Statements about Ebola: True or false? Part 1 Commented version for trainers only!

Statements about Ebola: True or false? Part 1 Commented version for trainers only!

The questions and answers are designed to revise key messages of the training. If necessary, you may adapt the questions yourself for each session. Ideally do not exceed 5 to 8 questions per session, and set 2 to 3 sessions per training course. If a lot of participants answer a question incorrectly, it may be repeated the following day. Only show the participants the questions; use the additional information purely for discussion and explanation.

Question 1: True or false? Ebola is only transmitted through mucous membranes.

FALSE Comment 1 The Ebola virus is transmitted through mucous membranes, damaged skin and parenterally (through injection). Non-damaged skin is usually an effective barrier. The most common point of entry is the eyes, nose or mouth through non-protected and therefore exposed mucous membranes. To protect yourself, you must: Not touch your face (close to mucous membrane). Wear safety glasses (without openings) to cover your eyes. Wear an appropriate mask to cover your nose and mouth. Beware! If wet, the masks are no longer waterproof!

Question 2: True or false? The current Ebola epidemic started in Sierra Leone in December 2013.

FALSE Comment 2 The epidemic s patient zero was a 2-year-old boy who fell ill on 2 December 2013 in the village of Meliandou, Gueckedou, Guinea. He died on 6 December 2013. Several members of his family (sister, mother, grandmother) consequently died in Meliandou and Dawa between December 2013 and February 2014. The Ebola Virus Disease (EVD) spread to Macenta, Nzérékoré and Kissidougou through a healthcare worker from Gueckedou, who died in Macenta on 10 February 2014, creating multiple chains of transmission. All infection clusters have been linked back to the initial clusters.

Question 3: True or false? The incubation period for EVD is between 5 and 25 days.

FALSE Comment 3 The incubation period for EVD is between 2 and 21 days The incubation period is defined as being the interval between infection and appearance of the first clinical symptoms For Ebola, the average incubation period is 8 to 10 days

Question 4: True or false? Before the initial clinical symptoms appear, a person infected with the Ebola virus may transmit the virus to another person living in the same household.

FALSE Comment 4 The Ebola virus is transmitted from person to person through direct contact with body fluids containing the virus. It is not transmitted before the initial symptoms appear. The virus quantity is low at the start of the illness, and quickly grows as the disease progresses. The most infectious fluids are: Blood Stools Vomit Other fluids which may also contain the virus are: Urine, sperm, saliva, breast milk, tears, sweat The Ebola virus may also be transmitted through direct skin contact with an infected person, though the risk is not as high as with body fluids.

Question 5: True or false? The Ebola virus is transmitted through the air (airborne transmission).

Comment 5 FALSE There is no evidence of infection through respiration via aerosols. Aerosols are different from droplets which may be produced through vomiting or diarrhoea. That s why respirator mask protection is recommend for anyone looking after Ebola patients.

Question 6: True or false? I can become infected by touching an Ebola patient without gloves.

Comment 6 TRUE Throughout the course of the illness, the Ebola virus invades all sorts of cells, and is spread to virtually all the organs through blood circulation, causing necrosis. The virus may be present on the skin of the infected person: Due to viral replication in the epidermal cells; Due to skin contamination through blood or other body fluids. To avoid infection, systematic hand hygiene is recommended when treating all patients : Wash hands before and after treating each patient Systematically wear gloves before any potential contact with body fluids Be very careful not to touch yourself (e.g. in the face)

Question 7: True or false? Ebola diagnosis is confirmed by a blood test (RT-PCR).

Comment 7 TRUE A blood sample (EDTA tube) is taken to confirm diagnosis of EVD in a patient. An oral swab may be taken if a blood test is impossible (deceased patient; child), though this is less sensitive than blood. The laboratory tests available are: RT-PCR (real-time polymerase chain reaction), which shows viral RNA Specific ELISA for viral antigens IgM-ELISA, which shows the antibodies fighting the virus At the start of the infection, the test may be negative (viral load under the detection threshold). In this case, the test must be repeated at least 48 hours later.

Question 8: True or false? It is safe to prepare and eat bats if they are properly cooked.

Comment 8 FALSE The reservoir of the Ebola virus is not totally known, but its RNA and antibodies have been found in bats. Unlike other wild animals and humans, bats do not show signs of illness, even with a significant viral load. The Ebola virus is destroyed by heat, but handling bats during cooking preparations poses an infection risk.

Question 9: True or false? I can get infected when more than two metres away from an Ebola patient.

Comment 9 FALSE Direct contact with body fluids or skin is impossible when a patient is at least 2 metres away. Even contagious droplets fall to the ground within a 2-metre radius. So this distance is considered safe for avoiding transmission. NB: It is nevertheless advisable to use protective equipment during patient screening (safety glasses, mask, coats, overalls, gloves)

Question 10: True or false? A gold washer who returned from Guinea 6 weeks ago may transmit the Ebola virus.

Comment 10 FALSE The incubation period for the EVD is between 2 and 21 days. This means that the person must have been exposed to the virus in the 21 days prior to symptoms commencing. Once 3 weeks have passed since an exposure risk, Ebola virus infection and therefore transmission can be discounted. NB: It is important to explore the risk of exposure to the virus during questioning, and to adapt the questions based on the progression and spread of the outbreak.

Question 11: True or false? Before displaying clinical symptoms, a person infected with the Ebola virus may transmit the virus to someone else travelling in the same bus.

Comment 11 FALSE The person infected with the EVD may transmit the virus to another person through body fluids containing the virus. The risk of transmission depends on the quantity of virus in the fluid. The virus presence in the blood is accompanied with inflammatory reactions, initially manifesting as fever and other non-specific symptoms. The further the illness progresses, the more the virus multiplies and the greater the quantities found in body fluids. Contagiousness thus increases as symptoms worsen. The virus is not transmitted before the initial symptoms appear.