Asymptomatic ebola virus infected patients need no quarantine

DELHI, India - Oct. 29, 2014 - PRLog -- President Barack Obama has defended his administration's controversial recommendation to monitor but not quarantine clinicians returning from Ebola care assignments in West Africa.

Obama's remarks reinforced interim guidance issued by the Centers for Disease Control and Prevention (CDC) that rejects mandatory quarantines, but calls for restricting the movement of clinicians having had the highest risk for exposure to the Ebola virus in West Africa, which could result from a needle stick or a splash of blood in their eyes.

Such clinicians should avoid public transportation and public places, but need not confine themselves at home.  For example jogging in the park is fine.

During the 21-day incubation period of the virus, public health officials should monitor them in person, and on a daily basis, for Ebola symptoms especially fever.

Doctors in the categories of "some risk" and "low risk" for Ebola exposure also should undergo some form of daily monitoring.

Travel restrictions, but not outright quarantine, may be warranted for "some risk" clinicians but on a case-by-case basis.

The CDC guidance are in line with the positions of the World Health Organization and the Infectious Diseases Society of America.

They assert that it is pointless to quarantine individuals while they are asymptomatic, and therefore unable to spread the virus.

CDC recommendations are also endorsed by the American Medical Association, the American Nurses Association, and the American Hospital Association.

How ebola spreads

1.      Person-to-person transmission occurs through direct contact of broken skin or unprotected mucous membranes with virus-containing body fluids from a person who has developed signs and symptoms of illness.

2.       The most infectious body fluids are blood, feces, and vomit.

3.       Ebola virus has also been detected in urine, semen, and breast milk. .

4.       Saliva and tears may also harbor the virus.

5.      It is unclear whether infectious virus exists in sweat.

6.      One type of direct contact that leads to transmission is the ritual washing of Ebola victims at funerals

7.      Healthcare workers are at risk of infection if they care for a patient with Ebola or Marburg virus disease without appropriate protective measures.

8.       Ebola virus may also be transmitted though contact with previously contaminated surfaces and objects.

9.      Viable virus may exist for up to several days on fomites

10.   The potential risk can be reduced by proper environmental cleaning

11.   Ebola virus disease is rarely, if ever, spread from person to person by the respiratory route

12.   Simply being in proximity to a healthy-looking person (for example, in a public transport conveyance) does not constitute a risk.

[The author Dr K K Aggarwal is Sr National Vice President Elect of IMA]