General Question

flo's avatar

Why are so many health care workers being infected with Ebola if it is not airborne?

Asked by flo (7723 points ) August 6th, 2014

“The virus may be acquired upon contact with blood or bodily fluid…” (from Wikepedia)
They are wearing all that protective gear, and they still get infected. How? Even among the general population, how?

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62 Answers

hearkat's avatar

I’ve been wondering the very same thing; but suspect it is because they don’t have adequate protective gear and/or infection control practices.

zenvelo's avatar

They are handling hundreds of patients in a less developed country. This isn’t happening in a US facility. And three health care works is not “so many.”

hearkat's avatar

@zenvelo – The reports I’ve heard have made it sound like numerous health care workers have been infected. Flo and I are talking about ALL health care workers there, regardless of their country of origin — not just the three from the USA. Also, you state “country” (singular); but the outbreak is in currently three countries, plus a few cases in other countries of people who travelled there from the main outbreak locations.

@flo, if the virus has mutated and become airborne, the travelers will have infected other travelers – that’s how we’ll know. If anything, perhaps it’s mutated to live longer outside the body or grown resistant to the milder antiseptic agents they’re using to clean the linens and instruments – that would probably be part of the evolutionary process before it mutates to the degree of becoming airborne anyway, I would think. But I’m not a microbiologist.

Buttonstc's avatar

The conditions in which they are working are far more primitive than anything we are used to here in the US.

There was one brief newsreel of one of the clinics showing the same half dozen pieces of equipment (including needles) which are re-used over and over.

They are on shoestring budgets over there and don’t have the type of protective gear that is necessary.

JLeslie's avatar

I don’t think they have all the protective gear. I think even salive has enough virus to be contagious, unless I misunderstood, so that might be the cause assuming they are taking all precautions with blood. Also, I am not sure when they caught it. If they caught it before the mass knowledge that the virus was on the rise, they might not have taken enough precautions. I don’t know how long the illness lasts, all I know is it can incubate for up to 21 days. it would be interesting to know if they know exactly when they likely caught it. Like if they stuck themseves by accident.

Coloma's avatar

Honestly, I almost feel that these poor souls should just be left to die. I know it sounds horrible and inhumane but this is a serious disease, not even like AIDs where one can live for many years and the risks are relatively modest.
The mortality rate is astronomical and it is extremely rare for anyone to recover. I commend those helping but we’re talking plague here, and well…I don’t know.

Disease is natures way of thinning the herd, be that humans or Antelope.
Now, before anyone goes ballistic here, just random but palpable thoughts showing up.

rojo's avatar

I believe these workers make do with whatever they can get a hold of. There is, for the most part, not even enough medicines/bandages/antibiotics/equipment available for treatment of less aggressive diseases. My impression is if they have a mask and latex gloves they consider themselves fortunate.

And yet they continue to do all they can for those who so desperately need their help; sometimes at the cost of their own health and well being, disregarding the inherent dangers.

JLeslie's avatar

@Coloma I thought the Americans were given an experimental drug that seems to be working well.

Coloma's avatar

@JLeslie I hadn’t heard that. Good news then.

dappled_leaves's avatar

@Coloma It’s true that the mortality rate is very high, but it doesn’t spread easily. One of the reasons it persists in the regions where it is found is that the death rites of those affected involve touching and kissing the body of the person they are mourning; people travel distances to do this, then bring the disease back home with them. If people could be made to understand the risks involved in these practices, I think we’d see this become an extremely rare disease.

Coloma's avatar

@dappled_leaves Thank You for enlightening me further. My comments were not intended to be callous, just the misery factor of a mostly incurable situation. The mourning practices make a lot of sense in how the disease is unconsciously spread. Interesting.

JLeslie's avatar

@dappled_leaves Do the governments do anything to inform their citizens? From what I understand some governments in Africa are resistant to give out accurate information about HIV transmission, because it goes agains some norms and mores in the culture. Drives me crazy. I believe it because even in America when AIDS first hit the scene Reagan and Bush didn’t want to take the advice of Surgeon General Koop to promote condoms or talk about the disease in public informative commercials. Just another wedge in the relationship between Koop and the administration. Reagan and his Christian right saw it as a gay disease and certainly were not going to talk about sex, and if they did it would be abstinence.

rojo's avatar

I heard an interesting report on NPR (maybe, definitely not Fox) that one method that seems to be working pretty well is it inform and educate the Liberian community in the US and let them pass it on to friends and family in Liberia. The population is more likely to believe the info from friends and family than from a government agency and those living in the US are better educated and informed. The good thing is that although many communities may not have electricity or water, cell phones are ubiquitous and the information can be be quickly disseminated by cell phone. But, on the down side, trying to change centuries of funerary tradition is not an easy task. Asking someone to burn a family member in a society where that is not the norm is going against the grain.

Response moderated (Off-Topic)
dappled_leaves's avatar

@JLeslie I honestly don’t know what the situation is with the government, but the health officials are trying. They’re working hard to track the movements of the victims, so they stop the spread, but it’s difficult – especially because there is a tendency for people to hide symptoms for fear of being labelled as sick.

rojo's avatar

@dappled_leaves also, many times they will not go into the hospital even though they are sick because of the fear of being put into isolation/quarantine. Many are not convinced that it is not the act of going into the hospital that kills you.

zenvelo's avatar

One particular difficult belief is that the doctors and nurses were spreading the disease, because they would show up to care for someone and mean while a dozen close people in the same village would get sick.

So people have worked to get family out of the hospitals and back home in the belief they will die if they stay in the hospital. But the family is poorly equipped to take precautions and everyone gets sick from tending to the patient

ibstubro's avatar

NPR made it sound like PPE was prevalent and available for the health care workers in the affected countries.

I suspect the health care workers are getting infected by dealing patients family members that have become infected, but are not yet showing signs.

Response moderated (Flame-Bait)
Buttonstc's avatar

It was really driven home how easily it can be transmitted when I was watching a news report tonight.

In addition to blood and sexual contact it can be transmitted by vomit, saliva, and sweat. Can you imagine how many people are sweating in a region with a hot climate? Yikes ! !

HIV and AIDS were bad enough but it really wasn’t that easy to catch it. There needed to be sexual activity or direct blood transfer. Just saliva or shaking someone’s hand or even hugging them wasn’t sufficient as the years of experience have demonstrated.

But simply shaking hands with or hugging someone infected and sweating is enough with Ebola. No small wonder health care workers are so vulnerable (unless they have head to toe Hazmat suits.) This really is scary stuff.

dappled_leaves's avatar

@Buttonstc The fact that sweat can transmit the disease does not mean that just touching sweat will do it… it’s like any other bodily fluid. It’s going to have to get into a person via an orifice or a wound. It’s not that different from HIV in that respect.

rojo's avatar

or wiping your eyes or nose with your forearm that has been been bathed in sweat and made contact at some point.

dappled_leaves's avatar

@rojo Well, duh. That will get you the common cold, too.

rojo's avatar

Just trying to be thorough, some people don’t think of eyes and noses as orifices (orofici?).

Buttonstc's avatar

You wrote: “It’s not that different from HIV in that respect”

I disagree strongly about that. As rojo pointed out, there are numerous orifices involving muccus membranes as routes of transmission.

For HIV, (or anything else) blood, semen or vaginal fluids quite simply just aren’t that pervasive. You normally aren’t encountering them in copious amounts (barring surgery) and they’re usually from rather specific locations in the body. Plus, blood gives you a visual clue so you’re more likely to thoroughly wash either stationary surfaces or you’re own hands rather quickly before touching eyes, mouth etc.

This virus is vastly different because HIV is not transmitted through casual contact whereas Ebola certainly is.

People aren’t normally bleeding from ever body pore but they certainly can be sweating from every pore, especially in African climates.

And if one is dealing with an infected Ebola victim who has not yet shown symptoms, it’s not at all difficult to get significant amounts of their sweat on you or your clothing. From there to wiping your eyes, nose, mouth is certainly a common enough gesture.

Ebola is as easily caught as a cold. HIV requires some work. Ebola CAN BE transmitted through everyday casual contact (even a handshake): HIV CANNOT.

There is a vast difference between the two in every way possible.

After reading the info on the CDC site, I’m not at all surprised that healthcare workers are becoming infected. As a matter of fact, I’m surprised there aren’t more of them.

flo's avatar

Thank you so much all.

I didn’t know it has become airborne. Now I see how. .
Here is a CDC article.

JLeslie's avatar

It’s not airborne.

If it were airborne there would be thousands, maybe millions of cases now, and prior Ebola outbreaks would have been much larger.

@Buttonstc I heard that Ebola is not contagious until symptoms appear, but that sounds odd to me, do you have any information on that?

@rojo Like my mama said, “don’t touch your face.”

@zenvelo That sort of belief even still exists in the US today among some people. I’m guilty of believing doctors sometimes overtreat or make mistakes or sometimes the treatment is worse than the actual disease. A friend of mine who worked with black prisoners to inform them about AIDS said that a lot of them have the events of Tuskegee passed on to them, and so fears of government and white doctors is a real fear among some.

flo's avatar

@JLeslie Your second statement sounds fair.

It just doesn’t make sense that just by shaking sweaty hands it gets transmitted.

Buttonstc's avatar

@flo

That article you linked is from the website of Alex Jones. This is a guy who believes (among other outrageous stuff) that the films of the moon landings were staged fakes and the government is covering up the deaths of THOUSANDS of astronauts.

He also says that climate change is another govt. hoax etc. etc.

I would have a hard time taking seriously his interpretation of anything important. Whenever he appears in interviews, all he knows to do is constantly outshout his opponents while completely ignoring any of their attempts to be logical. Even Rush Limbaugh thinks he’s an over-the-top idiot.

Anyhow, I can’t do links cuz I’m on my old iPhone but do a little googling on “the difference between airborne and aerosolized” transmission of diseases.

The reason the animals infected each other was because of their close proximity (even tho no direct contact) in the same time period. They were affected by the aerosolized droplets.

Airborne transmission occurs over much larger distances and periods of time.

As was pointed out already, if it were airborne transmission, there would be thousand or millions rather than hundreds in specific areas.

Alex Jones is a xenophobic idiot who doesn’t want any of the healthcare workers brought into the US for treatment even tho the strictest isolation precautions are being put in place. He’d just rather they died elsewhere as someone
else’s problem.

Buttonstc's avatar

@flo

It’s not just the handshaking contact, per se; it’s the all too common transfer of the sweat to any mucosal areas by simple unconscious type reflex actions, eg: swiping ones own forehead sweat (mingled with the infected droplets) out of
the eyes, wiping ones nose,
eating fruit or anything else bringing fingers in direct contact with mouth etc etc.

Many people are touching their eyes, nose, mouth all day long without even thinking about it.

The only person I can think of who would be pretty safe in those areas would be OCDish germaphobe Howie Mandel who refuses to shake hands
with anybody, sweaty or not :)

flo's avatar

@Buttonstc OMG! I didn’t realize that it is his site, I was just focused on the fact that they are really geared up.(maybe not as much as that)

But again, the health care workers are too aware to touch eyes etc. And even if they were to they can’t, they are covered up.

Buttonstc's avatar

I’m pretty sure that they were not geared up at the time they first became infected because they were barely able to afford basic medical care items, even re-using items designed to be disposable. I seriously doubt they had the type of Hazmat suits being worn by govt. workers now.

These were medical missionaries with a small organization on a limited budget.

flo's avatar

I just don’t get it, that is all I know @Buttonstc

ibstubro's avatar

PPE reported in July, yet a leading doctor died of the virus.

Concern is warranted, especially among health care workers.

seekingwolf's avatar

I read somewhere that ebola can be transmitted via droplets. Not quite “airbourne” but pretty close. So someone working in close proximity to someone with ebola could easily get the disease via droplets flying in the air from the sick person.

If I am wrong, please correct me, okay?

ibstubro's avatar

Like a sneeze, @seekingwolf? I have the same understanding. Air transmitted.

seekingwolf's avatar

@ibstubro

Something like that. Or from vomit, or sweat, like if someone is shaking their head and the droplets fly off. The article I read gave me an actual droplet size (apparently those exist) that is optimal for Ebola transmission, but I don’t remember the exact size. It sounds like it’s pretty damn infectious but maybe not as infectious as something like TB.

I don’t know, is this what you have heard as well? I hope I’m not wrong and giving out bad information by accident.

dappled_leaves's avatar

@Buttonstc “I disagree strongly about that. As rojo pointed out, there are numerous orifices involving muccus membranes as routes of transmission.”

You say that you are disagreeing with me, but you haven’t contradicted what I’ve said at all. Ebola is transmitted through orifices or wounds. It is not that different from HIV in that respect. What is inaccurate or unclear about that? I did not say that it is harder to catch than HIV.

Here is a recent story about the difficulty surrounding death rites and the spread of ebola, for anyone who is interested.

Buttonstc's avatar

@seekingwolf

They make a distinction between airborne vs. aerosolized as I previously noted. They sound similar but are not identical.

When you are referencing people nearby each other and sneezing, etc, that is what they term as aerosolized rather than airborne.

Airborne refers to transmission over longer distances and periods of time, thus being truly borne by the air rather than carried by droplets suspended in air.

It may sound like semantics but it really is the distinction which they make.

My primary problem was with the original link posted from the Alex Jone’s website where he is conflating the two definitions to bolster his viewpoint that the health care workers should not be brought here for treatment. That’s what annoyed me the most.

flo's avatar

”...it is harder to catch than HIV.” How is it harder than HIV? Don’t you have to work kind of hard to get HIV?

Anyway, do you have a site similar to this one with the key words (from @Buttonstc post)
airborne vs. aerosolized….
“sweat” to any “mucosal areas” by simple unconscious type reflex actions, eg: swiping ones own forehead sweat (mingled with the infected droplets) out of
the eyes, wiping ones nose, ...” orfices

flo's avatar

This
is the Google Images page for the gear I wish I had linked to a couple of posts ago.

Coloma's avatar

Reminds me of a history biography I read once on the Yellow Fever plague in Philadelphia in 1792, entitled, ” Bring out your dead.” haha Off topic but this was way before anyone made the connection to mosquitos and the disease link, they thought it was caused by a cargo of rotting coffee beans dumped on a beach by a trade ship.

Buttonstc's avatar

@flo

In fairness to @dappled_leaves, you only quoted HALF OF the sentence written. Look at it again carefully and you will notice that the full sentence reads:
“I DID NOT SAY that it is harder to catch than HIV”

It’s pretty obvious from recent events, and I think we all agree, that it is much much EASIER to catch than HIV.

Buttonstc's avatar

@flo

www.scienceblogs.com/aetiology

This is the site for Tara C.
Smith, a respected
epidemiologist who has written
several books on Ebola and
other contagious diseases.
It’s a bit to wade through,
but read her 3 most recent posts in which she cites scientific studies to back up her contention that Ebola is not airborne.

You can also follow her on Twitter for the latest updates and findings.

flo's avatar

@Buttonstc thanks for the correction re. @dappled_leaves post, and for the link.

@dappled_leaves, sorry.

flo's avatar

And touching the fresh bread in the supermarket (do you see this practice?) after touching the eyes nose etc. I mean the actual brerad.

Buttonstc's avatar

I don’t buy unwrapped bread at a supermarket where it can be touched by anyone and everyone but not because I’m concerned about Ebola.

It’s far more likely a transmission route for the flu or the common cold, both of which I’d prefer to avoid.

But there’s another item which we can’t really avoid touching which has been handles by thousands and we usually don’t give it a second thought: plain everyday money.

That’s why the first thing I do when I get home (after putting away groceries) is thoroughly wash my hands.

Coloma's avatar

Meh…..the amount of unseen weirdness we breathe, ingest, come into contact with is everywhere and yet we survive. What’s the difference between bread and squeezing the avocados, tomatoes, peaches, nectarines, melons, etc. in the produce isle?
I shared some frozen yogurt with my cat the other day, she had a lick, I had a lick, here I am, alive and well. haha
Why borrow trouble, I’m much more afraid of getting creamed by a drunk driver or stepping on a rattlesnake over here than I with who touched the bread. lol

flo's avatar

@Buttonstc _ “there’s another item which we can’t really avoid touching which has been handles by thousands and we usually don’t give it a second thought: plain everyday money.“_ Some people use their sweater or something sleeves to open doors( I don’t know think that is the ideal thing) some keep some tissue paper or similar all the time and some people just wait for someone behind them to open the door.
Re. money they wipe their hands before they handle anything else.

@Coloma What’s the difference between bread and squeezing the avocados, tomatoes, peaches, nectarines, melons, etc. in the produce isle? Those things can be washed (people usually wash them)
Andre. the sharing with the cat, just because you don’t immediately experience the ill effect of something you did does it mean it is all fine? I am not so sure.

Coloma's avatar

@flo True, fruits and veggies can be washed, but unless they are washed in hot soapy water not really going to make much difference.
I am clean and tidy and cautious, just not overly OCD about things. Hey, proof is in the pudding, I turn 55 in a few months and have spent a lifetime kissing cats and dogs and horses and rabbits and rats, and parrots and geese and Llamas and goats and, and,....
Here I still am, no hoof and mouth disease or rabies or Parvo Virus or parasites.

The more we’re exposed to the healthier our immune system and that’s a fact.

flo's avatar

@Coloma The more developed an area is the more healthy the people are.

Coloma's avatar

@flo I live in a developed area, but it is a rural area, just saying that in over 45 years of critter kissing no health issues.
Besides, wouldn’t you rather die of some rare and interesting disease than cancer or Pneumonia? I would. Quite frankly I’d love to be taken out by a Mountain Lion, better than Ted Bundy. haha

flo's avatar

@Coloma Why aren’t comminicable diseases more common developed areas if the theory is that there is more cleanliness there? That is my question.

Coloma's avatar

@flo Because their are more people. More masses more disease speared, that’s why we get flu shots, hopefully. haha

flo's avatar

@Coloma Because there are more people? I don’t know if I’m convinvced.

ibstubro's avatar

There was a report on NPR today that another American doctor was infected with Ebola in Africa. The key this time? He was a general physician, not an Ebola doctor, and he had not treated an Ebola patient to his knowledge. Time and means of transmission are unknown.

They are also 100% out of the experimental drug used to successfully treat people in the US. Apparently it’s not something you can whip up like a batch of pudding, and there’s no time frame on additional supplies. 40% of the total Ebola deaths have occurred in the past 3 weeks.

Scarey stuff.

Coloma's avatar

The drugs are in the Presidents bunker for his family and staff. lol

Coloma's avatar

Also..I just read last night that those that do recover still carry the virus in their semen for months and months, if not forever. So Ebola could also be sexually transmitted by a survivor.
I don;t know how that works with females, if they too could, potentially infect somebody via sexual contact.

ibstubro's avatar

I’m not sure that’s accurate, @Coloma, transmission wise.

Coloma's avatar

@ibstubro Can’t find the link to the particular article but it said months via semen. ???

rojo's avatar

@Coloma, @ibstubro is this what you were looking for? “People remain infectious as long as their blood and body fluids, including semen and breast milk, contain the virus. Men who have recovered from the disease can still transmit the virus through their semen for up to 7 weeks after recovery from illness.”

Coloma's avatar

@rojo Yes, but I thought they said “months” not weeks. Close enough. :-)

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