How big is the danger of Ebola?

Questions and answers about the symptoms and dangers of Ebola

17/10/2014

With the reports about the treatment of Ebola patients in German clinics also in this country a discussion over the possible spreading of the exciters within Germany used. Almost hysterical reactions, as they are currently shown in the US media from various sides, but are completely inappropriate. For the West African countries affected by the Ebola epidemic are dependent on any help, and the medical standards in Germany make the transmission of pathogens much more unlikely in treatment than under local conditions.

Since the beginning of the year, the Ebola epidemic has raged in the West African states of Guinea, Liberia and Sierra Leone. Early on, the aid organization Doctors Without Borders had warned that the situation was out of control. But for months, only hesitant help was provided by the international community and more and more people fell ill. According to the World Health Organization (WHO), the death toll has now increased to more than 4,500. Other African countries, such as Nigeria and Senegal, also had multiple infections. The medical conditions in the affected West African countries represent a huge challenge for the assistants and the health workers in their daily work are often exposed to an enormous risk of infection due to the inadequate equipment.

High risk of infection of health workers
The high risk of infection of health workers is also reflected in the number of infected medical workers. According to the WHO, 427 volunteers have already become infected with Ebola and 236 have died as a result of the infection. It would be relatively efficient to avoid transmission of the deadly pathogens using modern medical standards. However, even these do not provide 100% security, as the case of the first human-to-human transmission outside of Africa has shown in a Spanish nurse. She became infected with a patient from Sierra Leone, who was being treated in Spain. Given the dramatic conditions on the ground and the spare capacity of special clinics in Spain, the USA, Germany and other European countries, transferring individual patients still seems appropriate, although this may be associated with an infection risk, especially for medical personnel. For on-site conditions are significantly worse and the risk of infection is correspondingly higher.

West African States depend on help
Even German clinics have faced up to the difficult task of taking on several Ebola patients, although not all of them could be rescued. German doctors are also active locally in the West African countries to help the infected and curb the spread of the disease. While the selfless volunteers voluntarily expose themselves to a risk that should not be underestimated, in some places it is also discussed in this country - rather than through support - about possible risks of introducing the disease into Germany. There are many diffuse fears in the room that do not do justice to the difficult situation in dealing with the epidemic. The affected West African countries are clearly overburdened with the situation and urgently need international support. Thousands have already died here and an end to the epidemic is not yet foreseeable. Although individual infections of medical helpers can occur in the treatment of Ebola patients in other countries, it is extremely unlikely that the disease will be passed on to Europe or the USA, for example.

Which transfer risk exists?
People's fears of an uncontrollable spread of the Ebola epidemic are often linked to a lack of knowledge about the Ebola virus. For example, it is widely believed, for example, that the viruses can be transmitted over the air, or at least threaten mutations that allow such transmission. However, there are no signs for this, reports the news agency „AFP“ citing the World Health Organization. Anyone who does not come in contact with body fluids of the infected (directly or indirectly via contaminated objects), therefore, has no fear of infection. However, when dealing with the sufferers, there is the problem that the typical Ebola symptoms in addition to fever include diarrhea, nausea and vomiting, as well as bleeding from the mucous membranes and body orifices. Therefore, the contact with the body fluids can hardly be avoided and the medical personnel must wear appropriate protective clothing to protect themselves from infection. The establishment of quarantine stations is also essential.

Vaccines against Ebola in the trial
According to the experts of the Robert Koch Institute (RKI), whether or not after contact with an infected person a disease is also dependent on how many pathogens have been taken up, according to the announcement of the „AFP“. The incubation period also depends on this influencing variable. In most cases, the disease outbreak is recorded after eight to ten days, but it may take up to three weeks before the first symptoms appear. In general, it can be said that in the late phase of the disease the viral load and thus the transmission risk is greatest. However, the medical possibilities to preventively protect against the disease have so far been limited to equipment and hygiene. A vaccine is currently not available, even though initial successes with trial vaccines have already been reported. Here are two vaccines from the WHO as „promising“ The first test results are expected by November or December „AFP“. The deployment could possibly begin at the beginning of 2015.

Ebola risk for Germany extremely low
Overall, the likelihood of human-to-human transmission of the Ebola viruses in Germany remains extremely low, even if significantly more patients were admitted to German hospitals in the coming months. The risk of introduction of the epidemic by travelers is also considered to be unlikely, but the RKI here to consider that on air travel in the worst case may well be an infection. However, the Foreign Office makes it clear that „by fleeting contact in public with people who do not work sick, Ebola is not transferred.“ Nor is it at „the touch of money, locally purchased food or while bathing in the pool“ to fear an infection. Transmission of the Ebola virus by mosquitoes remains equally excluded. Overall, the spread of the epidemic to such a drastic extent as in West Africa can only be explained by the combination of extremely poor medical infrastructure, a lack of knowledge about the disease in the population and the social rituals in dealing with the sick and the dead. In Germany, however, there is at most the risk of isolated infections, for example when traveling or when treating Ebola patients in German hospitals. (Fp)