The District of Columbia Department of Health (DC DOH) has been working closely with other public health organizations and the Centers for Disease Control and Prevention (CDC) since the beginning of the current Ebola outbreak more than seven months ago. The outbreak is currently centered in the countries of Liberia, Guinea, Sierra Leone and Mali, all located in West Africa. While there is potential for this outbreak to spread to neighboring African countries, Ebola does not pose a significant risk to the US public at this time. The US is currently assisting affected regions in many ways, including sending workers to West Africa to assist efforts to control the outbreak.

What is Ebola?

The Ebola virus causes viral hemorrhagic fever disease. Symptoms of infection include: fever, muscle and joint aches, headache, weakness, diarrhea, vomiting, stomach pain, lack of appetite, and abnormal bleeding. Symptoms may appear anywhere from 2 to 21 days after exposure to the Ebola virus, though developing symptoms 8 – 10 days after exposure is most common.

Where is Ebola found?

Ebola is found in Africa, with cases occurring outside Africa for the first time with this outbreak. Ebola is not endemic (naturally occurring) in America, and it is almost impossible it will ever be.

What is my risk of contracting Ebola?

Your risk of contracting Ebola here in the District of Columbia is infinitely small, practically nonexistent, mostly because there is such a low chance of any exposure. While this is an important situation, there is absolutely no reason for panic. This simply will not affect our day to day life, and we should continue to proceed without any paranoia or panic about this unfounded risk. Ebola is not like many other infectious diseases. You will not catch it from riding public transportation or casual contact (e.g. shaking hands) and it is NOT airborne.

How is Ebola transmitted?

Ebola is only spread through direct and close contact (through broken skin or mucous membranes in, for example, the eyes, nose, or mouth) with:

• blood or body fluids (including but not limited to urine, saliva, sweat, feces, vomit, breast milk, and semen) of a person who is sick with Ebola
• objects (like needles, syringes, soiled linens) that have been contaminated with the virus
• infected animals
• Ebola is NOT spread through the air or by water, or in general, by food.

What is the District of Columbia Department of Health doing to prepare?

We remain vigilant at the District of Columbia Department of Health, and are in constant communication with hospitals, healthcare providers, federal agencies and neighboring jurisdictions to assess the threat and also to continue preparation. We remain confident in our ability, with our partners, to keep you safe in the highly unlikely event of any Ebola cases.

Communication: The Department of Health continues to issue the latest guidelines from the CDC as well as sharing our public health expertise with everyone playing a role in our preparation and possible response. We will continue to keep the community abreast of any important developments or revisions that pertain to Ebola.

Collaboration: The Department of Health will continue to draw on the experience and skills of public health experts, the CDC, and of course our tremendous force of doctors and public health professionals to ensure we remain on the cutting edge and continue to anticipate any danger and effectively protect our population.

Ongoing surveillance: The Department of Health continues to monitor local hospitals, health care venues, points of entry and the city in general for ANY unusual disease occurrence, and solid protocols are in place to deal with any threat or contingency.

Expertise: The Department of Health is a robust workforce of dedicated, talented and exceptional public health professionals devoted to keeping the community and our city safe. Our doctors, disease control specialists and everyone involved in this important effort are among the best and the brightest, with an enormous breadth of experience, training and proficiency. We remain poised and ready to deal with ANY threat and keep the residents of our great city safe. The Department of Health has one of the strongest and most comprehensive public health infrastructures in the nation, and a distinguished history of admirably addressing a plethora of diverse public health threats to our city and our residents and keeping everyone safe.

Can I get Ebola from a person who is infected but doesn’t have any symptoms?

No. Individuals without symptoms are not contagious. Transmission occurs through direct contact with an infected individual’s bodily fluids.

What is being done to prevent ill passengers in West Africa from getting on a plane?

US public health efforts are assisting with the education of local officials and active screening efforts currently taking place in West Africa to prevent sick individuals from boarding planes. Airports in areas currently affected by the outbreak (Liberia, Sierra Leone, Guinea and Mali) are screening all outbound passengers for Ebola symptoms. In this effort, travelers are screened for fever and required to complete a healthcare questionnaire designed to detect potentially sick individuals. US public health workers are also deployed to the affected region to assist in these efforts. Screening efforts are now in place at major US airports handling passengers from affected areas.

What are US Public Health Organizations doing in the US?

The DC DOH has met with CDC officials to reinforce existing protocols that are in place to protect against further spread of disease. These include international airlines notifying CDC officials of suspected ill passengers observed on their planes prior to the plane’s arrival. Notifications result in further evaluations and investigations by CDC officials of ill travelers and their contacts, and, if necessary, isolation of the sick travelers. CDC has also provided guidance to airlines for managing ill passengers and crew and for disinfecting aircraft. The DC DOH has been in contact with local health care providers to provide guidance and remind US healthcare workers of the importance of taking steps to prevent the spread of this virus, how to test and isolate suspected patients and how they can protect themselves from infection.

What about ill Americans with Ebola who are being brought to the US for treatment? How are public health officials protecting the American public?

The CDC has very well-established protocols in place to ensure the safe transport and care of patients with infectious diseases back to the United States. These procedures cover the entire process – from patients leaving their bedside in a foreign country to their transport to an airport and boarding a non- commercial airplane equipped with a special transport isolation unit, to their arrival at a medical facility in the United States that is appropriately equipped and staffed to handle such cases. CDC’s role is to ensure that travel and hospitalization is done to minimize risk of spread of infection and to ensure that the American public is protected. Patients were evacuated in similar ways during SARS.

What does the CDC’s Travel Alert Level 3 mean to US travelers?

On July 31, 2014 the CDC elevated their warning to US citizens encouraging them to defer unnecessary travel to Guinea, Liberia, and Sierra Leone over concerns that travelers may not have access to health care facilities and personnel should they need them in country. On November 16, 2014 the CDC issued an additional travel advisory advising travelers to practice enhanced precautions when traveling to Mali.

Additional information on Ebola can be found at the following:

• Centers for Disease Control and Prevention website: cdc.gov/vhf/ebola.
• Contact the DC Department of Health Department of Epidemiology, Disease Surveillance & Investigation at (202) 442‐8141.