Ebola and Me

[aggienaut]

Yesterday - I froze and stared at the bloody tissue. People get bloody noses all the time right? _I_ don't get bloody noses, I can't remember ever having had a bloody nose before, but it's normal. But the doctor had called just the day before to confirm that I didn't have it -- "ebola." When I calmed down, naturally, I thought to myself "it's probably about time I blogged about ebola."

   I'm not a worrier. In fact I am probably more on the side of more cavalier than I should be about potential risks. When I went to Guinea the outbreak was already making headlines, people asked me "are you sure you want to go there, with the outbreak?" but I did some quick math. There were, I believe at the time, about 300 cases of ebola, and Guinea has a population of ten million. The odds of me being the 301st person out of ten million? Not high. And then I got sick.

   Ebola, in case you don't know, begins with the same symptoms as the common flu. Then you die by bleeding out of your eyes. There's no vaccine, there's no cure, and it kills 60-90% of the people who come down with it.

   So the initial symptoms are soreness muscles, a sore throat, coughing. Conakry, the capitol of Guinea, is ground zero for the worst ebola outbreak of history, and I was in Conakry, and came down with sore muscles, a sore throat, coughing.
   I'm not a worrier, I wasn't concerned at first. But in the month since then I would say its been one of the biggest emotional burdens of my life.


Relative strangers eat with their hands from communal bowls in Conakry while breaking fast in the evening during Ramadan

Being Patient Zero
   Aside from the relatively low odds of getting it, purely statistically speaking, when I was still in Guinea none of the ancillary ethical quandaries had appeared yet. If I came down with ebola, I would be death number 653 or whatever the count was presently at, end of story. It was only when I wasn't in Guinea any more that I became haunted by the question "what if I'm infecting everyone??"
   A friend suggested I get checked out before I left Guinea, and I brushed off the suggestion. It sounded like a good way to wind up in an incompetent third world quarantine, mess up all my travel plans, and increase my odds of actually getting it. It did seem plausible they wouldn't let me leave the country though, they shouldn't let me leave the country. I figured if they stopped me at the airport, fair's fair and they can check me out then if they want ... but I was still going to do my best not to look sick in the airport.
   And then they just... let me leave. No medical check on departing the epicenter of the ebola outbreak while exhibiting the ebola symptoms. I'm very glad they let me leave, but, frankly, I don't think they should have let me.
   As I sniffled and coughed and blew my nose on the flight to Paris, and then Frankfurt, and then Goteborg, I started to feel the first hauntings of "what IF I do have it?" To my knowledge I didn't come into contact with anyone sick, but we all ate out of communal bowls in the village, and at the hotel in Mamou where I didn't know anyone... what if I was spreading ebola across Europe??

   I purposefully didn't mention "the E word" while on the ship in Goteborg. No need to get people unnecessarily freaked out. Then my sickness started to clear up and I worried about it less, though it was always there, in the back of my mind.



Relapse
   Ebola has a 4-21 day incubation period, during which the infected person will not exhibit any symptoms. I was still well within that when I returned to the States. Suddenly, the day after I returned, my health suddenly rapidly deteriorated. I was trying to pack to go sailing for ten days on the brig Pilgrim, but all I wanted to do was lie down, and I had a headache. I don't get headaches. As I lay on the couch feeling miserable I listened to a newscast mentioning that all 300 peace corps volunteers in Guinea and neighboring countries had been evacuated. That's big, they don't do that often. I thought of the PC volunteer I had talked to, and the other one, who had taught my people beekeeping "but then he died." The newscast reminded me of the 21 day incubation period, during which there are no symptoms, and then suddenly it hits.
   I'm not a worrier, but I think after having it in the back of my mind for nearly a month already it was wearing me down, and my very rapid breakdown in health and unusual headache, I was suddenly veritably terrified. And worst of all, if I had ebola I had probably already given it to everyone I knew and loved. That's... a pretty heavy thought.

   We have a family friend who is a Norwegian doctor specializing in tropical diseases. They may not have many in Norway but he gets sent all over the world. We called him in Norway and after talking about my symptoms and such he seemed relatively dismissive about my odds of having ebola (I'm not sure why?) but was a little more concerned about malaria. Only ebola can make potentially having malaria seem like a good thing. (Interesting fact: malaria kills more people every two days than ebola has killed in thirty years).
   Still though I managed to pack my things and get onto the ship



The Shunning
   Another interesting aspect of ebola is that because people are so freaked out about it, people who potentially have it (in Africa) are frequently shunned. As such, people who think they might have it try to hide the fact. As such, people who DO have it go around while disguising the symptoms, and thus infecting people.
   On the brig Pilgrim I felt free to talk about ebola and the emotional burden it had been on me, since I'd been told by a doctor that I didn't have it, and most of the 21 day incubation period had gone by anyway. Despite still being fairly sick I did my duty in every manner -- I stood all of my watches (four hours each day and four hours each night), and went aloft to help with the sails even when told I could sit it out.
   But then when we arrived in Santa Barbara the organization's old curmudgeonly maritime director came aboard and much to my shock I was suddenly being told "there's some concern you.. may have been exposed to ebola ... and it would be best if you leave the ship immediately." I couldn't believe it, I was getting kicked off! I was getting shunned!


   I saw a doctor as soon as I got home (by train), to be certified ebola-free, and sure enough I had nothing more than a sinus infection. I now have a doctor's note saying I don't have ebola.

   Despite this, as mentioned at the beginning of this entry, a day or so later I had a good minute of alarm when I had a slightly bloody nose before I convinced myself that it was really probably nothing. This whole thing has made me kind of... jumpy about it.


Ebola in Popular Culture
   Meanwhile a lot of people have been posting things about ebola on the "computer internets." I feel a little rift between myself and my own friends who post about it -- to them its a really far away news story, to them its a thing I haven't been able to be sure I don't have. And so when my friend blithely posts something like this:



It kind of irks me. I've seen a few things like this, people basically saying "hey its not that contagious." I just want to say, hey, it isn't like AIDS, you don't have to have sex with someone to get it. Do you see AIDS doctors wearing the same hazmat suits you see ebola doctors wearing? No. Because I could have gotten it from a passerby's sneeze, or someone's sweaty palms during a handshake.
   I also see newscasters smugly saying "oh it couldn't come here, it couldn't spread here," and I think, I dunno, I came through the airports to get here with the symptoms, and even if I hadn't I could have been incubating, and then we could all be giving eachother high fives with sweaty palms...


   Long story short, this past month has been very emotionally draining on me. Today is day 21, I officially don't have ebola. It's still out of control in Africa though, and it is a scary thing, let me tell you.

Comments

[ilovegravy.livejournal.com]

Whew!! I'm glad you don't have ebloa!!!

[xo-kizzy-xo.livejournal.com]

Holy crap, I think I'd be a basket case right now if I were in your shoes.

[missfuzzybunny.livejournal.com]

Wow, I would have been shitting myself with worry.

And yeah, I get how those insensitive internet memes suddenly really irk. I've gone through breast cancer treatment recently and sometimes I get SO tired of all these Worldnet links on friends' feeds about miracle cancer cures. It's really insensitive and ignorant.

[mallorys-camera.livejournal.com]

This is a public entry, right. Would you mind if I linked to it on my Facebook account? It's quite fascinating.

I'm not sure what makes ebola scarier than, say, malaria. Part of it is that it's hemorrhagic, and blood is scary. Part of it is that there's no magic bullet "cure" -- though reportedly, it does respond well to support measures that are mostly unavailable in Africa. Part of it, I suspect, is that it originated in Africa, though -- the whole heart of darkness meme.

I'm glad you're well.

[belleweather.livejournal.com]

It IS actually really hard to catch Ebola, though. It's not really transmissible through sneezing or handshakes -- it's transmissible through blood, urine, saliva, sexual fluids and stool, but not through the air or through sweat. Even then, you'd have to get those bodily fluids into your body through a break in the skin, rather than pneumatically, by mouth or through the eyes or nose . I can see why you're worried -- says the girl who isn't entirely sure she doesn't have Chikungunya or Dengue, although she probably just has a sore throat and a bad fever -- but if you're not hanging with sick people or corpses or eating bush meat, your risks are really pretty low. (Also, you're also not contagious unless you're symptomatic.)

My understanding is that Peace Corps evaced their volunteers partially from the fear of the disease but more from fear of mass panic and/or violence directed at "outsiders" in the rural areas they serve in because of the epidemic. It's been really interesting talking to all my friends in Liberia and Sierra Leone and Nigeria while this has been going on and watching them try (futilely) to reassure their families that really, they're just fine while the families in the States freak out and insist that they should be evacuated immediately and this is the worst oversight since Benghazi. (*eyeroll*)

[belleweather.livejournal.com]

(Aaah, Karma. I post this and then not 15 minutes later get the notice that Liberia is evacuating family members, due to the epidemic. *sigh*)

[fimbrethil.livejournal.com]

Ebola requires blood to blood contact for human transmission. You could not have gotten it from a passerby's cough or a sweaty handshake. Luckily for the human race, ebola is a very stable virus and shows no signs of going airborne for it's human hosts. The only time science has seen it go airborne was in Reston, Virginia in bloody aerosal transmitted from monkey to monkey only. Ebola Reston, fortunately, is not contagious to humans. One reason it is spreading so quickly and effectively right now is because people are ignoring basic sterile procedures and are caring for their sick loved ones themselves and preparing their own dead for burial. The other reason is that there is inadequate basic medical care available in the areas of the countries that are infected. Research has shown that simply replacing lost blood and bodily fluids can go a long way toward recovering from the disease. However, many hospitals still reuse needles and don't know the basics or have the materials to practice safe medical procedures. It's also spread to the doctors and nurses because they are understaffed and accidents are happening because the rooms aren't being properly cleaned and because tired medical staff can make deadly mistakes such as accidently sticking themselves or not maintaining their suit's integrety.

Ebola has been around for a very long time and one main reason it hasn't spread more is because of shunning. It's harsh but it does contain the disease. Right now, there is distrust and hysteria in Guinea and the surrounding areas because villagers mistakenly believe that health workers are spreading the disease and are not letting them into the villages to properly treat the infected.

It is highly unlikely that ebola could spread in the United States even if someone did travel to this country with it because we follow safe medical procedures and have the infrastructure to support quarantines.

Richard Preston, a narrative non fiction writer, has a book called The Hot Zone, which is all about ebola and well worth the read. He also just did a Reddit a couple of days ago on the current outbreak which was very informative as well.

[drcuriosity]

Bloody hell. I'm glad you came through okay. I can't imagine the kind of emotional stress that would put on you - and I'm waiting for my mother to die of brain cancer, most likely in the next two weeks.

[ellakite.livejournal.com]

There was a bit of drama back in the US in recent days when two Americans suspected of having Ebola were flown back here to the states for medical treatment. One patient was sent straight to a special isolation facility in Virginia... while the other was brought to a hospital here in my home town of New York City.

When the news was released that someone potentially having the Ebola virus had been brought into this city, more than a few folks started freaking out, claiming that millions of people would start dropping dead in the coming weeks as the illness would spread across the city like a proverbial plague...

I come from a medical family, and thus I have a solid understanding of how Ebola is spread. So I was disgusted when quite a few folks criticized the decision to bring these patients here for treatment. Putting aside the fact that extraordinary measures were taken to keep these two patients isolated, the simple truth is that only the health care employees directly dealing with the patients would be the only ones at risk of exposure... and it turned out that the patient brought here to NYC does not have Ebola after all. (The patient in Virginia does have a confirmed case of Ebola, but is reportedly responding well to a new experimental treatment.)

I'm glad you don't have Ebola... but I know that sinus infections aren't pleasant. Please get well soon.

[emo-snal.livejournal.com]

feel free to link it (-:

[millysdaughter.livejournal.com]

I fully understand the feeling of "malaria is a very good thing" - we went through that when we discovered "emphysema is a Very Good thing" - because they were testing a loved one for lung cancer!

[bleodswean.livejournal.com]

Sorry you had to suffer through that sort of mental anguish. I get it. So glad to hear that you are okay.

[reckless-blues.livejournal.com]

My friend in Washington DC mentioned peripherally that the city doesn't have good epidemic procedures, so I spent a good portion of the last few months trying to figure out how to infect and kill as many people in the capital as I could. (You know. For science.) (Seriously, I got all these books on water treatment and rapid sand filtration plants. It was a great thought exercise.) Now I feel kinda bad.

Anyway - because of what I learned I'm not surprised you got through the airport. Sort of conflicted about it - as you said, putting people in third-world quarantines is only going to pretty much guarantee they'll be too unhealthy for travel. But at the same time ...

[furzicle.livejournal.com]

What are your sources for the requirement for "blood to blood contact"? This contradicts everything I have read about the disease, as does your dismissal of becoming infected from a cough. Most sources also implicate "bodily fluids" which would seem to suggest saliva and sweat.

[adoptedwriter.livejournal.com]

Scary indeed! AW

[anyonesghost.livejournal.com]

When news broke, I actually thought of you and wondered if you were all right. It's a scary time to be traveling, to be sure ... and best thing people can do is stay informed. (Unfortunately, there's knowing, and then there's the illusion of knowledge.)

I'm glad you're okay, and hopefully you have a chance to unwind a bit before your next adventure.

[fimbrethil.livejournal.com]

Cdc.gov is a good source. In the Q&A section on the left side of the ebola page you will find a lot of good answers. It says there that since it is not a respiratory illness, it cannot be transmitted through the air.

You can also see some good info on the recent Richard Preston Reddit. He's a science writer and an expert on ebola. Also check out The Hot Zone by Mr. Preston if you want a good overview of the disease.

To clarify, saliva and sweat might be a vector if you had a cut and encountered those fluids with such but not with unbroken skin. I should have been clearer. Thanks for the counterpoint.

[favoritebean.livejournal.com]

I was wondering if you had been exposed to ebola during your stay in Guinea.

[emo-snal.livejournal.com]

so was i :-O

[penpusher.livejournal.com]

I'm glad you're not infected, as are all members of WHO and the CDC!

People have been talking about the possibility that the disease is airborne, which, of course, would make it a lot more transmittable. I haven't heard anything about that being the case, still, there is a lot of worry, and an impressive amount of hand washing going on.

I suppose we should focus on more likely scenarios, like people trampling us while using their smartphones on the sidewalk, or getting struck by lightning.

Stay healthy!

[swirlsofblue.livejournal.com]

Glad you're okay.

A thought-provoking entry, thank you for sharing your insights.

[theun4givables.livejournal.com]

I probably would have been like you and just went and did everything without really worrying about it until that sinus infection came up. At that point I probably would have really started freaking out.

Glad you're safe and ebola free. :)

[emo-snal.livejournal.com]

I just reviewed the information available and don't see anything about necessary blood-to-blood contact. Most places just say "contact with an infected persons bodily fluids," which I can see is easy to misunderstand as necessary fluid-to-fluid contact, but for example in this CDC question-and-answer transcription they do specifically mention transmission through unbroken skin or "touching it."

[emo-snal.livejournal.com]

I just reviewed the information available and don't see anything about necessary blood-to-blood contact. Most places just say "contact with an infected persons bodily fluids," which I can see is easy to misunderstand as necessary fluid-to-fluid contact, but for example in this CDC question-and-answer transcription they do specifically mention transmission through unbroken skin or "touching it."

[emo-snal.livejournal.com]

Thanks, me too! (: