Ebola virus: What you need to know to protect yourself

A Toronto doctor who specializes in the treatment of tropical diseases says it's unlikely a recent outbreak of the deadly Ebola virus in West Africa could spread to North America. Dr. Jay Keystone, in an interview with CBC, gives travellers tips on how to protect themselves.

Case identification and control methods lacking in Africa, Dr. Jay Keystone tells CBC

A woman puts on a protective mask to protect against SARS at a wash station at the entrance to North York General Hospital in Toronto in May 2003. (Kevin Frayer/The Canadian Press)

A Toronto doctor who specializes in the treatment of tropical diseases says it's unlikely a recent outbreak of the deadly Ebola virus in West Africa could spread to North America.

Dr. Jay Keystone, who works in the tropical diseases unit of Toronto General Hospital, was interviewed on CBC Radio's Metro Morning in July.

Dr. Jay Keystone said the recent Ebola outbreak in West Africa highlights the importance of identifying cases and isolating those infected, practices that are often lacking in the countries affected. (David MacIntosh/CBC)

He said the SARS outbreak in 2003 that killed more than 40 people in Toronto helped improve how we identify, treat and contain infectious diseases. He said such measures are lacking in countries affected by the current Ebola outbreak: Guinea, Liberia and Sierra Leone

The fast-acting Ebola virus, which first appeared in 1976, produces a violent hemorrhagic fever that leads to internal and external bleeding. The infection is transmitted by direct contact with blood, bodily fluids, and tissues of infected people or animals.

Though there is no vaccine and no specific treatment for Ebola, Keystone said there are a number of measures travellers to the region can take to protect themselves.

Here's what Keystone told Metro Morning guest host David Common:

How does a person contract Ebola?

"They usually acquire it from close contact with blood and body fluids, and that means someone coughs in your face, you handle a body or you look after someone and don't have ideal infection-control methods. You get the virus on your hands, you touch your nose, your mouth."

What symptoms do Ebola patients show?

"It looks like the flu: fever, headache, sore throat, muscle aches and pains. That's in the first few days. And then vomiting, diarrhea and the really serious part of the illness — that is the hemorrhage part — really doesn't occur until toward the end of the first week."

Once a patient is hemorrhaging, can he or she be saved?

"It all depends on the quality of medical care. Most Ebola outbreaks have occurred in villages, in mission hospitals where essentially they have a very poor level of health care and very poor infection control methods. The mortality rate in this outbreak ... is about 60 per cent. So you can survive. The better the care, more likely you are to survive but there's no antibiotic or anti-viral agent to treat this disease."

Why has this outbreak been so bad?

"First, there's a lot of cross-border travel. Whereas most other outbreaks have been isolated in the middle of virtually nowhere. Also, people in these countries don't trust the government. They don't believe in the infection. They hide their cases. If someone dies, they take [the body] home. And unfortunately the funeral procedures where you touch the body, and handle the body, markedly increases your risk. These cases are now more in central areas, cities rather than tiny villages. All of those reasons I think have compounded to make this a much greater outbreak."

Doctors treating patients in Africa have died. Foreign doctors have been infected. Should we be worried about Ebola making its way to Canada?

"I don't think we need to be worried. Health-care providers, paramedics, the people who deal with the situation first-hand, I think we're the ones who have greatest risk. You have to remember since 1976 when this virus was first described, there are less than a handful of cases of [patients] who've gone to North American or European countries and very rarely is there secondary transmission. And that's because we have much better public health, infrastructure and certainly better methods of isolating [patients]. SARS was a perfect wake-up call and Ebola is following that ... our health-care system improved dramatically after SARS."

What do doctors in West Africa need to do to control the outbreak now?

"Mostly it's case finding. And that's the biggest problem. Someone comes in ill, they go back to their village and other people are infected but no one knows about it. The problem is they don't have enough personnel to follow up carefully and also people are hiding cases. It's all about case finding, surveillance, making the diagnosis, isolating the individuals and using appropriate isolation procedures. That will help, but it's going to take a long time given what's going on there.

What should people travelling to West Africa know and do to protect themselves?

"The most important thing is to try and stay away from people who are ill. You won't get Ebola unless the individual you're in contact with is sick. So if someone is well, you're not going to get it. So you just need to have a heightened awareness that this is going on and wash your hands frequently, certainly before meals. [Ebola is spread through] direct contact, it's not someone walking into a room with someone with Ebola and getting the infection. Ebola generally is not aerosolized, meaning it doesn't go well into the air."