Germany's Ebola plan
July 14, 2014The virus travels unnoticed on an airplane. A group of young adventurers lands in Germany after a backpacking trip through the West African jungle. A few days later, most of them return to work, but one of the backpackers has a high fever.
At first he thinks it's just a normal case of the flu, but then he begins bleeding from all of his bodies' cavities, and his girlfriend calls the ambulance. She's beginning to suffer from headaches herself, and can feel a fever coming on.
Meanwhile, one of the fellow travelers, who works as a nurse for the elderly, is also starting to notice similar symptoms. By the time doctors issue a diagnosis of Ebola, dozens of people in Germany have been infected with the virus, and a few have already died.
This scenario is purely hypothetical. It sounds just like something from a disaster movie a la "Outbreak." Jonas Schmidt-Chanasit, a specialist at the Bernhard Nocht Institute for Tropical Medicine in Hamburg, says that while the risks shouldn't be underestimated, this scenario is far from reality: "It would be very, very rare for a virus from the affected areas to be brought to Europe." So far there hasn't been a single case of the Ebola virus disease in Germany.
Highly contagious pathogen
There are several reasons for this, says Schmidt-Chanasit. "The Ebola virus can't spread over large distances by way of small droplets."
Person-to-person transmission can only take place when someone has close contact with excretions from infected patients, he added. Doctors and nurses therefore face a high risk of infection, especially if they don't have the proper protection.
In West Africa, local customs play a big role, says Schmidt-Chanasit. "They keep many people at the ceremonies there, and they come into close contact with the secretions of ill patients and the deceased - and so they get infected with this virus."
Humans can also contract Ebola from infected animals, especially primates and bats. Meat from these animals is sometimes sold at markets in West Africa, and should be avoided at all costs.
People who've been infected usually don't travel over large distances because the incubation period - the time between infection and onset of the disease - only takes a few days. "The normal population in these remote areas actually has no way to travel to Europe. That means they can only really affect the on-site support staff, who usually come from Europe or other countries."
Quarantine is crucial
Nevertheless, Germany would be well prepared in the unlikely event of a virus infection in Europe. There are contingency plans in place at all major airports in case a patient carrying the relevant symptoms lands in the country.
At the beginning of July, there was a practice drill held at the Cologne/Bonn Airport in collaboration with the Cologne-Holweide Hospital. "It was really a coincidence that the exercise happened at the same time as this outbreak, because it had been planned for months," said Michael Krakau, a senior physician at the hospital.
The clinic has an isolation ward just a few minutes drive from the airport. "The patient would be taken to the hospital in a special isolation ambulance, and driven right up to the room," said Krakau. "The station is hermetically sealed off from the rest of the hospital. The air pressure in the room is lower than outside, so no air can escape. And any waste is specially collected and disposed of."
Beware the mosquito
But why is such a huge effort necessary to seal the room if the disease doesn't even spread through the air? "We would treat the patient in a special isolation ward because the virus is so dangerous for those affected," said Krakau.
Effective medication to combat the virus doesn't exist. And symptoms can only be treated in intensive care, in some cases preventing the disease from taking a deadly course.
But experts say there are other tropical diseases that pose a greater risk to Germany than the possibility of an Ebola infection at one of the country's airports.
"There are pathogens transmitted by mosquitoes, and they have a completely different capability," said tropical medicine expert Jonas Schmidt-Chanasit. These mosquito-borne diseases could certainly affect Germany, he says.
"We have around 1,000 registered cases of the dengue virus each year in Germany, and there's also a high number of unreported cases. There's a real risk that these viruses could be here at home - at least for a short period this summer."