If Ebola Isn't Very Contagious, Why Are Healthcare Workers Getting It?
In the early stages of Ebola, the virus is not as likely to spread, yet healthcare workers in the United States have gotten sick. How is this possible? The answer lies in the fact that the sicker a person gets (by which point they are likely in the hospital), the larger their viral load and the more likely the virus is to be shed. Good infection control practices can help combat this.
The American people have been told that Ebola is not very contagious. We have been told that in the United States, where we have good infection-control practices, highly trained healthcare workers, and plenty of knowledge about how to prevent the spread of this deadly virus, we do not need to be afraid of this virus.
How then, is it possible that our "highly trained" nurses are coming down with the virus? How could doctors (some of whom are experts in Ebola) have contracted the disease while caring for patients in Africa? Why do the experts, with their special hazmat suits, have such a high risk for getting Ebola, while we're told that our risk (for instance, from contact on airplanes) is very low?
Many of the questions about the contagiousness of Ebola can be answered by looking at how contagiousness varies over the typical course of the illness. When people first start to show symptoms, they have low levels of the virus in their bodies. It is theoretically possible for them to spread the virus early on in the course of their illness, but it's not very likely.
However, as a person gets sicker and sicker, their "viral load" (the amount of Ebola viruses in the body) increases exponentially. As the virus invades more parts of the body, it starts to be "shed" more in the bodily fluids, such as urine and feces. As the illness progresses, copious amounts of bodily fluids, in the form of diarrhea, urine, vomiting, and blood, are produced. At the time of death, the body is literally overrun by the virus.
This alone isn't enough to explain why Ebola isn't highly contagious to the general American public. One more key piece of information is necessary to complete the puzzle: Here in the United States, we don't care for deathly ill people at home. Extremely sick people are cared for in the hospital.
Put these two pieces of information together, and it's easy to see why Ebola is highly contagious to healthcare workers who care for people as they are dying of Ebola, but not to the general public. By the time a person with Ebola is very ill (and very contagious), they are likely already in the hospital.
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