Experts: Airborne Ebola transmission has likely been happening
It seemed strange that a nurse in Texas contracted Ebola recently, since health officials have adamantly claimed there was no major risk to people in…
Is Ebola airborne now? (AP Photo/Yonhap, Shin Jun-hee, File)
It seemed strange that a nurse in Texas contracted Ebola recently, since health officials have adamantly claimed there was no major risk to people in the United States. The country had been preparing for cases of the virus since the outbreak in West African occurred, and we were confident our technology and ample medical staffing could prevent Ebola from spreading.
Now, a second health care worker who cared for Thomas Eric Duncan has been diagnosed with Ebola, and people are wondering how, with all our safety precautions, the virus managed to escape our control.
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While a few cases in the United States is a far cry from the thousands of individuals affected in West Africa, the virus could claim more victims for one very specific reason: experts feel it is–and likely has been–transmitted through the air, despite what we originally thought.
“We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients, which means that healthcare workers should be wearing respirators, not facemasks,” write Lisa M Brosseau, ScD, and Rachael Jones, PhD, national experts on respiratory protection and infectious disease transmission, in a Center for Infectious Disease Research and Policy commentary. “The minimum level of protection in high-risk settings should be a respirator with an assigned protection factor greater than 10. A powered air-purifying respirator (PAPR) with a hood or helmet offers many advantages over an N95 filtering facepiece or similar respirator, being more protective, comfortable, and cost-effective in the long run.”
Current standards for Ebola containment only require medical staff to wear facemasks as protective gear; Ebola was thought to only be transmittable through direct physical contact with an infected individual’s bodily fluids. This rationale was based on the fact that no one at a distance from an Ebola patient had developed the virus.
This undated file image made available by the CDC shows the Ebola Virus. As a deadly Ebola outbreak continues in West Africa, health officials are working to calm fears that the virus easily spreads, while encouraging those with symptoms to get medical care. (AP Photo/CDC, File)
All the cases initially could be traced to some possible physical contact, and health care workers in West Africa, who were poorly outfitted with supplies, were at-risk because they were considered ill-equipped.
But the U.S. was supposed to have all the Ebola management capabilities available, and experts knew something was wrong when the first health care worker got ill.
Jones and Brosseau explain the common understanding of how a virus becomes transmissible throughout the air is outdated. It was once believed that only small particles in the air could infiltrate the body. We now know this isn’t true. “Particles as large as 100 mcm (and perhaps even larger) can be inhaled into the mouth and nose. Larger particles are deposited in the nasal passages, pharynx, and upper regions of the lungs, while smaller particles are more likely to deposit in the lower, alveolar regions,” state the authors in the commentary.
While the full nature of Ebola and how it is transmitted is not yet understood, based on similar virus models and past experiences, it seems entirely likely the disease has been spreading through the air in a number of ways.
“The potential for transmission via inhalation of aerosols, therefore, cannot be ruled out by the observed risk factors or our knowledge of the infection process,” they write. “Many body fluids, such as vomit, diarrhea, blood, and saliva, are capable of creating inhalable aerosol particles in the immediate vicinity of an infected person. Cough was identified among some cases in a 1995 outbreak in Kikwit, Democratic Republic of the Congo, and coughs are known to emit viruses in respirable particles. The act of vomiting produces an aerosol and has been implicated in airborne transmission of gastrointestinal viruses. Regarding diarrhea, even when contained by toilets, toilet flushing emits a pathogen-laden aerosol that disperses in the air.”
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Thought Ebola is likely most efficiently spread through direct contact, all factors are pointing to a significant risk by way of inhalation as well. Facemasks, unfortunately, do not offer protection against inhalation of small infectious aerosols, because they lack adequate filters and do not fit tightly against the face. This means all health care workers should be wearing respirators instead–something that may be difficult to supply in developing countries such as those in West Africa.
The United States, however, should have no problem ensuring health care workers have the gear they need. The Centers for Disease Control (CDC) have stayed on top of monitoring people in close contact with the current Ebola cases in the country, and now, fully understanding how Ebola is transmitted, they may be able to prevent more cases from happening.
“Health officials have interviewed the latest patient to quickly identify any contacts or potential exposures, and those people will be monitored,” the department said, as reported by Yahoo! News. “An additional health care worker testing positive for Ebola is a serious concern, and the CDC has already taken active steps to minimize the risk to health care workers and the patient.”
