How big is the risk from Ebola?

How big is the risk from Ebola?

Questions and answers on symptoms and dangers of Ebola

With the reports on the treatment of Ebola patients in German clinics, there has also been a discussion here in Germany about the possible spread of the pathogens within Germany. Almost hysterical reactions, as are currently shown in the US media from various sides, are completely inappropriate. Because the West African countries affected by the Ebola epidemic are dependent on any help and the medical standards in Germany make transmission of the pathogens during treatment much less likely than under the local conditions.

The Ebola epidemic has been raging in the West African states of Guinea, Liberia and Sierra Leone since the beginning of the year. The aid organization MSF warned early on that the situation had gotten out of control. But for months, the international community gave only hesitant help and more and more people fell ill. The number of fatalities has now risen to more than 4,500, according to the World Health Organization (WHO). Other African countries such as Nigeria and Senegal have also had several infections. The medical conditions in the affected West African countries represent an enormous challenge for the auxiliary staff and the health workers are often exposed to an enormous risk of infection in their daily work due to the insufficient equipment.

High risk of infection by health workers The high risk of infection by health workers is also reflected in the number of infected medical assistants. According to the WHO, 427 helpers have already been infected with Ebola and 236 have died as a result of the infection. A transmission of the deadly pathogens could be avoided relatively efficiently with the help of modern medical standards. However, these also do not offer 100 percent security, as the case of the first human-to-human transmission outside Africa with a Spanish nurse has shown. She became infected in a patient from Sierra Leone who was being treated in Spain. In view of the dramatic conditions on site and the free capacity of special clinics in Spain, the USA, Germany and other European countries, transfer of individual patients still seems appropriate, even if this can be associated with an infection risk, in particular for medical personnel. Because the conditions on site are significantly worse and the risk of infection is correspondingly higher.

West African countries rely on help German clinics have also taken on the difficult task and taken in several Ebola patients, although not all of them could be saved. German doctors are also active in the West African countries to help those infected and to limit the spread of the disease. While the selfless helpers voluntarily expose themselves to a risk that should not be underestimated, in some places here in Germany - instead of support - the possible risks of an introduction of the disease to Germany are discussed. There are many diffuse fears here that do not do justice to the difficult situation in dealing with the disease. The affected West African countries are clearly overwhelmed by the situation and urgently need international support. Thousands have already died here and an end to the epidemic is not yet in sight. Even if individual infections of medical assistants in the treatment of Ebola patients can occur in other countries, a spreading of the epidemic, for example to Europe or the USA, remains extremely unlikely.

What is the risk of transmission? The fears among the population of an uncontrollable spread of the Ebola epidemic are often related to the lack of knowledge about the Ebola virus. For example, it is often assumed that the viruses can be transmitted via the air or at least threaten mutations that make such a transmission possible. However, there are no signs of this, reports the AFP news agency, citing the World Health Organization. Anyone who does not come into contact with the body fluids of the infected (directly or indirectly through contaminated objects) has no fear of infection. However, when dealing with the sick, there is the problem that the typical Ebola symptoms include fever as well as diarrhea, nausea and vomiting as well as bleeding from the mucous membranes and body openings. It is therefore difficult to avoid contact with body fluids and medical personnel must wear appropriate protective clothing to protect themselves from infection. Setting up quarantine stations is also essential.

Vaccines against Ebola in trials According to the experts from the Robert Koch Institute (RKI), whether an illness develops after contact with an infected person also depends on how many pathogens have been ingested, according to the AFP. The incubation period also depends on this influencing variable. In most cases, an infection occurs after eight to ten days, but it may take up to three weeks for the first symptoms to appear. In general, it can be said that the viral load and thus the risk of transmission is greatest in the late phase of the disease. The medical options for preventive protection against the epidemic have so far mainly been limited to equipment and hygiene. Vaccination is not yet available, even though initial successes with trial vaccines have already been reported. Here two vaccines were classified by the WHO as "promising" and the first test results should be available by November or December, reports the "AFP". The deployment could possibly start as early as 2015.

Ebola risk for Germany extremely low Overall, the likelihood of a person-to-person transmission of Ebola viruses in Germany remains extremely low, even if significantly more patients would be admitted to German clinics in the coming months. The risk of the disease being brought in by travelers is also considered to be rather unlikely, but the RKI points out here that in the worst case, an infection could very well occur on air travel. The Federal Foreign Office, however, makes it clear that "fleeting public contact with people who are not ill does not transmit Ebola." Neither is "infection when touching money, locally bought food or bathing in the pool" to fear. A transmission of the Ebola virus by mosquitoes is equally excluded. Overall, the spread of the disease 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 when dealing with the sick and dead. In this country, however, there is at most the risk of isolated infections, for example when traveling or when treating Ebola patients in German clinics. (fp)

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