10/23/2014 12:15 pm ET Updated Dec 23, 2014

How Ebola Spreads


In the wake of a blog I posted earlier this week regarding my experience with hazmat, I noticed in the comments that what is most confusing about Ebola is the transmission -- or rather, the contradictory reports about how the virus spreads and infects. While the hazmat information I provided was interesting, it did little to quell the concerns of those who read the blog.

One major area of confusion around the transmission of Ebola is whether or not it is airborne. In the blog I wrote, I sort of glazed over the concept of airborne vs. aerosolized, and I realized that this was a major disservice to readers. I'll try to explain it better. Before I do, though, I just want to remind you that I am not a nurse, or an epidemiologist or even a scientist. The information that I'm communicating to you is available via the CDC and to a near limitless extent in the Google Scholar archives. I'm not trying to tell you things you already know, I'm just trying to frame it in a way that is easier to understand than what is being pumped out into the media at present.

Ebola lives in your spit, blood, poop, urine, semen, breast milk, sweat, snot and tears. Coming into contact with any of these can spread the infection. What does contact mean? Well, we say "contact" because if you get any of these on your skin, especially your hands, there is a risk that you will get some in your mouth or nose (like if you are eating or, well, picking your nose) or that there will be small cuts on your skin that will be an open door for the virus to enter your body. This is why people who are treating those infected with Ebola need to wear protective gear.

The CDC says that coughing and sneezing can, in theory, spread Ebola because it lives in the spit and snot of the infected person. However, Ebola doesn't cause coughing and sneezing like influenza does, so it's more likely that Ebola would spread through vomit or diarrhea, which are the primary symptoms of the illness.

If someone with Ebola sneezes and you get snot on your arm, then you have had direct contact with the virus. If someone sneezes in the room with you, and you do not get sneezed on directly, you wouldn't be exposed. It's not like influenza, where when you sneeze and send sneeze bits out into the world they float along the air and get inhaled by other people who then get sick. Someone has to sneeze or spit on your skin or in your face/mouth/eyes, etc. This kind of transmission has been observed in chimps that have been in Ebola studies as a means of transmission because chimps spit and throw poop at each other a lot.

I erroneously said that you can't kill Ebola -- by which I really meant that you can't cure it. You can, however, kill the virus with bleach. It's like Norovirus in that sense. Norovirus is enough virus that is spread through direct contact, much of which comes from vomit and diarrhea, and it is very contagious. However, it is killed by bleach, and you can protect yourself from it through good hand washing practices, which is true of most viruses -- Ebola included.

We do not know for sure whether there is any long-term immunity to Ebola once a person has been infected. It would make sense that there would be antibodies at least for a while in the body of a person who has recently been infected, but this is just conjecture.

The big takeaway? Where would you be most likely to get Ebola? If you're a health care worker, you're most likely to get it in the hospital or clinic where you work if you're treating an Ebola patient and not using personal protective equipment, or your PPE is faulty in some way. If you are not a health care worker, you're most likely to contract the virus if you are caring for a friend, neighbor or family member who has Ebola and you are not protecting your skin, mouth and eyes from the vomit, spit, blood and poop of the person you're taking care of.

If you are not in either of these categories, it is unlikely that you would become infected with Ebola unless Ebola became so widespread that the streets were overflowing with the dead bodies of Ebola victims, sick people who are vomiting and bleeding in the streets or, you are traveling to the countries in Africa (Liberia, Sierra Leone, etc.) where this is actually the case.

I'm not telling you any big secrets. I'm not even giving medical advice or telling you anything that you couldn't have learned yourself. The difference is, I'm attempting to put it into perspective and provide actionable information that isn't filled with jargon and half-truths and promises that can't be kept. That's all I'm trying to do.