Training staff on exit screening protocols and
appropriate PPE use, and
- Training in-country staff to provide future trainings.
During Travel
CDC works with international public
health organizations, other federal agencies, and the travel industry to
identify sick travelers arriving in the United States and take public health
actions to prevent the spread of communicable diseases. Airlines are required
to report any deaths onboard or ill travelers meeting certain criteria to CDC
before arriving into the United States, and CDC and its partners determine
whether any public health action is needed. If a traveler is infectious or
exhibiting symptoms during or after a flight, CDC will conduct an investigation
of exposed travelers and work with the airline, federal partners, and state and
local health departments to notify them and take any necessary public health
action. When CDC receives a report of an ill traveler on a cruise or cargo
ship, CDC officials work with the shipping line to make an assessment of public
health risk and to coordinate any necessary response.
In the United States
CDC has staff working 24/7 at 20
Border Health field offices located in international airports and land borders.
CDC staff are ready 24/7 to investigate cases of ill travelers on planes and
ships entering the United States.
CDC works with partners at all ports
of entry into the United States to help prevent infectious diseases from being
introduced and spread in the United States. CDC works with Customs and Border
Protection, U.S. Department of Agriculture, U.S. Coast Guard, U.S. Fish and
Wildlife Services, state and local health departments, and local Emergency
Medical Services staff.
Relatively few of the approximately
350 million travelers who enter the United States each year come from these
countries. Secondly, most people who become infected with Ebola are those who
live with or care for people who have already caught the disease and are
showing symptoms. CDC and health care providers in the United States are
prepared for the remote possibility that additional travelers could get Ebola
and return to the U.S. while sick.
Beginning Oct. 27, 2014, Maryland began active monitoring of all travelers returning from Guinea, Liberia and Sierra Leone. Screening and active monitoring of travelers returning from Mali began on Nov. 17, 2014. Maryland continues to actively monitor travelers arriving from Guinea and Sierra Leone, however, the active monitoring of travelers from Mali and Liberia has been discontinued. For more information, click here.
Should people traveling to Africa be
worried about the outbreak?
Ebola has been reported in multiple
countries in West Africa (see Affected Countries).
For the most up-to-date information on travel notices to these countries, visit http://wwwnc.cdc.gov/travel/notices.
CDC currently does not recommend
that travelers avoid visiting other African countries. Although spread to other
countries is possible, CDC is working with the governments of affected
countries to control the outbreak. Ebola is a very low risk for most travelers
– it is spread through direct contact with the blood or other body fluids of a
sick person, so travelers can protect themselves by avoiding sick people and
hospitals in West Africa where patients with Ebola are being treated.
Why were the ill Americans with
Ebola brought to the U.S. for treatment? How is CDC protecting the American
public?
A U.S. citizen has the right to
return to the United States. Although CDC can use several measures to prevent
disease from being introduced in the United States, CDC must balance the public
health risk to others with the rights of the individual. In this situation, the
patients who came back to the United States for care were transported with
appropriate infection control procedures in place to prevent the disease from
being transmitted to others.
Ebola poses no substantial risk to
the U.S. general population. CDC recognizes that Ebola causes a lot of public
worry and concern, but CDC’s mission is to protect the health of all Americans,
including those who may become ill while overseas. Ebola patients can be
transported and managed safely when appropriate precautions are used.
Is there a danger of Ebola spreading
in the U.S.?
Ebola is not spread through casual
contact; therefore, the risk of an outbreak in the U.S. is very low. We know
how to stop Ebola’s further spread: thorough case finding, isolation of ill
people, contacting people exposed to the ill person, and further isolation of
contacts if they develop symptoms. The U.S. public health and medical systems
have had prior experience with sporadic cases of diseases similar to Ebola. In
the past decade, the United States had 5 imported cases of Viral Hemorrhagic
Fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in
any transmission in the United States.
Ebola
and Animals
How are animals involved in Ebola
outbreaks?
Because the natural reservoir host
of Ebola has not yet been confirmed, the way in which the virus first appears
in a human at the start of an outbreak is unknown. However, scientists believe
that the first patient becomes infected through contact with an infected
animal, such as a fruit bat or primate (apes and monkeys), which is called a
spillover event. Person-to-person transmission follows and can lead to large
numbers of affected persons. In some past Ebola outbreaks, primates were also
affected by Ebola, and multiple spillover events occurred when people touched
or ate infected primates. In the current West African epidemic, animals have
not been found to be a factor in ongoing Ebola transmission.
Can dogs get infected or sick with
Ebola?
At this time, there have been no
reports of dogs or cats becoming sick with Ebola or being able to spread Ebola
to people or other animals. Even in areas in Africa where Ebola is present,
there have been no reports of dogs and cats becoming sick with Ebola. There is
limited evidence that dogs become infected with Ebola virus, but there is no
evidence that they develop disease.
Here in the United States, are our
dogs and cats at risk of becoming sick with Ebola?
The risk of an Ebola outbreak
affecting multiple people in the United States is very low. Therefore, the risk
to pets is also very low, as they would have to come into contact with blood
and body fluids of a person with Ebola. Even in areas in Africa where Ebola is
present, there have been no reports of dogs and cats becoming sick with Ebola.
Can I get Ebola from my dog or cat?
At this time, there have been no
reports of dogs or cats becoming sick with Ebola or of being able to spread
Ebola to people or animals. The chances of a dog or cat being exposed to Ebola
virus in the United States is very low as they would have to come into contact
with blood and body fluids of a symptomatic person sick with Ebola.
Can my pet’s body, fur, or paws
spread Ebola to a person?
We do not yet know whether or not a
pet’s body, paws, or fur can pick up and spread Ebola to people or other
animals. It is important to keep people and animals away from blood or body
fluids of a person with symptoms of Ebola infection.
What if there is a pet in the home
of an Ebola patient?
CDC recommends that public health
officials in collaboration with a veterinarian evaluate the pet’s risk of
exposure to the virus (close contact or exposure to blood or body fluids of an
Ebola patient). Based on this evaluation as well as the specific situation,
local and state human and animal health officials will determine how the pet
should be handled.
Can I get my dog or cat tested for
Ebola?
There would not be any reason to
test a dog or cat for Ebola if there was no exposure to a person infected with
Ebola. Currently, routine testing for Ebola is not available for pets.
What are the requirements for
bringing pets or other animals into the United States from West Africa?
CDC regulations require that dogs
and cats imported into the United States be healthy. Dogs must be vaccinated
against rabies before arrival into the United States. Monkeys and African
rodents are not allowed to be imported as pets under any circumstances.
Can monkeys spread Ebola?
Yes, monkeys are at risk for Ebola.
Symptoms of Ebola infection in monkeys include fever, decreased appetite, and
sudden death. Monkeys should not be allowed to have contact with anyone who may
have Ebola. Healthy monkeys already living in the United States and without
exposure to a person infected with Ebola are not at risk for spreading Ebola.
Can bats spread Ebola?
Fruit bats in Africa are considered
to be a natural reservoir for Ebola. Bats in North America are not known to
carry Ebola and so CDC considers the risk of an Ebola outbreak from bats
occurring in the United States to be very low. However, bats are known to carry
rabies and other diseases here in the United States. To reduce the risk of
disease transmission, never attempt to touch a bat, living or dead.
Note: The information on this page will be updated as needed. For the
most current information on national and international cases and guidance, see http://www.cdc.gov/vhf/ebola/. For the most current information on the
situation in Maryland, see dhmh.maryland.gov/ebola.