Can I catch Ebola traveling on the bus?

Questions and answers about the virus that has infected a nursing assistant in Madrid

The ebola virus.
The ebola virus.

Can I get Ebola on the bus?

The Ebola virus is not transmitted through the air, or through water, or normally through food. Direct contact with bodily secretions of a patient who is showing symptoms is necessary to become infected, Madrid regional health chief Antonio Alemany emphasized on Monday evening, whether it is their blood, urine, saliva, semen or feces. The nursing assistant who became infected with the virus in Madrid was on vacation from September 27 – the day after the death of the Spanish missionary who was infected with the virus in Sierra Leone whom she treated – until she was admitted to hospital in the Madrid suburb of Alcorcón on Monday, during which time she was in close contact with her husband. However, during this period she displayed no signs of high fever – over 38.6ºC – a symptom that is considered necessary for infection to take place. “While there are no symptoms you have to remember that the disease is not contagious,” Alemany stated. Spanish Health Minister Ana Mato on Monday sought to convey a “message of calm to all citizens.” Regarding the dangers of air travel with Ebola sufferers, the World Health Organization (WHO) says that “while travellers should always be vigilant with regard to their health and those around them, the risk of infection […] is very low.”

Will there be more cases in Spain?

Alemany has announced that teams of epidemiologists are now examining any possible close contact that the nursing assistant and her husband may have had with others. The authorities have already got in touch with the health professionals who initially treated her at Alcorcón hospital. Normal protocol is to find possible cases and isolate them. “We have no news about any other case,” Alemany said on Monday.

Why is there an outbreak in Africa and not here?

Authorities consider it highly unlikely that an outbreak could occur in a country with good healthcare infrastructure. In Africa the problem is often poverty and a lack of medical resources. In Liberia there is just one doctor for every 100,000 inhabitants, compared with one for every 370 inhabitants in Spain. In some parts of West Africa health workers are treating Ebola patients in conditions that lack even running water. In Guinea, where the current outbreak originated, the majority of infections are related to tradition burial procedures, in which relatives remain in close contact with the bodies.

Was it a mistake to bring the two infected Spanish missionaries back from Africa?

In a statement published on August 8 the WHO said: “States should be prepared to facilitate the evacuation and repatriation of nationals (e.g. health workers) who have been exposed to Ebola.” Both Manuel García Viejo, the 69-year-old priest who was infected in Sierra Leona, and Miguel Pajares, the other missionary who was infected in Liberia, were moved and admitted to the Carlos III hospital in Madrid, which is theoretically prepared to receive this type of patient. Nevertheless, staff have complained that the protective suits given to health workers did not comply with regulations, something the hospital itself denies.

What are the symptoms of the disease?

The symptoms normally appear eight to 10 days after coming into contact with the virus, though they could arrive any time between two and 21 days later. The most common signs are fever of over 38.6ºC, a strong headache, muscle pains, diarrhea, vomiting, stomach pains and hemorrhaging with no apparent cause.

And if I get bitten by a mosquito?

There is no scientific evidence to suggest that mosquitoes can transmit Ebola. For now, some wild animals, such as monkeys, apes and bats have been shown to spread the virus.

Is there a cure for Ebola?

No. A historical lack of financing has delayed the development of an effective treatment for the virus. They are various vaccines and experimental treatments that look promising, such as ZMapp, produced by US firm Mapp Biopharmaceutical. But the company itself admits that supplies of the drug – a cocktail of proteins produced by genetically modified tobacco plants that unite with the virus in such a way that the immune systems of monkeys are able to identify and eliminate it – have been exhausted. There are also doubts about its effectiveness. “Does ZMapp work? We don’t know,” the company says on its webpage. “Larger trials are necessary to determine whether ZMapp is safe and effective.”

So how do doctors treat patients?

As the WHO explains, Ebola patients in a serious condition are usually dehydrated and require intravenous drips or oral re-hydration. It is less about attacking the root of the disease, but rather moderating its symptoms. “Some patients will recover with adequate medical care,” the WHO explains. In the case of the nursing assistant infected in Madrid, the management of the Carlos III hospital explained to staff on Tuesday morning that she was being treated using “serum [containing antibodies] from missionaries who survived the disease,” according to labor union sources. This experimental treatment consists of using the defenses generated in the blood of cured patients to bolster the sick person’s immune system.

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