No one yet knows exactly how the Ebola virus crept into nurse Nina Pham’s body, past standard protective gear and despite her training, as she cared for Thomas Eric Duncan.
She was part of Duncan’s medical team from the day he arrived at Texas Health Presbyterian Hospital Dallas, Sept. 28, until he died there Oct. 8. Pham’s name appears often throughout the hundreds of pages of medical records provided to The Associated Press by Duncan’s family.
The fact that a trained nurse wearing protective gloves, mask and gown could become infected raises questions about contagion.
While the U.S. Centers for Disease Control and Prevention has said repeatedly that the virus itself is not airborne, an Ebola question and answer page on the agency’s website says it’s possible for Ebola to be spread by a sneeze or a cough.
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But Darrin D’Agostino, medicine department chairman at the University of North Texas Health Science Center in Fort Worth, said workers caring for an extremely ill patient would be at most risk for that kind of transmission. He said it is less of a concern for friends and family members in contact with the patient in the early stages of the illness.
“It has to be large enough of a viral load,” D’Agostino said. “A person has to have a significant illness, and usually those people are hospitalized by that point. From the public’s point of view, the chances of getting it this way are still very small. You’re more likely to get it from vomit or diarrhea not being cleaned up properly than somebody sneezing.”
Another portion of the CDC website says a “low risk” for Ebola can result from household contact or other close contact defined as being “within approximately 3 feet (1 meter) of an EVD [Ebola Virus Disease] patient or within the patient’s room or care area for a prolonged period of time (e.g., healthcare personnel, household members) while not wearing recommended personal protective equipment.”
The same page goes on to say that close contact includes “having direct brief contact (e.g., shaking hands) with an EVD patient while not wearing recommended personal protective equipment.” It adds that “brief interactions, such as walking by a person or moving through a hospital, do not constitute close contact.”
Officials at the CDC did not respond to questions submitted by email Tuesday seeking clarification.
But D’Agostino said a good rule of thumb is that if you haven’t been to West Africa in the past 21 days, and haven’t been in contact with such a traveler during that period, you are at essentially no risk for exposure to Ebola.
He said Ebola tends to attack its victims quickly — often causing death in less than two weeks and leaving little time for the victim to spread the disease.
“Ebola … the chances are the number of people you’re going to spread it to is about two,” D’Agostino said. “With meningitis, the number is more like 18, and HIV is also in the teens.”
Flu much more likely
So in the coming weeks and months, if you begin to feel icky, you’ve more likely come down with something much more common, like the flu, he said.
“The flu kills far more people in the U.S. every year than Ebola,” he said, and flu season is right around the corner.
There are several differences in transmission, D’Agostino said. Influenza lives in small particles that float in the air for several seconds after a sneeze or a cough. Those particles can land on doorknobs and other surfaces, where they have the potential to infect the next person who comes in.
And the flu can more easily be spread at its earliest stages, before a person carrying the disease displays many symptoms.
Doctors recommend that North Texans use a household cleaner with bleach, as well as an alcohol-based sanitizer, while out and about.
This report includes material from The Associated Press.