News Brief: First cases of Ebola acquired outside Africa

Two health workers picked up disease while treating patients in Spain and U.S.

Ebola viruses (red) adhere to the surface of a monkey cell (blue) in this scanning electron micrograph.

NIAID/Flickr (CC BY 2.0)

Health workers have become the first two people to become infected with Ebola outside of Africa, official health agencies report.

The first case showed up in Spain. A nurse had been treating a patient. That patient had been flown home after contracting Ebola in Sierra Leone in West Africa. The nurse developed a fever on September 29. She was eventually diagnosed with Ebola and put into isolation. The World Health Organization reported the case on October 9. This United Nations agency is based in Geneva, Switzerland. It has been keeping track of the current Ebola epidemic.

One day before the WHO report, a Liberian man died of Ebola in a hospital in Dallas, Texas. On October 10, a nurse who had treated him reported she had developed a fever overnight. When she told doctors at the hospital where she worked, they tested her and placed her in quarantine. Two days later, the Centers for Disease Control and Prevention, or CDC, confirmed that she has Ebola. This government agency is based in Atlanta, Ga. It is providing guidance about Ebola in the United States.

The Dallas nurse is the first person to become infected with Ebola while living in the United States. The man she had treated had picked up his infection in Liberia. This West African country has experienced almost half of all Ebola cases in 2014. The Liberian man’s symptoms emerged after he arrived in Dallas last month. Only then did he become contagious.

The Dallas nurse had worn protective gear each time she came into contact with her infected patient. So did the healthcare worker who became infected in Spain. CDC officials are now reviewing how to better protect nursing teams from contracting Ebola.

Healthcare workers face a high risk of picking up this disease. As of September 23, the WHO reports, 375 doctors, nurses and other health workers in Africa have picked up Ebola while taking care of patients. Of those, 211 have died.

Ebola can spread only after an individual develops symptoms. These include fever, vomiting, diarrhea and muscle pain. Flu and many other diseases also cause such symptoms. So doctors must do blood tests to confirm Ebola. Only then can they know whether a patient has contracted the rare disease. These tests typically have taken about two days. But a faster technique is becoming more available.

The International Atomic Energy Agency, or IAEA, is based in Vienna, Austria. On October 14, it said it would provide a new Ebola-detection system to Sierra Leone. Ebola has already sickened some 2,950 people there this year. The new virus-detection system can tell doctors within a few hours whether someone has Ebola. Called reverse transcriptase PCR, or RT-PCR, this technique makes huge numbers of exact copies of Ebola genes. When there are more of them present, they can be easier to clearly recognize. The RT-PCR technology uses radioactive materials. They serve as “markers” to help identify whether the target virus is present.

West African nations already have some access to this RT-PCR technology. However, “there is a shortage of the diagnostic kits and other materials needed” to use this technology, the IAEA notes. The affected countries also need backup equipment in case one of their RT-PCR machines breaks down.

As of October 14, this year’s outbreak in Africa has resulted in 8,914 cases of known or suspected Ebola infections, notes Bruce Aylward of the WHO. At least 4,447 of these patients have died. But CDC suspects that the actual number of 2014 cases in Africa may be 2.5 times as high as the official reports.

Especially concerning, Aylward noted in a tweet, “by December 2014” WHO expects to see between 5,000 and 10,000 new Ebola cases emerging each week in the West Africa.

Power Words

Centers for Disease Control and Prevention, or CDC     An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.

Ebola   A family of viruses that cause a deadly disease in people. Most cases occur in Africa and Asia. Its symptoms include headaches, fever, muscle pain and extensive bleeding. The infection spreads from person to person (or animal to some person) through contact with infected body fluids

electron microscope     A microscope with high resolution and magnification that uses electrons rather than light to image an object. Images taken with such a device are known as electron micrographs.

gene   (adj. genetic) A segment of DNA that codes, or holds instructions, for producing a protein. Offspring inherit genes from their parents. Genes influence how an organism looks and behaves.

infection    A disease that can spread from one organism to another.

International Atomic Energy Agency, or IAEA.    Created in 1957, this organization is based in Vienna, Austria. It coordinates global cooperation in peaceful uses of nuclear science and technology.

outbreak   The sudden emergence of disease in a population of people or animals.

polymerase chain reaction(or PCR)  A biochemical process that repeatedly copies a particular sequence of DNA. A related, but somewhat different technique, copies genes expressed by the DNA in a cell. This technique is called reverse transcriptase PCR. Like regular PCR, it copies genetic material so that other techniques can identify aspects of the genes or match them to known genes.

quarantine    A temporary restriction on the movement of people (or animals) that are sick — or suspected of being infected — to a small area. The goal is to prevent a spread of their illness. If the illness is life-threatening and an epidemic is underway, police sometimes may be called in to enforce a government-imposed quarantine.

radioactive    An adjective that describes unstable elements, such as certain forms of uranium and plutonium. Such elements are said to be unstable because their nucleus sheds energy that is carried away by photons and/or and often one or more nuclear particles. This emission of energy is by a process known as radioactive decay.

tweet   Message consisting of no more than 140 characters that is available to people with an online Twitter account.

virus  Tiny infectious particles consisting of RNA or DNA surrounded by protein. Viruses can reproduce only by injecting their genetic material into the cells of living creatures. Although scientists frequently refer to viruses as live or dead, in fact no virus is truly alive. It doesn’t eat like animals do, or make its own food the way plants do. It must hijack the cellular machinery of a living cell in order to survive.

World Health Organization  An agency of the United Nations, established in 1948, to promote health and to control communicable diseases. It is based in Geneva, Switzerland. The United Nations relies on the WHO for providing international leadership on global health matters. This organization also helps shape the research agenda for health issues and sets standards for pollutants and other things that could pose a risk to health. WHO also regularly reviews data to set policies for maintaining health and a healthy environment.