Air­borne Ebola can’t be ruled out, doc­tors in ’89 Vir­ginia out­break say

The Washington Times Weekly - - National - BY TOM HOW­ELL

Both Pres­i­dent Obama and his top in­fec­tious dis­ease ex­perts tried to calm Americans’ fears about Ebola last week by say­ing the cur­rent out­break can­not be trans­mit­ted through the air. But less than 30 miles from where top gov­ern­ment of­fi­cials made their dec­la­ra­tions in Wash­ing­ton, sci­en­tists a quar­ter cen­tury ago did in fact prove that an Ebola strain con­tained to mon­keys could spread air­borne.

The 1989 episode at the sub­ur­ban Re­ston, Vir­ginia, mon­key re­search fa­cil­ity — made fa­mous by Hol­ly­wood movie “Hot Zone” — along with ad­di­tional re­search by a sci­en­tist who helped fight the Re­ston out­break and then went to Africa to treat a later Ebola out­break in hu­mans — leaves some of the na­tion’s top dis­ease ex­perts will­ing to con­sider that the Ebola virus could mu­tate or go air­borne.

“We can never say never, but I just don’t think the risk is very high,” said Thomas Geis­bert, a pro­fes­sor at the Univer­sity of Texas at Galve­ston who co-dis­cov­ered the Re­ston strain of Ebola.

There’s no ev­i­dence of air­borne trans­mis­sion in to­day’s cases, although a team su­per­vi­sor for the Re­ston out­break, Dr. C.J. Peters, chal­lenged dec­la­ra­tions by fed­eral sci­en­tists de­signed to re­as­sure the pub­lic at a fear­ful time.

Dr. Peters wrote in an ex­ten­sive study on Ebola in hu­mans that he found some ev­i­dence that a 1995 out­break in Congo may in fact have spread in some cases by aerosol trans­mis­sion.

“We just don’t have the data to ex­clude it,” Dr. Peters, also a pro­fes­sor at the Univer­sity of Texas in Galve­ston, told The Los An­ge­les Times.

Of­fi­cials say they un­der­stand how the virus is spread — di­rect con­tact with an in­fected per­son’s bod­ily flu­ids — and that talk of air­borne trans­mis­sion is un­war­ranted. To be sure, noth­ing would be more likely to set off panic among the pub­lic.

Dr. Tom Frieden, di­rec­tor of the Cen­ters for Dis­ease Con­trol and Preven­tion, stressed that point sev­eral times be­fore Congress on Thurs­day.

“We don’t be­lieve it is spread­ing in any other way,” he told the House En­ergy and Com­merce Com­mit­tee. “We are con­fi­dent this is not air­borne trans­mis­sion.”

Even so, Chair­man of the Joint Chiefs of Staff Gen. Martin E. Dempsey raised the specter of an air­borne mu­ta­tion in a re­cent in­ter­view with CNN.

“I mean if you bring two, you know, two doc­tors who hap­pen to have that spe­cialty into a room, one will say, ‘No, there’s no way it will ever be­come air­borne,’ but it could mu­tate, so it would be harder to dis­cover,” he said.

The Ebola virus has killed more than 4,000 in West Africa, mainly in Liberia, Sierra Leone and Guinea. But when the virus came to Texas, Dun­can had the ben­e­fit of an Amer­i­can in­ten­sive care unit.

The virus is be­hav­ing as it usu­ally does and, to be cer­tain, ev­ery pa­tient but Dun­can has sur­vived their Ebola treat­ment in the U.S. But use of in­tra­venous lines, me­chan­i­cal ven­ti­la­tion and dial­y­sis comes with its own risks, ex­perts say.

Jerry and Nancy Jaax, who were among the team of re­searchers that fought the Re­ston out­break and later con­cluded from lab test­ing the strain could be trans­mit­ted be­tween mon­keys through the air, said they’re most con­cerned about the “droplet haz­ard,” such as when some­one next to you sneezes and you feel a droplet. They also noted the in­her­ent dan­gers of work­ing in a health care set­ting.

“Any pro­ce­dure where you’re in­va­sive, where you’re ven­ti­lat­ing, cre­at­ing an aerosol, or where there’s blood or se­cre­tion con­tam­i­na­tion, you cre­ate a risk,” said Mrs. Jaax, who is now re­tired.

Mr. Jaax said of the cur­rent Ebola out­breaks among hu­mans that “noth­ing’s im­pos­si­ble, but it’s un­likely” that it is be­ing trans­mit­ted through the air.

After Re­ston, lab re­search showed that the strain could be trans­mit­ted by aerosol with spe­cial equip­ment, and mon­keys could be ex­posed through the nose or in sit­u­a­tions where the eyes and mu­cous mem­branes came in con­tact with the virus.

“This is ef­fec­tively a mi­nus­cule ‘droplet’ type ex­po­sure,” the cou­ple said. “There is no ev­i­dence Ebola can ‘hang in the air for long pe­ri­ods’ — the droplets are heav­ier than air.”

Rep. Michael C. Burgess, a Texas Repub­li­can and doc­tor, echoed those sen­ti­ments, say­ing thin ev­i­dence of air­borne trans­mis­sion does not worry him just yet.

“What keeps me up at night is the fact that you’ve got peo­ple in­volved in di­rect pa­tient care with pa­tients with enor­mous vi­ral loads, and that di­rect con­tam­i­na­tion is enough to worry about for right now,” Mr. Burgess said.

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