On another post, a reader replied to someone concerned about transmission of Ebola virus through the air:
Do you have the same concern when caring for patients with Hepatitis C or HIV? Do you fear that they will suddenly change to airborne (aerosolized) transmission? If you don't, what makes Ebola so special? Please, don't let fear affect your logical/critical thinking.
First of all, there is a difference between 'airborne' and 'aerosolized' transmission.
Airborne transmission occurs when bacteria or viruses travel on air currents over considerable distances. These droplets are loaded with infectious particles.
Infections that can spread by airborne transmission:
Anthrax, Chickenpox, Influenza, Smallpox, Measles, etc.
Aerosol (or droplet) transmission occurs when contagious droplets produced by the infected host are propelled a short distance and come into contact with another person's conjunctiva, mouth or nasal mucosa, or are inhaled. These droplets travel 3 to 6 feet. They can remain suspended in the air for up to 90 minutes.
Aerosols (droplets) are produced by things like coughing, sneezing, projectile vomiting, flushing a toilet containing diarrhea, or aerosol-generating medical procedures like intubation, cardiopulmonary resuscitation, bronchoscopy, open suctioning of respiratory tract (including trach care), and nebulizer therapy.
There IS as risk of aerosol transmission of Ebola. And because Ebola is such a deadly disease that has no treatment or cure, healthcare workers MUST protect themselves from potential aerosol transmission. Think about it -- you're working in a closed isolation room with a patient who may be producing aerosols. It's a concentrated environment.
And there is still controversy surrounding how Ebola is transmitted, no matter how sure POTUS and the CDC seem to be. Because of that,
"Personal protective equipment guidelines should not be based on presumed mode of transmission alone, but also on uncertainty around transmission, on the severity of the disease, on health worker factors, and on available treatments or preventions."
The CDC website says this about Ebola:
There are a small number of BSL-4 (Biosafety Level 4, the highest) labs in the United States and around the world. The microbes in a BSL-4 lab are dangerous and exotic, posing a high risk of aerosol-transmitted infections. Infections caused by these microbes are frequently fatal and without treatment or vaccines. Two examples of microbes worked with in a BSL-4 laboratory include Ebola and Marburg viruses.
In speaking about Ebola transmission, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota said this:
"Some scientists are urging health officials to acknowledge what they don't know. At a meeting on Ebola Tuesday, one infectious disease researcher told an audience at Johns Hopkins University in Baltimore that scientists should get comfortable with uncertainty and be honest with the public about gaps in knowledge about Ebola.
"We're making this up as we go. We have to be mindful that we're making it up. One of the worst enemies we can have today is dogma."
http://www.usatoday.com/story/news/nation/2014/10/15/nurses-protest-ebola/17302987/
Ebola is capable of infecting a wide variety of cells:
"Some pathogens are limited in the cell type and location they infect. Influenza, for example, is generally restricted to respiratory epithelial cells, which explains why flu is primarily a respiratory infection and is most likely aerosol transmissible. HIV infects T-helper cells in the lymphoid tissues and is primarily a bloodborne pathogen with low probability for transmission via aerosols.
Ebola virus, on the other hand, is a broader-acting and more non-specific pathogen that can impede the proper functioning of macrophages and dendritic cells--immune response cells located throughout the epithelium. Epithelial tissues are found throughout the body, including in the respiratory tract. Ebola prevents these cells from carrying out their antiviral functions but does not interfere with the initial inflammatory response, which attracts additional cells to the infection site. The latter contribute to further dissemination of the virus and similar adverse consequences far beyond the initial infection site.
The potential for transmission via inhalation of aerosols, therefore, cannot be ruled out..."
http://www.cidrap.umn.edu/news-perspective/2014/09/commentary-health-workers-need-optimal-respiratory-protection-ebola
"University of Minnesota CIDRAP scientists are now warning both health care providers and the general public that surgical facemasks will not prevent the transmission of Ebola. According to the airborne Ebola report, medical workers must immediately be given full-hooded protective gear and powered air-purifying respirators."
http://www.dailykos.com/story/2014/10/16/1336994/-Ebola-Is-Already-Airborne-Say-Two-Professors
Ebola isn't a disease to take chances with. It's very unforgiving virus that kills 70% of those it infects. There is no vaccine, and there is no cure. There are still unknowns about Ebola. Healthcare workers need to wear respiratory protection no matter how small the possibility of aerosol transmission may be, as long as that possibility exists. Why take a chance?
