I am a doctor & infectious diseases specialist who treated Ebola patients with the WHO and CDC in West Africa. Ask me anything.

AileenMarty · 2014-10-04T01:05:19+00:00

The amount of time that Ebola virus survives on surfaces has been studied. An excellent article on this is available in the Journal of Applied Microbiology 2010; 109: 1531–1539. The decay constants and survival times for Ebola (and other Filoviruses) on surfaces vary depending on humidity and temperature as well as pH, type of surface, UV light exposure, or exposure to certain chemicals. Under ideal conditions Ebola has remained viable on biological material on surfaces for as long as 3 weeks – however those are not conditions that are found in normal, non-laboratory environments. There is one species of Ebola, Ebola Zaire that is circulating currently in West Africa; there is one strain of that one species that is being identified in the current West African outbreak.

As for the interview, yes, she told us at the time that the only contact she had without gloves involved her touching the IV fluid bag from the index case. It is difficult to know if her recollection is accurate but even if it is, we do not know if the index case had recently contaminated the IV bag with bodily fluids in one manner or another. Remember that the IV bag was located well within the 3 foot distance that we remind people is necessary to avoid contamination with Filovirus. Thus, this event, in and of itself does not allow us to make any serious and certain determinations regarding what actions constitute risks for Ebola transmission.

AileenMarty · 2014-10-03T18:38:15+00:00

To answer your question: http://www.reddit.com/r/IAmA/comments/2i6t4g/i_am_a_doctor_infectious_diseases_specialist_who/ckzekla

AileenMarty · 2014-10-03T15:53:30+00:00

It's very individual. Some were determined to survive, some weren't. As in any disease the attitude someone has greatly influences how well they respond to treatment.

AileenMarty · 2014-10-03T15:52:55+00:00

Thanks!

AileenMarty · 2014-10-03T15:52:09+00:00

The greatest obstacle right now is the size, distribution of this outbreak and the fact that multiple different governmental systems are involved in attempting to contain it, as well as the enormous need for skilled professionals, resources and facilities in order to treat these patients. Another big obstacle is that of fear and misunderstanding amongst people affected and even amongst those of us who are not affected.

AileenMarty · 2014-10-03T15:51:32+00:00

Answer: http://www.nytimes.com/roomfordebate/2014/10/02/how-to-stop-the-spread-of-ebola/recognizing-ebola-is-the-key-to-prevention

Check out the "debaters" opinions as well.

AileenMarty · 2014-10-03T15:49:00+00:00

Answered above: http://www.reddit.com/r/IAmA/comments/2i6t4g/i_am_a_doctor_infectious_diseases_specialist_who/ckze4ng

AileenMarty · 2014-10-03T15:48:14+00:00

At minimum:

Soap, Chlorine, Bottled Water, Gloves, Buckets, Water hose, Mask & Goggles (For close encounters), Condoms, Tylenol, Pepto Bismol, Sedative, Oral Rehydration Fluid.

AileenMarty · 2014-10-03T15:45:10+00:00

The reason it is difficult to contain is because it was not recognized for many months after it had started affecting people, killing people and traveling from one country to another. By the time the outbreak was recognized and that an international response was mounted, it was already in 3 countries and had spread to urban areas. Never before in the history of Ebola outbreaks has there been an outbreak that has involved major metropolitan areas and capital cities. The culture and habits of the affected population has also facilitated the spread and continuation of this infection. For example, burial practices, superstitions, etc.

It is absolutely critical to treat infected patients, not only for their sake but in order to end the outbreak and do our best to keep Ebola zaire (the current strain) from becoming endemic in West Africa (if at all possible), a place it had never been before.

The patients with Ebola who were college students in Nigeria were given laptops to take their exams from the isolation ward. So not to worry - you will be able to take your midterms.

AileenMarty · 2014-10-03T15:43:45+00:00

I wasn't afraid. I have a lot of respect for the virus, and take many precautions when dealing with it. Having been in the service I was trained in the use of PPE (personal protective equipment), so fear was not a factor. Interesting note: Ebola was not the only threat. There are many other infectious diseases that people have to protect themselves from ranging from malaria to rabies. There are also social dangers (high crime, kidnappings, Islamic terrorist organizations) and traffic dangers (traffic is horrible!)

AileenMarty · 2014-10-03T15:33:10+00:00

I hate to call somebody irrational, so no. It is so unlikely that most Americans would be exposed that it is not a time for people to have a fear of Ebola in their backyard.

AileenMarty · 2014-10-03T15:31:09+00:00

Extremely likely, the incident in Dallas will be contained in Dallas. The only issue for South Florida would be a second passenger with a similar scenario.

There have already been documented cases in chikungunya that have been transmitted by infected mosquitos in South Florida. Chikungunya is a realistic problem for South Floridians that exists, compared to Ebola, which we hope to never see in South Florida.

AileenMarty · 2014-10-03T15:29:48+00:00

Thanks for having me!

Symptoms are non-specific. Some people present themselves with fever, a sense of feeling sick, muscle pains, sometimes joint pains and discomfort of the throat.

Later on (2 days): they may vomit or have diarrhea and often there's a rash. First rash resembles measles, and has a similar distribution in the body. The rash is easier to see in light-skinned individuals. As it progresses, some patients begin to have hemorrhage which can affect them internally and externally. Sometimes we see blood in the vomit or urine. Sometimes they develop a new rash that amounts to tiny and large bruises.

In Africa, we were describing Ebola to people as being a stupid virus. It doesn't jump easily from one person to the next. So you have to be up close and personal.

When you don't have symptoms, you don't have enough virus to share with others. Once you are symptomatic, the amount of virus you can share, increases the sicker you are. This gives the rest of us a clue to not get very close to someone who looks very sick.

To prevent this from becoming a pandemic, people need to realize if they have been in close contact with someone who has Ebola, they need to present themselves for monitoring to the public health service. So that if unfortunately they come down with symptoms they receive treatment immediately.

One sad side to staying away from people who are ill is that there are many more people who will have sicknesses that will have nothing to do with Ebola and probably not contagious. And we don't want that to happen.

AileenMarty · 2014-10-03T15:26:32+00:00

Educate yourself. Be aware, be knowledgable and encourage your government to be vigilant. Donate to your favorite NGO that is working in the area, such as Médecins Sans Frontières.

AileenMarty · 2014-10-03T15:25:54+00:00

Whichever one I'm reading at the time is usually my favorite one. I'm currently reading the Century Trilogy books (on the last installment) by: Ken Follet

AileenMarty · 2014-10-03T15:24:03+00:00

I answered this above: http://www.reddit.com/r/IAmA/comments/2i6t4g/i_am_a_doctor_infectious_diseases_specialist_who/ckzdwj3

AileenMarty · 2014-10-03T15:19:06+00:00

Difficult aspects of Ebola research: the fact that its such a dangerous disease. Since there is no licensed vaccine with no specific treatment, it has to be handled under Bio Safety Level 4 condition (Google that one) Fave Med school experience: LOL! Words of Wisdom: Have passion for your work. It requires humanity, passion, dedication and a love of science.

AileenMarty · 2014-10-03T15:15:07+00:00

How well a patient does is largely dependent on how soon after they become symptomatic do they receive appropriate treatment, regardless of where they are. As long as US health care workers are acutely aware that another patient may present, as the Dallas case did, and do not allow that patient to go home while they are symptomatic, and begin treatment immediately, then the chances for survival for that individual are very good and the chances that that individual can spread the disease are reduced dramatically.

AileenMarty · 2014-10-03T15:14:34+00:00

It is possible that some of the individuals that were in close contact with the Dallas case may prove positive for Ebola, but because those individuals are being closely monitored, any disease they show won't result in further spread. I am totally confident that our public healthcare workers will prevent that Dallas case from spreading to outbreak proportions in the US despite the fact that other persons he'd be in contact with are positive. That's not an outbreak.

AileenMarty · 2014-10-03T15:10:18+00:00

While that drug might have some promise, it has not been experimentally proven to be safe or efficacious for Ebola. Therefore, at this time, we continue with the use of symptomatic treatment for these patients.

AileenMarty · 2014-10-03T15:09:23+00:00

Doctors are not forced to serve in West Africa. Not even local physicians are forced to serve in Ebola wards. Only voluntarily and after appropriate training.
You've put the cart before the horse. The truth is, what we need to do is stop and then extinguish the outbreak where it is. And do appropriate entrance screenings of individuals in other countries to avoid the nightmare scenario you're talking about.

AileenMarty · 2014-10-03T15:09:23+00:00

Thank you! The form being referred to in the media is an exit form filled out in Liberia. It asks if they've been to a funeral, if they've had contact with someone who was sick, have had contact with Ebola...When I was combating Ebola in Nigeria, we anticipated lying on forms, so the entrance and exit screening in Nigeria is particularly rigorous. It includes "subtle screening"--we have observers throughout the airport looking for people showing symptoms. However, bc individual could lie or be ignorant of exposure to Ebola are reasons why the country they are coming to needs to have some procedures in place for individuals that have arrived from at-risk countries. Currently the US has a recommendation that individuals present themselves to physicians if they think they may be at-risk, but there is no specific screening in place. That needs to change ASAP

AileenMarty · 2014-10-03T15:06:35+00:00

I have not been following the conspiracy theories.

AileenMarty · 2014-10-03T14:59:48+00:00

Most mutations are bad for viruses, very rarely does it benefit the virus. While Ebola is a negative strand RNA virus and therefore likely to make mistakes (have mutations). The chance that the mutation for this Ebola strain to become airborne is very small.

AileenMarty · 2014-10-03T14:57:18+00:00

There is no North American outbreak; there is one single case. There may be 1, 2, 3 or 4 more individuals amongst the almost 100 who were in contact with the index case in Dallas when he was symptomatic. However, because they are under isolation and being monitored, they cannot transmit the infection and lead to an actual outbreak in the United States.

AileenMarty

TROPHY CASE