WATCH: Officials are reassuring people the chance of a man, hospitalized in Toronto, testing positive for Ebola are slim. But, even if he has the virus, officials there is protocol in place to prevent it from spreading. Jennifer Tryon reports.
TORONTO – U.S. health officials have meticulously retraced the steps of North America’s first Ebola patient, hoping to track down anyone who came in contact with the man after he fell ill.
This week, the Centers for Disease Control and Prevention said that a patient is in isolation in a Texas hospital after he tested positive for the deadly disease.
Four of the patient’s close family members have been ordered to stay home, and armed enforcement officials are even posted outside to make sure of it. Health authorities are also reaching out to about 100 people to determine if they had contact with the Ebola patient now in isolation.
While the medical community is working hard to remind the public that it has safety measures in place to prevent an outbreak, there is concern about how the case made its way into North America and if more cases could be reported.
Here’s what you need to know about Ebola and how it spreads.
You might not feel symptoms right away
On Sept. 20, the patient arrived in Dallas from Liberia. He didn’t report any symptoms and that’s normal.
Symptoms can take from two to 21 days to show up after exposure, but Dr. Joel Kettner said that it’s typically between six to 10 days. That’s a window of about a week to two weeks. Kettner is medical director of Winnipeg’s International Centre for Infectious Diseases. He was Manitoba’s chief medical officer of health from 1999 to 2012.
The symptoms include fever, headache, diarrhea, vomiting, and muscle pain. In its later stages, unexplained bleeding could occur, too.
By Sept. 24, the patient went to hospital reporting illness but he was sent home with antibiotics.
He’s been identified by U.S. outlets as Monrovia native, Thomas Eric Duncan. The Associated Press also reports that he’ll be prosecuted by Liberian officials for lying on his airport screening questionnaire.
On the form, he answered ‘no’ when asked whether he had cared for an Ebola patient or touched the body of someone who had died in an area affected by Ebola. Days before he left Liberia, Duncan had helped carry to a taxi a pregnant woman who later died of Ebola, according to neighbours. Her illness at the time was believed to be pregnancy-related.
At the time Duncan left for the U.S., it’s not clear if he knew of the woman’s diagnosis.
WATCH: Centers for Disease Control and Prevention Director Dr. Tom Frieden says the chances of the Ebola virus spreading are low
You’re only contagious once symptoms kick in
Ebola can only be spread to others after symptoms begin.
“You can’t share it with anybody. It happens only when it comes out through bodily fluids,” according to Jason Tetro, a Canadian microbiologist and author.
Ebola grows within your cells, multiplying until you build up a high level of the virus. That’s why it takes time to appear in the bodily fluids.
READ MORE: Canada prepping for potential Ebola cases
“Even though the virus is growing within the body, during that incubation period there isn’t sufficient amount of virus to transmit disease to others until the illness is apparent,” Kettner explained.
“It’s quite a fortunate feature of the disease – you can imagine if people are infectious without having symptoms how much more difficult this would be to contain the spread,” he said.
This is why the CDC isn’t worried about his fellow passengers on the plane – it’s saying there is no need to monitor anyone else on the flight and didn’t reveal flight information.
Instead, 12 to 18 people – including three ambulance staff who looked after him – are going to be watched closely every day for the next three weeks – the longest incubation period for the disease.
(Andrew Miller/Global News)
The virus is passed on via bodily fluids
Once your symptoms kick in – the fever, the nausea and stomach pain, for example – you’re contagious.
“Bodily fluids” refers to blood, vomit, feces, urine, spit, sweat, semen and even tears.
Some bodily fluids have higher counts of the disease than others. Doctors say that the disease is hard to transmit because you have to be in “very close contact” with an infected person and his or her fluids. It’s not airborne like, say, the seasonal flu or the chicken pox, which are both highly contagious.
It’s not as simple as touching a door knob with a sick patient’s germs, Kettner said.
“Just getting it on one’s skin is not necessarily a danger as long as you can wash your hands and get it off your skin,” he said.
If you have a break in the skin – a cut, scratch or blister – the virus can get into your bloodstream by getting through the barrier the skin provides. It can also enter through the lining of the eye, nasal passages or the mouth – it’s here that the virus can get absorbed easier than through the skin.
It can also be transmitted via sexual contact, objects (such as needles) contaminated with the virus or through the blood or fluids of infected animals and their meat.
“It’s not spread casually. You won’t get it from the cashier when buying groceries or when you’re in the same room as somebody who is sick. You need direct contact and that means direct contact with someone’s fluids that contain the virus,” he said.
How the CDC is handling its first case
For starters, the patient is in isolation at the Texas Health Presbyterian Hospital. His close family is being forced to stay home – groceries are being delivered to their home and it will be professionally cleaned because officials suggest that the “house conditions need to improve.”
The blankets and bed sheets the patient slept in will also be collected. Ebola dried on surfaces can surive for hours – again, it’s not a risk to handle soiled clothing or bed sheets, but if you’re not wearing gloves, then touching your nose, eyes or mouth, there is a risk of infection.
When the patient was initially screened, a nurse concluded he had a common virus and discharged him even though he said he had travelled to West Africa. That hint about his travel history wasn’t widely shared with the hospital staff, U.S. reports say.
It was a missed opportunity to put him into isolation – instead he went back to the ER days later when his condition worsened.
“They sent him home with antibiotics, he showed up on again on a stretcher in an ambulance. That’s not how it’s supposed to work,” Tetro said.
The CDC sent a team to the airport in the Liberian capital, Monrovia, on Wednesday to make sure health officials there are screening passengers properly. All people travelling from the outbreak zone are supposed to be checked for fever and asked about their travel history before being allowed to leave. Plastic buckets filled with chlorinated water for hand-washing are present throughout the airport.
“There were no signs of any disease when the gentleman boarded the flight,” said Dr. Tom Kenyon, director of the CDC’s Center for Global Health. “This was not a failure of the screening process at the airport.”
Here’s how Canada is trying to stifle spread
Both Kettner and Tetro say Canada doesn’t need to ramp up its security against the disease. Based on how the country’s already handled its suspected cases, Canada’s health care system is taking the threat of a potential case seriously.
“There’s absolutely no reason to worry or to panic,” Tetro told Global News.
“The fear we’re going to be submerged in a worldwide Ebola outbreak is an unbased fear that’s unlikely. There isn’t evidence this is spreading beyond in a way that should worry people living thousands of miles away,” Kettner said.
During an outbreak such as this one, there are special communications to and heightened awareness among health care providers.
Patients are now screened for a fever, cough or trouble breathing. They’re asked a critical, telling question: have they recently returned from another country?
The communication lines — between hospitals to provincial ministries, between provinces and Ottawa, and between agencies and the media to the public — are opened.
Quarantine officers are at all of Canada’s international airports — Vancouver, Calgary, Toronto and Montreal, for example — and they work around the clock, seven days a week, according to the Public Health Agency of Canada.
And then there’s the Quarantine Act, which would help in detection and management of sick travellers. It requires travellers to report to CBSA agents if they’re ill upon arrival. Airlines and flight attendants are also required to report sick passengers coming off of international flights.
– With files from the Associated Press