General Dempsey Is Alarmed About Ebola Global Spread
October 19, 2014 • 11:26AM

Chairman of the U.S. Joint Chiefs of Staff Gen. Martin Dempsey was belittled in a Foreign Policy online publication yesterday, which accused him of creating panic, when he told CNN in an interview Oct. 16 that he has been concerned about Ebola as a global threat for at least three months.

One of his points of concern was of the possibility that the virus can also be spread through the air, a violation of the CDC specification that it can only be spread through direct contact with bodily fluids, after a person infected with Ebola exhibits symptoms.

However, a study entitled “Respiratory Protection for Health-care Workers Treating Ebola Virus Disease (EVD): Are Facemasks Sufficient To Meet Occupational Health and Safety Obligations?” published in the November 2014 issue of the International Journal of Nursing Studies noted that despite the fact that the WHO and the CDC only recommended surgical masks for health-care workers treating Ebola, countries such as the U.K., and the frontline medical charity fighting EVD in Africa, Médecins Sans Frontières (MSF), have recommended the use of respirators, which are protective against aerosol infection. The study cited the case of two out of three control monkeys, housed in separate cages in a room with Ebola-infected monkeys, becoming infected. The study also cited cases of treatment of Ebola patients in South Africa: one in which a health-care worker treating another Ebola-infected health-care worker became infected while using only surgical attire; in the second case, health-care workers treating two Ebola-infected health-care workers in South Africa in 1996 used respirators for high-risk procedures, and no further infections occurred despite 300 potential contacts.

This study was authored by C. Raina MacIntyre, Abrar Ahmad Chughtai, and Holly Seale of the School of Public Health and Community Medicine, Faculty of Medicine, University of New South Wales, Sydney; Guy A. Richards, University of Witwatersrand Johannesburg and Critical Care Charlotte Maseke Johannesburg Academic Hospital, Johannesburg; and Patricia M. Davidson, Johns Hopkins University, Baltimore, Maryland, and University of Technology, Sydney.

In addition, a report by Lisa M. Brosseau, ScD, and Rachael Jones, PhD, which focused on protecting health-care workers from airborne infection, was published Sept. 17 by the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, which stated that “We believe there is scientific and epidemiologic evidence that Ebola virus has the potential to be transmitted via infectious aerosol particles both near and at a distance from infected patients.”

Dr. Brosseau is a professor and Dr. Jones an assistant professor at the School of Public Health, Division of Environmental and Occupational Health Sciences, at the University of Illinois at Chicago.

Documenting its conclusion, the report noted:

“The potential for transmission via inhalation of aerosols, therefore, cannot be ruled out by the observed risk factors or our knowledge of the infection process. Many body fluids, such as vomit, diarrhea, blood, and saliva, are capable of creating inhalable aerosol particles in the immediate vicinity of an infected person. Cough was identified among some cases in a 1995 outbreak in Kikwit, Democratic Republic of the Congo, and coughs are known to emit viruses in respirable particles. The act of vomiting produces an aerosol and has been implicated in airborne transmission of gastrointestinal viruses. Regarding diarrhea, even when contained by toilets, toilet flushing emits a pathogen-laden aerosol that disperses in the air.”

The report concluded that the CDC and WHO function under an outdated mode of thought when it comes to how infectious diseases are transmitted via aerosols, and, given the gravity of the crisis, opts for respirators, a more conservative approach of protection, to prevent a possible aerosol mode of infection for health workers, which obviously also applies to the general population.