COMMENT: Ebola risk prevention

Ebola – a disease we can wash our hands of?

In recent weeks, reports about the Ebola virus have been appearing with frightening regularity.

The virus, for which there are no licensed treatments or vaccine, was identified in Africa as long ago as the mid-1970s but this year’s outbreak in Guinea, Liberia, Sierra Leone and Nigeria has proved the deadliest to date.

According to the NHS: “An infected person will typically develop a fever, headache, joint and muscle pain, sore throat, and intense muscle weakness. These symptoms start suddenly, between two and 21 days after becoming infected, but usually after 5-7 days. Diarrhoea, vomiting, a rash, stomach pain and impaired kidney and liver function follow. The patient then bleeds internally, and may also bleed from the ears, eyes, nose or mouth. Ebola virus disease is fatal in 50-90% of cases.”

As these words were written a Spanish nurse was critically ill with the disease, becoming the first person known to catch Ebola outside the outbreak zone in West Africa during the current epidemic. She was part of the medical team that treated a 69-year-old Spanish priest, Manuel Garcia Viejo, who died in the same hospital late last month, and it is currently unclear how the disease was transmitted.

Elsewhere it is reported that Thomas Duncan, the first person to be diagnosed with Ebola within the USA, had recently died in hospital in Texas. He had caught the virus in his native Liberia before flying to the USA and four other occupants of the flat where he lived are now being kept in isolation.

So, do we need to be wary of infected masses turning up at airports around the world spreading the disease? The NHS website refers to the likelihood of catching Ebola virus disease as “very low unless you've travelled to a known infected area and had direct contact with a person with Ebola-like symptoms, or had contact with an infected animal or contaminated objects.”

It points out that just one case of Ebola has been imported into the UK (a British nurse who contracted the disease during aid work) and goes on to say: “While it is possible that more people infected with Ebola could arrive in the UK on a plane, the virus is not as easily transmitted as a respiratory virus such as influenza.”

This is, of course, reassuring to hear, but in today’s world of widespread international travel it is all too easy for regional diseases to become worldwide problems – as evidenced by the 2002-2003 SARS outbreak that saw travel restrictions placed on Beijing and Toronto.

Late last week the British government issued new guidelines for airports handling passengers travelling from Liberia, Sierra Leone and Guinea – who will now "be questioned about travel arrangements and recent contacts."

A Downing Street spokesman said: "These measures will help to improve our ability to detect and isolate Ebola cases. However, it is important to stress that given the nature of this disease, no system could offer 100 per cent protection from non-symptomatic cases."

In the NHS’s guidance for travellers in ‘at-risk’ areas is advice to “wash hands frequently using soap and water (alcohol hand rubs when soap is not available), as this destroys the virus.”

Obviously the last thing anybody wants at the moment is to overreact and instil panic into the travelling public but this last comment does make one wonder if it’s time to introduce hand gel regimes at immigration desks?

This may not eradicate all the risk, but even if it merely reduces the chances of the virus being transmitted it must surely be a good thing? The procedure is commonplace on cruise ships and takes a matter of seconds – what harm can it do?

Alternatively, let’s wait until the first person dies of Ebola in Surrey, then panic and look for somebody to blame…

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