Ebola in the US - Hype or Hazard?

Hype or Hazard

A scientist working at the CDC mobile Ebola lab in Liberia.
A new mobile Ebola lab the CDC recently set up is a big step up from previous equipment being used to fight the Ebola epidemic in West Africa. Photo by John Moore/Getty Images


Ebola or Ebola hemorrhagic fever is caused by direct contact with the blood or body fluids of a person or animal who is infected with the Ebola virus.

Symptoms can include the sudden onset of fever, headache, joint and muscle aches, sore throat, weakness, diarrhea, vomiting, and stomach pain. Other symptoms can include a skin rash, red eyes, and internal and external bleeding.

Ebola is deadly. That's why it worries people.

It is one of the "world's most virulent diseases." Fortunately, Ebola is not overly contagious. Unlike measles, one of the most contagious infections, it is not easy to catch Ebola.

After it was first discovered in 1976, small outbreaks of Ebola have occurred in several countries in Africa, including Uganda, south Sudan, and the Democratic Republic of Congo. In the latest outbreak, Guinea, Liberia, Nigeria, and Sierra Leone have been affected.

That West Africa is seeing the worst Ebola outbreak in history has a lot to do with limited resources and overwhelmed doctors and not just the virus itself.

“Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,” said CDC Director, Dr. Tom Frieden, M.D., M.P.H.

“While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.”

Even after the secondary cases in the United States, the CDC remains "confident that wider spread in the community can be prevented with proper public health measures including ongoing contact tracing, health monitoring among those known to have been in contact with the index patient and immediate isolations if symptoms develop." 

Ebola in the US

A traveler in Dallas, Texas who had recently returned from West Africa is the first imported case of Ebola to be diagnosed in the United States. Tragically, he has died.

An additional case, a health care worker who helped care for the first patient in Dallas, was diagnosed with Ebola. She had extensive direct contact with him and it is thought that this likely represents some kind of a breach in safety protocols, which have since been updated. The new patient was already self-monitoring for symptoms and is doing well. She only had one additional contact while she had symptoms and he was under observation. This nurse, Nina Pham, is now clear of Ebola and has been released from the hospital.

A second health care worker at Texas Presbyterian Hospital has also tested positive for Ebola after developing a low-grade fever and was to be transferred to a specialty hospital in Atlanta. She had traveled on a flight from Cleveland to Dallas on Frontier Airlines the night before developing symptoms, which lead the CDC to "begin interviewing passengers about the flight, answering their questions, and arranging follow-up." Since you are not contagious before you have Ebola symptoms (and she did not on the flight) and other passengers likely would not have any direct contact with any of her bodily fluids, the people in Cleveland and passengers on this flight or any subsequent flights should not be at any real risk for developing Ebola.

She is also doing well and was released from the hospital.

No one else in Dallas or Ohio developed Ebola and the monitoring period has now passed for all of those contacts.

Two Americans who developed Ebola were health care workers in Liberia. They were transferred to a hospital in Atlanta for further treatment and both survived.

An NBC cameraman who may have contracted Ebola in Liberia while washing a contaminated car was being treated in Omaha, Nebraska. He is now free of the Ebola virus and has been released from the hospital. The rest of the news team (who were considered at low risk for infection and are symptom-free), including Dr. Nancy Snyderman, were under mandatory quarantine because they broke an agreement to isolate themselves from others.

Their quarantine is now over and none of them ever developed symptoms of Ebola.

A doctor returning from Guinea, where he had been treating Ebola patients with Doctors Without Borders, was diagnosed with Ebola in New York City. He was in isolation at Bellevue Hospital Center after developing a low-grade fever. His fiance and two friends were also in isolation, although they had no symptoms. No one else in New York City is thought to be at risk. Dr. Craig Spencer was discharged from the hospital after being treated for 19 days.

Dr. Martin Salia was diagnosed with Ebola while treating patients in Sierra Leone. He died at the University of Nebraska Medical Center in November.

After more than three months with no one with Ebola in the United States, an infected American healthcare worker in Sierra Leone has been flown to a high-level NIH containment facility in Maryland. Ten other Americans without symptoms, but who had contact with him, are also returning to the United States to be quarantined near Ebola treatment centers.

How do you Catch Ebola?

According to the CDC, Ebola is spread through:

  • the direct contact with the blood or body fluids of a person who has Ebola, such as their urine, saliva, feces, vomit, and semen, etc.
  • the direct contact with an object that has been contaminated with the Ebola virus, such as a contaminated needle and syringe
  • the direct contact with an animal (fruit bat, monkey, or forest antelope, etc.) that is infected with Ebola (which is how most outbreaks likely start)

The people most likely to get sick are those who are caring for a sick person with Ebola and those who prepare their body for burial if they die.

Can you catch Ebola if someone with Ebola coughs or sneezes near you?

That seems to be the biggest worry that people have, especially as we have gotten used to the idea of covering our coughs and sneezes to keep from spreading germs. Fortunately, Ebola is nowhere near as contagious as many other infections, such as measles or the flu.

In addition to the fact that coughing and sneezing aren't even typical Ebola symptoms, Ebola is not spread by respiratory aerosols.

Even when in an isolation ward with a patient sick with Ebola, one study found that "other than in samples grossly contaminated with blood... environmental contamination did not occur."

Unfortunately, health care workers do sometimes get infected. According to the CDC, "Care for a patient with Ebola requires meticulous attention to detail.." The CDC has made "immediate improvements in processes and procedures reduce risk to health care personnel."

In addition to the two health care workers in Dallas, a nurse in Spain became infected with Ebola while caring for two missionaries, as did 16 members of the Doctors Without Borders aid  organization who provide direct patient care in West Africa.

Are your Kids at Risk from Ebola?

Your kids are almost certainly not at risk for Ebola unless you are planning a trip to West Africa in the near future.

It is important to keep in mind that the US Ebola patient did not contract Ebola in the United States. He got Ebola in West Africa, traveled to the US while still healthy, and then later developed symptoms of Ebola.

Parents should also have confidence that the CDC knows "how to stop Ebola’s further spread: through case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola."

School Closings and Ebola Panic

School closings in the face of an outbreak are nothing new, although they typically have more to do with fear rather than keeping kids safe and healthy. For example, many schools closed during the H1N1 pandemic, even though the CDC said that most schools should stay open unless they have so many sick children and staff that it interferes with school functioning.

And now we are seeing schools in Ohio and Texas close because of Ebola. Not because a student or staff member has Ebola or because they were advised by the CDC or a state health official to close, but instead despite that advice.

In an "abundance of caution," these schools, against medical advice, are closing so that they can be cleaned, including:

  • Davis Elementary and Ruth Cherry Intermediate School in Royse City ISD (Texas) because a parent whose kids goes to these schools was a health care worker that cared for one of the nurses with Ebola in Dallas. The parent has no symptoms and is even keeping their kids home while in isolation.
  • Solon Middle School and Parkside Elementary School in Solon, Ohio because a "staff member traveled home from Dallas on Frontier Airlines Tuesday on a different flight, but perhaps the same aircraft, as the Texas nurse with Ebola"
  • Horizon Science Academy in Lorain, Ohio evacuated students and sent them home when they learned that a staff member flew on the same plane, but at a different time, as the nurse from Dallas who later developed Ebola.
  • North Belton Middle School, Sparta Elementary & Belton Early Childhood School in Belton ISD (Texas) because two students were on the flight from Ohio to Dallas with the Dallas nurse who developed Ebola.

In addition to school closing, it has been reported that Ebola panic and fear has led to other incidents, including that:

  • a teacher Strong Elementary School in Strong, Maine was placed on leave for 21 days because she attended an educational conference in Dallas, even though she had no contact with anyone that had Ebola. The action was "spurred by fear among parents of possible exposure to the Ebola virus during her travel."
  • in Phenix City, Alabama, a Central High School employee is on 21-day paid leave because they were on a flight the day after a nurse flew to Dallas, but using the same plane, even though they have no risk of developing Ebola.
  • two students at Howard Yocum Elementary School in Maple Shade, New Jersey were made to stay home for 21 days because they are from Rwanda, a country in central and east Africa that has not had any cases of Ebola and is currently screening US travelers to keep Ebola out of their country.
  • Universities are canceling speakers from Africa, including a three-time Pulitzer Prize winning photojournalist who had returned from Liberia, even though he was past his self-monitoring period.
  • an "enormous crowd of parents" in Hazlehurst, Mississippi pulled their kids out of school because their principal had recently visited Zambia (for his brother's funeral), a country in south Africa that is far from the Ebola outbreaks in west Africa.
  • a school bus driver in Poplarville, Mississippi, who recently visited Ghana, a country in West Africa, has not been allowed to return to work, even though there haven't been any Ebola cases in Ghana.
  • some parents in Pewaukee, Wisconsin, are keeping their kids at home because the school recently hosted a priest and a teacher from Uganda, a country in east Africa.
  • Morocco has refused to host the African Nations Cup, a 16-team soccer tournament that was to be held in January 2015, over Ebola fears.
  • Canada and Australia, like some other less developed nations and against WHO guidelines, have stopped issuing travel visas to people living in Guinea, Liberia, and Sierra Leone.
  • a teacher at St. Margaret Mary Catholic School in Louisville, Kentucky was asked to take a 21-day 'precautionary' leave of absence after she returned from a medical mission trip in Kenya, a country in eastern Africa where there have been no cases of Ebola. The teacher, a registered nurse, instead quit.

It is important to note that these decisions are based on fear and not caution. The children and teachers in these schools were not at risk for Ebola.

We should applaud those school districts who did not give in to fear, including Garland ISD and Rockwall ISD in Texas. According to the Dallas County Medical Society, "Keeping all schools open, including schools that have children of parents who are being monitored, presents no risk to students or teachers and sends an important message of allaying fears in the community."

What about cleaning the schools? The Dallas County Medical Society also states that "There is no evidence to support “deep cleaning” or similar actions for schools or school buses related to the current Ebola situation. Such measures also would send the wrong message about the risk of contracting the disease."

Ebola Conspiracy Theories

It is unfortunate and very unhelpful that the usual suspects have already created a long list of Ebola conspiracy theories that only help contribute to the fear and confusion surrounding this deadly infection. These conspiracy theories include that:

  • the Ebola outbreaks are a plot by the CDC to distract people from a link between vaccines and autism
  • the Ebola outbreaks are fake and just another way for the government to push another vaccine on everyone.
  • the Ebola virus is a genetically modified organism (GMO) created by the government and may have been let loose during a UN immunization campaign
  • Ebola has been introduced as a plot to control the world's population

Since many of these crazy theories are being pushed by anti-vaccine folks, it shouldn't be surprising that they mirror many anti-vaccine conspiracy theories that we have been hearing for years.

The political conspiracy theories surrounding Ebola are even worse.

While it might seem simple to dismiss these crazy ideas, that they could make people more afraid of Ebola and could lead people to distrust the very people who are working to control the Ebola outbreaks, makes the theories and those who push them dangerous.

Ebola Hype

People are scared enough about Ebola.

Hyping the disease even more by saying that it has become airborne (it hasn't), that the CDC doesn't know what they are doing (they do, despite some missteps, Ebola is being contained in the United States), or going out of their way to scare people on the news isn't helping anyone.

One media host went out of his way to say "I wasn't worried until all you guys kept saying, don't worry."

Another had to be reassured by an infectious disease expert that the "community aspect of this Ebola response has been done by the book."

Some websites are even worse. One site tried to push the idea that the Ebola really has a 42-day incubation and not the 21 days that everyone has been learning. Why 42 days? Because they read about that number on the WHO website where they talk about how they decide if an outbreak is over - "The maximum incubation period for Ebola virus disease is 21 days. The 42-day period set by WHO (twice the maximum incubation period) provides a margin of security to cover any possible missed cases, uncertainty in reporting dates or hidden chains of transmission." The Ebola incubation period is still 21 days.

Ebola is certainly something to take very seriously, but as CDC Director Dr. Tom Frieden recently stated, "...Ebola is hard to fight, but we know how to fight it and how to beat it. The situation changes every day. We're always going to be open with what we know, share more rather than less. We're going to put in extra measures of safety to protect Americans."

What You Need To Know

You are not at any big risk to get Ebola in the United States.

  • You can not get Ebola from contaminated water or food or through the air.
  • There is no treatment or cure for Ebola virus infections, although limited supplies of an experimental treatment are being used for some patients.
  • The incubation period for Ebola ranges from 2 to 21 days.
  • Unlike measles and the flu, people with Ebola are not contagious until they develop symptoms.
  • Banning travel to West Africa, while advocated by some, is not recommended by most health experts, as it is thought that it wouldn't be effective and would likely limit the ability to send help to the area and stop the Ebola outbreaks there. Tom Frieden, MD, the CDC director also states that a travel ban would "increase people's distrust of government, making them less likely to cooperate to help stop the spread of Ebola," it could "drive patients with Ebola underground," and "it could even cause these countries to stop working with the international community as they refuse to report cases because they fear the consequences of a border closing."
  • Emerging infections, like Ebola, are a great reminder for why our local and state health departments and the CDC need to be well-funded and ready to respond to any threat. They also shouldn't have to be bogged down in trying to contain outbreaks of vaccine-preventable diseases, like measles, because of intentionally unvaccinated kids.

Most importantly, be sure to mention your recent travel history if you get sick after a trip, especially if you had been out of the country.

We should also remember that "Controlling Ebola at its source – in West Africa – is how we will win this battle."


Bausch, Daniel. Assessment of the Risk of Ebola Virus Transmission from Bodily Fluids and Fomites. J Infect Dis. (2007) 196 (Supplement 2): S142-S147.

CDC. Ebola Transmission. Accessed October 2014.

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