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How Do You Catch Ebola? A New Case but No Surprises

It may sound like Ebola is spreading out of control in the United States, but the general public is at virtually zero risk.
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Federal health officials are tracking down people who were on a flight with Amber Vinson, a nurse freshly diagnosed with Ebola. Cleaning crews are disinfecting her apartment. Nurses are complaining they weren’t protected.

It may sound like Ebola is spreading out of control in the United States, but what is happening is not unexpected. Scientists who study viruses say there’s no change and no surprise in what is happening with Ebola. Here are some answers to your questions about the virus:

How did two nurses get infected?

From the beginning of the Ebola epidemic in West Africa, it’s been clear that health care workers such as doctors and nurses are at high risk of infection. That’s because Ebola spreads by close, physical contact with a patient’s bodily fluids. Taking care of a patient with vomiting and diarrhea is very messy, and that’s how the virus can spread.

But they were wearing protective gear

Protective gear works only as well as the techniques used to put it on and take it off. The virus doesn’t spread far, but fluids from a very sick patient are highly infectious, and it only takes a droplet in the eye, up the nose or into the mouth to cause infection. Health workers also use needles, which can slip and cause what’s called a needle stick injury. If an infectious droplet is left on protective gear, someone taking it off could touch it and then carry the virus to her eyes, nose or mouth without even thinking. Several accounts suggest that Thomas Eric Duncan, who died at a Dallas hospital last week, was very ill when he began receiving treatment.

And the director of the Centers for Disease Control and Prevention, Dr. Thomas Frieden, says nurses and other health care workers at the hospital may have in fact overdone it. “We noted that some health care workers were putting on three or four layers of protective equipment in the belief that this would be more protective,” Frieden told a news conference. “But in fact by putting on more layers of gloves and protective clothing, it becomes much harder to put them on and it becomes much harder to take them off.”

Doctors who have worked successfully with Ebola patients say it takes a team to do it safely — each health care worker needs someone else spotting them as they gear up and take gear off.

Are people who were on the flight at risk?

Not according to what’s known about the virus. The health care worker was not showing symptoms when she flew, according to the CDC and Frontier Airlines. She had a slightly elevated temperature of 99.5, not quite considered a fever yet.

“The fact that the patient number two did not have a fever until the next day, did not have nausea or vomiting on the plane, suggests to us that the risk to anyone around that individual on the plane would have been extremely low,” Frieden said.

“If you are a member of the traveling public and you are healthy, should you be worried that you might have gotten it by sitting next to someone, and the answer is no.”

But Ebola is such a deadly virus that public health officials are not taking any chances and are tracking down 132 people who were on the flight with her from Cleveland to Dallas.

In this epidemic, up to 70 percent of patients are dying. Early, effective medical care seems to help — people who get treated quickly, who get rehydration fluids and oxygen have a much better chance of survival. Frieden says the virus builds up in the body as people get progressively sicker, and blood tests often don’t detect the virus in people who are in the early stages of infection — something that suggests people who have just developed a fever are not very infectious.

Then why are the streets closed off and people in hazmat suits cleaning apartments?

Ebola's scary. State and local officials want to make sure they are not accused of exposing the public to a dangerous and potentially deadly virus. In theory, it's possible that some bodily fluids may have spilled from a patient, but it is very unlikely that someone walking by on the street or even entering an apartment would be infected.

How can I feel safe if even the experts cannot protect themselves?

The key here is close contact. Health care workers are at higher risk because they are handling patients, leaning closely in to them, cleaning up vomit and diarrhea and inserting needles. The Ebola virus lives in warm body fluids. It doesn’t float in the air and it doesn’t survive being dried out. And it has to get into your body to infect you — via the eyes, nose or mouth or in a cut. People who might transmit Ebola are very sick. In 40 years of Ebola outbreaks, there haven’t been any mystery infections.