Answering your questions on Ebola

Kristen Ehresmann, infectious disease director for the Minnesota Department of Health, answered questions from Star Tribune readers Monday about the Ebola outbreak that has killed more than 4,400 people in West Africa and created wide concern in the United States. Here is an edited excerpt. Read the entire session at www.startribune.com/ebola.

Q: CNN's headline this morning said, "Glimmer of hope in fight to stop Ebola." This is based on people moving off observation in Dallas, and on Nigeria and Senegal successfully stopping the spread of Ebola infections. Are we out of the woods, so to speak?

A: The news about Nigeria, Senegal and the community contacts in Dallas is wonderful! As long as there are cases occurring in West Africa, there is a risk of transmission to other countries, albeit a small one. However, there have been a number of efforts, like airport monitoring, put in place to reduce this risk even more.

Q: I'm in Chicago, and was going to fly to Minneapolis on Wednesday morning rather than drive back with friends. The Ebola scare and busyness of O'Hare has me thinking I should drive back. Am I crazy or on to something?

A: Given the seriousness of Ebola, it is reasonable to have some concern. However, individuals are being screened before they leave Liberia and then again when they are coming into the U.S. If someone gave me airline tickets to Chicago and I wasn't doing Ebola all day — I'd jump at the chance :-) You can feel safe flying.

Q: On a recent flight I noticed three separate people wearing masks. Do masks provide any protection from Ebola?

A: Ebola is not airborne. The way it is transmitted is with direct contact with blood, vomit, stool and other body fluids. So no, those masks really wouldn't do much.

A: Certainly all the media coverage keeps Ebola on the minds of everyone. The images of the late stages of Ebola, which can include bleeding from body orifices, are very scary. And speculation about the virus mutating to result in airborne transmission [NOT THE CASE] has caused a great deal of anxiety. Hysteria means that sometimes decisions are made to alleviate the public's fears but not based on science. That is not ideal.

Q: What does it mean for a virus to be airborne?

A: Airborne doesn't mean you were exposed on an airplane — nor does it mean that some body fluid flew through the air, e.g. projectile vomiting. Airborne means that the virus can actually hang in the air. In the case of measles, if a patient was in an examination room and someone else entered that room 45 minutes after they left — they could come down with measles.

Q: Are there cost concerns around how smaller hospitals prepare for this?

A: The Minnesota Department of Health is asking that all hospitals be prepared to assess and isolate a patient suspected of having Ebola. That means the hospital should be prepared for what is called standard droplet and contact precautions. But they should be prepared for that with any patient suspected of having an infectious disease. We don't expect that small rural hospitals would be in a position to provide ongoing care for someone with suspect Ebola — just be able to assess and isolate.

A: The [overall] fatality rate for Ebola is 50-90 percent. [Meaning the percent of all Ebola patients who die from it.] That rate improves greatly with early care and certainly with the resources available in the U.S. We have seen some very positive outcomes.