Roanoke Times
Copyright (c) 1995, Landmark Communications, Inc.
DATE: MONDAY, May 15, 1995 TAG: 9505160027
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
SOURCE: JOHN SCHWARTZ WASHINGTON POST
DATELINE: LENGTH: Long
Chris Shahin has Ebola fever. The National Park Service employee isn't sick; he simply can't get enough information on the Ebola virus, which he first learned about in ``The Hot Zone,'' Richard Preston's book about a close call with the virus in a Reston building in 1989.
The book worked its way from person to person in Shahin's office, virus-like, this year, making ``The Hot Zone'' the hottest topic of conversation there for weeks.
When a new outbreak of the deadly virus was reported last week in Zaire, the office members' fascination reached new heights: They sought out newspaper articles and Internet resources to learn more about Ebola and the current crisis. ``It was so gruesome, the deaths,'' Shahin said. ``It captures your attention - that it could happen to you. ... It could be in the United States within a matter of 24 hours.''
But, as American humorist Artemus Ward said, ``It ain't so much the things we don't know that get us in trouble. It's the things we know that ain't so.'' Shahin, like many people caught up in the media's recent preoccupation with Ebola virus, is concerned about scenarios that are highly unlikely, scientists said.
His reaction is understandable: The national obsession with Ebola and the potential for similar diseases to appear has led to a sort of Cuisinart effect. Ideas and images from sensationalistic films such as the televised ``Robin Cook's Virus'' are blended with information from more authoritative works such as writer Laurie Garrett's ``The Coming Plague.''
ABC's ``Nightline'' and other news programs even used scenes from the fictional movie ``Outbreak'' to sharpen reports on the Zairian Ebola outbreak last week. That outraged John Schelp, a former Peace Corps volunteer in Zaire who now lives in Research Triangle, N.C.
In an online discussion group devoted to Zairian issues, he wrote: ``The people suffering in Kikwit and the surrounding villages are not Hollywood actors - they are real people. ... The networks should be ashamed of creating a sensational heart-of-darkness atmosphere in the news accounts covering the events in Kikwit.''
Films such as ``Outbreak'' bend the facts to put moviegoers on the edge of their seats, said Stephen Ostroff, an epidemiologist at Atlanta's Centers for Disease Control and Prevention. He cited a scene in which a person infected with a deadly virus spreads it to other people in a movie theater by coughing and sneezing - a virtual impossibility with known strains of the Ebola virus. ``It's great in the movies. But in this virus, that's not real life.''
The result of this blending of fact and fiction: an epidemic of heightened apprehension and misinformation.
Following are five examples of the growing mythology surrounding Ebola:
Myth 1: Ebola is highly contagious.
It is not. ``This is not very transmissible. You have to work hard to get [it] from a person,'' said Ralph Henderson, assistant director general of the World Health Organization, which is coordinating the response to the Zairian outbreak. Scientists believe the disease is transmitted through contact with the blood or bodily fluids of an Ebola victim - the sort of exposure that can be controlled through barriers, such as latex gloves and face masks, that are commonly used in Western hospitals.
Myth 2: Ebola can travel though the air to infect people.
Although diseases such as measles can infect people who breathe in virus particles suspended in airborne droplets, the strains of Ebola discovered so far cannot. ``That would be a nightmare scenario,'' Henderson said. The main reason the disease has spread in Zaire is the poor sanitary conditions in hospitals, where scarce medical supplies such as hypodermic needles must be reused, often without proper sterilization.
Myth 3: The virus could rapidly mutate into a form that could be transmitted through the air.
Although viruses in the movies change moment by moment, evolution in the real world is a far more deliberate process. Retroviruses such as HIV, the virus that causes AIDS, do tend to mutate rapidly - possibly because their genetic instructions are stored in RNA instead of DNA, the genetic repository in our cells, said Mary Wilson, an infectious disease specialist and professor at Harvard. DNA has complex error-checking mechanisms that keep mutations to a minimum, and the Ebola virus' genetic instructions are stored in DNA.
Although viruses do evolve over time, switching from one form of transmission to another is very unlikely, Wilson said. ``Even if there are mutations and changes in the virus, it doesn't mean it will change its basic mechanism of attaching to a cell,'' she said.
Even in viral quick-change artists such as HIV, ``the basic means of transmission are basically the same as when we first started seeing cases'' more than a decade ago. And scientists at the CDC reported last week that the virus identified in the current Zairian outbreak shows remarkable genetic similarity to that isolated from the first outbreak nearly 20 years ago.
``To think all of a sudden, in a blink of an eye, it's going to transform itself into a flu-like agent just strains credibility,'' Ostroff said.
Myth 4: Ebola could come to the United States via an infected passenger on an international flight.
Highly unlikely, say the experts. Although such transmission is hypothetically possible - ``I never say never,'' said the CDC's Ostroff - Henderson of WHO said that ``the chance of someone's getting on an airplane with this disease is just vanishingly small.''
The incubation period for Ebola ranges from two to 21 days, averaging a week. Even if an infected person were in the incubation period or feeling the flu-like symptoms that precede the onset of full-blown hemorrhagic fever, the danger to others would be minimal, because victims don't become contagious until their profuse bleeding begins.
``You've got to be a sick cookie before you're able to transmit the disease,'' Henderson said. Anyone in that condition is not likely to get on an airplane. Thus, WHO on Friday advised air carriers not to change any of their procedures concerning flights in and out of Zaire.
Ostroff said that, in the one case in which a person infected with a type of hemorrhagic fever flew into this country (a Chicago man who contracted Lassa fever, caused by a different virus, while visiting his family in Nigeria), the infection did not spread to others, thanks to the sanitary precautions routinely taken in Western hospitals.
Myth 5: Ebola is the most dangerous disease ever encountered.
It's certainly one of the most gruesome. Yet, in many ways, a disease such as Ebola is much more easily contained than a host of better-known microbes. People infected with HIV, for example, typically have no symptoms for several years and can infect others throughout that period.
Ebola's swift course increases the likelihood that infected people will be quickly identified and isolated. Even when they are not, the period in which they are infectious - after the profuse bleeding begins - is short.
``Depending upon how severely a person is hemorrhaging, they may die within a few days or even a few hours,'' said CDC spokesman Tom Skinner. Scientists who have studied Ebola, however, do note that the few survivors of the disease might have the virus in body fluids for up to two months after recovery. As a result, survivors must remain in quarantine for some time.
Although the apocalyptic view is incorrect, scientists still have grave concerns about Ebola and potential similar diseases, which could prove more contagious. ``There are certain gaps in our knowledge,'' Wilson said.
by CNB