I’ve seen a lot of hysteria surrounding Ebola recently, and most of it isn’t grounded in reality. It’s a serious problem in West Africa right now, and it’s something we need to pay attention to, but the risk of Ebola becoming a serious problem in a first world country is incredibly low.

First, let’s discuss why Ebola is so scary.

Symptoms and Fatality Rate

Mayo Clinic lists the following symptoms for Ebola:

  • Fever
  • Severe headache
  • Joint and muscle aches
  • Chills
  • Weakness
  • Nausea and vomiting
  • Diarrhea (may be bloody)
  • Red eyes
  • Raised rash
  • Chest pain and cough
  • Stomach pain
  • Severe weight loss
  • Bleeding, usually from the eyes, and bruising (people near death may bleed from other orifices, such as ears, nose, and rectum)
  • Internal bleeding

Yeah… that’s scary. That list is bad enough, but the truly terrifying part is there is no treatment. Furthermore, early symptoms of Ebola are common to many diseases (headache, fever) so it can be difficult to diagnose early on. According to the WHO, Ebola has a case fatality rate of up to 90%; however, there has never been an outbreak outside Africa. All Ebola outbreaks have occurred in Central and West Africa where access to care is limited.

Freaking out yet? That’s normal, it’s a scary disease, but here’s why you shouldn’t worry (assuming you don’t live in Africa).


First, let me repeat something I just said. There has never been an Ebola outbreak in a country outside of Africa. That doesn’t mean there never will be one, but it is comforting.

We’ve established that Ebola is incredibly deadly, but that’s only part of the picture. The most important trait of any infectious disease is how it is transmitted.

We do not yet know where Ebola resides when there is not an outbreak, but it’s likely that an outbreak begins when a person comes in contact with an infected animal. Transmission can occur through direct contact (e.g. broken skin) with any of the following:

  • An infected person’s blood or body fluids (urine, saliva, feces, vomit, and semen).

Here’s a list of all the ways Ebola cannot be transmitted:

  • Through the air.
  • Through contaminated food.
  • Through contaminated water.
  • Direct contact with body fluids from somebody who is infected but does not have any symptoms.

The last bullet is probably the most important one. You cannot be infected by a person who is not currently showing symptoms. The most successful infectious diseases are able to infect others before any symptoms appear (I use the word successful from the point of view of the disease, not us). Ebola’s transmission is fairly benign compared to many other infectious diseases.

Prior to this year, there have been 2,387 known cases of Ebola since 1976. However, as of this writing there have been 1,310 confirmed cases just this year, with another 1,145 suspected cases. While this a tremendous tragedy, that’s a remarkably low number for an infectious disease with no cure, even counting this year’s cases.

For comparison, there are an estimated 3-5 million cases of cholera every year, with 100,000-200,000 deaths. Since 1976, an estimated average of ~24,000 people die from the flu every year in the United States. During the 2003-2004 flu season almost 50,000 people died from the flu in the United States. Now, it’s true that both of those diseases have effective treatments and primarily prey on young children and the elderly, but it still puts the Ebola numbers in perspective.


As I mentioned, we still aren’t sure how an outbreak begins, so there’s not much we can do to prevent that at the moment. However, there are many reasons why a first world country would easily be able to contain an Ebola outbreak. First, good access to care means that people would be diagnosed in a timely manner. Anybody who showed symptoms of Ebola would go in and get tested immediately, so you wouldn’t have people walking around with Ebola symptoms for very long. The governments are rich enough to provide free testing to anybody who can’t afford it.

Once Ebola is diagnosed then the only people who are at risk of infection are the healthcare workers and fellow patients of the hospital. First world hospitals all have facilities to isolate patients, so that wouldn’t be a problem. Beyond that, Ebola transmission to healthcare workers can be stopped with protective clothing (masks, gloves, goggles, the whole nine yards) and proper sterilization of equipment and facilities. Both of those steps are very simple for first world hospitals to implement.

In short, wear some extra clothing, use soap, and keep the patients isolated. These three things are notoriously difficult in poor countries and very easy in rich countries. That’s why you only see Ebola in Africa.

There are plenty of reasons to pay attention and care about the current outbreak in West Africa, but a fear of the disease coming to the US is not one of those reasons.