FAQs about the Ebola Virus and Emory University Hospital

About Ebola

What is Ebola?

Ebola is a virus discovered in Africa in 1976. It is a member of the viral hemorrhagic fever family. Ebola is a serious disease and reactions can range from mild to fatal in humans.

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What are the symptoms of Ebola?

Symptoms include:

  • Fever
  • Headache
  • Joint and muscle aches
  • Diarrhea
  • Vomiting
  • Stomach pain
  • Weakness
  • Lack of appetite

Some may experience additional symptoms. For a full list of signs and symptoms, visit the CDC website.

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How is it spread?

Ebola is spread similarly to HIV or Hepatitis B or C. It is spread through two ways:

  1. Direct contact with bodily fluids (e.g., blood) of the infected patients
  2. Needle stick injuries from sharps that have been in direct contact with the infected patients’ bodily fluids

Influenza (“the flu”) is much more contagious than Ebola.

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How do you treat Ebola?

There are no FDA-approved specific medications to treat Ebola available. Right now, we treat Ebola through:

  • Excellent medical and nursing care
  • Monitoring fluids and providing additional fluids, if needed
  • Maintaining frequent vital signs and lab monitoring

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If I come into contact with staff who are treating the infected patients, can I get Ebola?

The specialized team of nurses, physicians and staff who are treating the infected patients are carefully observing the same important contact precautions that we are grounded in as a health care organization that treats critically ill patients. They are well-versed in the proper methods of protection needed for contact with these types of patients. As employees in a heath care setting, we practice these protocols on a daily basis and understand their value and importance in ensuring the safety and proper care of our patients.

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Can I be a carrier for Ebola?

If you do not have symptoms of the Ebola virus, you are not contagious and you cannot be a carrier.

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How serious is Ebola?

Some people who come into contact with Ebola recover, while some do not. We do not know why this is the case. You may hear speculation that mortality rates for Ebola are as high as 90 percent. Keep in mind that these rates are based on patient care environments that are not nearly as sophisticated as the technology and resources available at Emory University Hospital and the United States.

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Since this virus has never been in the United States, how do we know how to treat it?

Although the Ebola virus has never been in the United States, it is not new to the world. We have been studying this virus in Africa for nearly 40 years. We understand how it is spread – just as HIV and Hepatitis B or C is spread.

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What are the long term effects of Ebola?

As with any ICU patient, long-term complications can arise that are secondary to infection and are, unfortunately, not recoverable, such as renal failure. Patients infected with Ebola virus do not become long term carriers. Patients are contagious only when showing symptoms of Ebola virus infection, or for a short period of time after they resolve their infection.

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About Emory University Hospital

Is it safe to come to Emory University Hospital?

Yes. The safety and security of our patients, families, visitors and staff is our #1 priority. We have many precautions in place to ensure that this priority is continually addressed in the best possible manner.

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What precautions is the hospital taking to avoid contamination?

Emory University Hospital is very prepared to handle arrival of the infected patients and has procedures in place to care for these patients in a number of ways:

Isolation Unit
Emory University Hospital has a special isolation unit that is physically separate from other patient areas. This unit is very special – it has unique equipment and infrastructure that provide an extraordinarily high level of isolation. In fact, it is one of only four of this type of facility in the country. We have treated other patients in this unit before that had highly communicable diseases. Check out this diagram of the unit:

Emory Isolation Unit

Patient Care Team
The specialized team of doctors, nurses and staff that manage this isolation unit are incredibly competent. They receive regular training in specialized infection control protocols. They understand how the disease is transmitted and observe the same stringent contact procedures we observe in other special care areas of our hospital. As we know, with these important contact procedures, as the risk for exposure increases, our methods of protection also increase. The care team is uniquely equipped to handle these extreme precautions if they become necessary.

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How will waste be disposed of for these patients?

All waste being generated is treated and disposed of consistent with CDC and federal regulations with the utmost care. As Dr. Bruce Ribner, director of our Serious Communicable Disease Unit, describes in his discussion with the team at NPR, “We disinfect it to kill any viruses and then flush the material down the toilet.”

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What is the special unit being used to house the infected patients?

Emory University Hospital has a highly specialized isolation unit that is very similar to our ICUs at the hospital, yet physically separate from other patient areas. The unit is inspected each year by members of the World Health Organization and CDC to ensure it is up to their rigorous standards. We have never had a problem with passing these inspections.

This unit is like our standard ICUs, but it also has unique equipment and infrastructure that provide an extraordinarily high level of isolation. In fact, it is one of only four of this type of facility in the country.

The unit is a negative pressure unit, meaning air in this unit goes from the hallway, to the anteroom (preparation room) to the patient room. Then the air is HEPA filtered. The air is monitored with mechanical monitoring 24 hours a day to make sure the airflow is always maintained. For this particular condition, this air filtration is above and beyond what we need to care for patients with Ebola. The unit and each patient room is set up at the level of an intensive care unit, so the patient would never have to be moved to another part of the hospital if a higher level of care is needed. It is also designed so all necessary lab testing can be done within the unit. All materials coming out of the unit will be autoclaved to kill all infectious viruses and then sent for incineration.

We have treated other patients in this unit before and we are highly confident in the ability to treat the infected patients successfully.

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What kind of training does the staff at Emory University Hospital undergo to provide care for the infected patients?

We have a specially trained team of physicians, nurses and staff who are prepared to care for these types of patients. They are highly trained in the procedures that are necessary to treat these patients. The specially trained staff go through classes, simulation training and do drills regularly each year to be fully prepared to handle this type of situation.

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Will there be other patients on this special unit?

Only the patients with Ebola will be housed on this unit. This is not because of concerns of exposure, but, rather, for privacy matters considering the high-profile nature of these patients.

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What kind of access will be put in place on the isolation unit? Will there be security? What about visitors?

Visitors to the infected patients will be addressed on a case-by-case basis. Visitors who are approved will interact with the patients via a separate glass plate and will not physically enter the patient care area. Security will be in place to ensure that no one has access to this unit other than those who are approved.

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Why are we bringing the infected patients to Emory University Hospital? Why can’t the patients be treated in Africa or somewhere else?

These patients are coming to Emory University Hospital because this is one of the very few hospitals in the country equipped to provide for their care. Our highly trained staff and physicians are ready to receive both patients, and provide them outstanding care of the highest quality

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When did Emory University Hospital learn of the possibility of receiving these infected patients?

We learned we may be receiving the first infected patient on Wednesday, July 30. We learned on Friday, August 1, we would be receiving an additional infected patient.

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If the Ebola virus is transmitted in the same way HIV and Hepatitis B or C are transmitted, why are there so many precautions (hazmat suits, protective gear, isolation unit) being put into place?

The Ebola virus is part of a list of agents that the United States government has determined to be a threat to bioterrorism. This list is called Level A agents. Because Ebola is on this list, we are required by law to take extra precautions when handling materials that may be contaminated or when treating patients that are infected with it.

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If Ebola is not airborne, why is the care team wearing powered air purifying respirators (PAPs)?

All health care staff treating the patients infected with Ebola were initially trained to use face masks and goggles, but because members of the care team may be in the patient room for 3-4 hours at a time, it is simply more comfortable for them to wear powered air purifying respirators. The Ebola virus is not airborne and it is not necessary for them to wear these respirators, but they are doing so for their own comfort.

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Have both patients received an experimental serum as part of their treatment?

There are reports in the media of both patients receiving an experimental immunoglobulin. There are no FDA-approved medications or vaccines available for treatment of Ebola. There are medications that are in the ground level of development and have been used in primates, but have not yet reached trials in humans. Due to HIPAA privacy regulations, we cannot confirm what treatment the patients are receiving for their condition. If, however, they were to both receive doses of an experimental serum, they would be the first humans to ever receive these treatments.

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How did the patient get from the plane to the unit without exposing anyone?

The patient was transported by a specially trained group of EMS personnel who followed all procedures necessary to prevent transmission of the virus.

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How are the transport crews protected?

Like our physicians, nurses and staff, the transport professionals are specially trained and prepared to transport patients with contagious infectious diseases.

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Will you be providing any updates on the patients?

We will continue to honor our commitment to protect the privacy of these patients as we do with all of our other patients. This commitment is absolute and does not change even when there is extensive media coverage about them.

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What containment level is Emory’s unit? Is it considered a BSL-4 facility?

BSL designations only apply to research laboratories. There is no equivalent grading system for health care facilities.

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Why couldn’t Emory send its doctors and equipment to provide supportive care in Africa?

Delivering advanced medical care requires extensive infrastructure, in addition to medical personnel. Unfortunately, that infrastructure does not exist in most of Africa.

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Do we have a plan to receive other patients with Ebola virus at Emory University Hospital?

As the outbreak in West Africa continues, we can expect to receive additional patients with Ebola virus. This will become our new normal. We are prepared, trained and competent, and welcome the opportunity to use our expertise to help those in need.

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Would other patients with Ebola virus infections be transferred to other isolation units in the United States?

It is possible that other patients with Ebola virus would be sent to one of the other few isolation units in the United States for treatment; however, patients with Ebola virus are no more contagious than those infected with HIV or Hepatitis B or C and can be treated in a normal hospital ICU. Because of media perception, plans for treating future patients would likely depend on logistics and other factors.

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  • Saundra J.

    As a retired Director of Laboratory Operations, I am very interested in learning how the clinical laboratory is prepared to handle the specimens of the ebola virus patient. Will the testing of these patients be performed on hand held devices isolated from other patients, or will some testing be performed on instruments in the main lab? If the main lab will perform some testing, what steps are being used to protect the safety of the staff and instruments to prevent the contamination from blood and body fluids? I believe the steps are in placed to manage the care of these patients at the bedside, but curious about laboratory testing protocol to provide clinical laboratory information to the physician treating the patients. Thank you and god bless you all.

    • Sarah P

      I am curious about the exact same thing. Would like advice for our clinical lab.
      I hope the Lab Director answers us.

  • Deb F.

    LORD Bless My thoughts and prayers are with you.

  • Barbara M.

    I will pray for the one that is sick with it. A man with leprosy came and . knelt down in front of Jesus, begging to be healed
    We long to be healed from sickness and disease. So we all shall pray for him.

  • Loyce DeGraffenreid

    Thank you for your information on this matter. While I understand people’s fears, ignorance can sometimes be more contagious than a disease. I wish it were some way everyone would have access to this information as some people do not have a computer. My prayers go out to the staff who will be taking care of these patients and to the families of those infected.

  • Reb Bacchus

    May God bless you and keep all who are dealing with this awful plague safe. Know that all are in my prayers.

  • Beverly H.

    I am glad to see this information out there. I worked as a research nurse at Emory for 37 years, 12 of those years with the Infectious Disease Division. I have been trying to quell fears on Facebook and plan to share this information on my page. Thank you for caring for these 2 dedicated, kind people.

  • Carol S.

    Thank you for receiving these two
    citizens and humanitarians. May your
    entire staff be blessed in every way.

  • Maria

    Both patients coming to Emory are healthcare workers directly caring for Ebola patients. Surely they are trained in protecting themselves from contracting the virus. How did they contract it? Was there carelessness on their part? Were the facilities dirty? Did they reuse needles or have a needle stick? I understand everything posted in your blog. What I don’t understand is how experts managed to contract the virus. Obviously, something went wrong. Someone got sloppy. This is something we can learn from.

    • Lorraine

      Maria,
      The 2 nurses did not have training until a later time. We can learn from their experience. In addition, this patient come to the hospital and was sent home without anyone knowing he had ebola.

  • Kristen

    Question

    I am scheduled to return to Buckhead area of Atlanta on August 20th and I am terrified for obvious reasons related to the Ebola carriers being housed in such close proximity. Specifically I’m worried about contamination of the already not so great water quality due to flushing of waste from these Ebola patients into the public water system. Can you confirm it is safe to return to ATL and the status os how you will be affecting the water? Thank you for a rapid response … The worry and stress over this is taking a toll on my health.

  • Dan Early

    Just curious–if Emory is one of four sites with this high level of isolation care, what are the other three? I assume you’re counting Nebraska and NIH, but I’d like to know the comparable sites. Thank you for your critical work in this area.

  • Jeff

    If the quality of the above “official” responses mirrors the care taken to ensure that the highly-deadly disease you have brought to the US doesn’t tragically “get loose”….well, I can’t say I am brimming with confidence.

    For instance….

    You describe the isolation unit as “very special”. Oh well that about covers how the unit’s HVAC, water supply/wastewater systens, solid waste, medical/biohazard waste, staff protocols, etc. are designed to ensure you don’t contaminate other parts of the hospital, or expose staff or the city at large to accidental infections.

    When responding to why the two could not be treated in situ (or perhaps a remote location/island/hospital ship). You completely dodge the point of the question, but spent ample keystrokes telling us what a fantastic facility you have. Apparently, you don’t have a good answer to that question, esp. since there is no treatment you would be able to provide that wouldn’t be possible in Liberia.

    Which makes your response to “When did you learn of the possibility of receiving these patients” appear similarly avoidant. I saw CDC Director, Dr. Frieden claim multiple times in interviews that the call to move the patients to the US was 100% the decision of Samaritan’s Purse. I find it extremely difficult to believe that the highest levels of the government (Obama Admin, NIH, Homeland Security, etc) were not involved in this very controversial decision. Dr. Frieden is an Obama appointee. Are you claiming he didn’t consult his boss on whether or not to bring Ebola to the US? To lay the responsibility for this on a charity, smells of political actors who are laying the groundwork to point fingers should you unleash a deadly disease. Perhaps you aren’t as confident in your “very special” facility as you claim.

    I hope you don’t end up with a body count due to a vainglorious desire for photo op back-patting and wanting to be a rock star at the next conference. I can assure you that the survivors will view your “mistake” as not merely homicide, but murder.

  • Emma

    I would like to second Kristen’s concern. This site was referred to me after I called the hospital in a panic asking how the waste was treated. All the representative said, and all it says here, is that the CDC has strict regulations. But this doesn’t change that bolidy waste containing a Class I virus which can be weaponized for bioterrorism is going into the municipal water system. This concerns me greatly. They can have their own floor and their HEPA filters, but if it is spread through bodily fluids, why wouldn’t they take more precautions with the urine and stool for the peace of mind of others? The public sewers? This is a disaster waiting to happen.

  • Will J

    As is the norm now a days, all we know is what is broadcasted on the news or read on social media. Unless we are in the isolation unit at Emory, we have no first hand knowledge of what is going on. Nor should we.

    They have as much a right to privacy as does the person two floors below them having a hip replacement.

    God bless the entire staff at Emory for taking on the task of caring for these sick individuals.

  • cthulhu

    While I have the utmost confidence in your protocols, could you go into a bit more detail of how they might be distinguished from the protocols at Texas Presbyterian, where your recent patient was exposed and contracted the disease? Could you inform the public as to how many of your protocols were indigenous v. how many were communicated by the CDC? And please pass on to those currently caring for Ebola patients, as well as the Ebola nurse patient — medicine is not a quick buck, or a career like any other…..it is a noble calling to service in the public interest — thank you for heeding that call.

  • Mary Ellen

    Are the staff treating patients with ebola quarantined? How do you monitor the staff’s heath? I think the mess with the nurse in Maine is appalling and I hope your people are treated with more reasonable protocols.