Ebola Versus Enterovirus Versus the Flu: What You Need to Know

Some of the ultrastructural morphology displayed by an Ebola virus virion is revealed in this undated handout colorized transmission electron micrographIn light of all the recent news stories swirling around about Ebola, the flu, and even Enterovirus, it’s important to know what’s accurate and what’s not. Being well-informed is your best defense towards handling any health-related situations related to these three top concerns. Right now, Ebola is certainly getting a lot of attention not just in the global sphere but in the United States as well. In fact, while the virus has had a limited reach within U.S. borders at this time, nearly forty percent of people consider Ebola a “major or moderate” threat to the public health of the country.

This article helps to understand three of the major health concerns being mentioned in media stories at the present time: Ebola, Enterovirus, and the flu. The impact of each virus is explored through a variety of factors, including rate of spread over time, the percentage of the population that could be affected by the spread of the virus, mortality rates, methods of transmission, methods of prevention, recurrence rates, chances of the virus becoming resistant, and likelihood of becoming airborne.


On face value at the global level, Ebola is certainly disconcerting: the CDC has already named the epidemic “the largest in history”. The outbreak is especially heartbreaking in West Africa, although healthcare workers and others working in the region increase the risk for U.S. impact.

How Infection Happens

The incubation period for Ebola lies somewhere between two to 21 days, but the average cases reported have an incubation time of between 8 and 10 days. Symptoms of Ebola mirror other viruses, but should always be checked out by a trained physician to obtain an accurate diagnosis. Those symptoms include stomach pain, vomiting, severe headaches, unexplained bleeding, muscle pain, and diarrhea.

Ebola can be spread through bodily fluids and direct contact with blood, but it cannot be spread through food, water, or the air. Those most at risk are those individuals who have had contact with other patients affected by the Ebola virus. If you believe that you have been possibly affected by Ebola, you need to check yourself for symptoms for a period of 21 days and discuss your exposure risk with your doctor. Since Ebola can be deadly, it’s better to be safe than sorry if you are experiencing the symptoms listed above.

West Africa Ebola virus disease outbreak - All Cases

                                                                Source: International SOS

Treatment Options

There is no vaccine or cure to treat Ebola at present. The National Institutes of Health are pursuing human testing on a new possible Ebola vaccine, but that trial just began this fall. The goal is to wrap up that testing before the end of 2014.

The only treatment options are present are transfusions, breath machines, IV fluids, and medications that can help to control blood pressure, but these are primarily supportive treatments and not cures.


The World Health Organization reports that more nearly 14,000 cases of Ebola are present in Sierra Leone, Liberia, and Guinea, with nearly 5,000 people having already passed away from the virus. Outbreaks of the virus in Nigeria and Senegal have been reported as now under control according to the WHO.

The current strain of the virus that is infecting patients is very deadly, known as Ebola Zaire. It ends up taking the lives of 9 out of 10 patients, but those statistics do not account for factors like access to modern medical care, which varies by country. Pittsburgh infectious disease doctor Amesh Adalja says that it’s very difficult to obtain accurate death rates for Ebola if the disease were being treated in modern hospitals with the technology available in intensive care units. This is part of what makes understanding and treating the disease different scenarios in West Africa and Canada or the United States.

Risk Evaluation

Despite the fact that Ebola has been a documented concern since the 1970’s, not enough is known about it yet. While some people are severely affected by the symptoms and die, others are able to survive and researchers are not sure what separates one group from another. Researchers are also looking into how Ebola has been able to mutate or resist treatments. Sadly, the risk factor for Ebola remains concerning at this time because of the lack of known information about the virus.

Enterovirus D68

Although Ebola has captured the primary headlines in newspapers around the country, more citizens are growing concerned about Enterovirus 68 as well. The virus causes afflicted patients to suffer from respiratory issues, although in more severe cases muscle paralysis has also been reported. To date, nearly 600 children across 45 separate states have become infected with this virus. For the most part, those patients have recovered quickly, but five children have also passed away.

The fact that there are more cases presently of Enterovirus within the United States generates questions about whether so much of the focus right now should be about Ebola.

How Infection Happens

Enterovirus infection impacts the respiratory symptoms, so sputum, saliva, or nasal mucus can all spread Enterovirus. A mix of a few Enteroviruses circulates every year in the United States, having been reported to the CDC since 1987. Symptoms that you have been impacted are runny nose, sneezing, cough, muscle aches, wheezing, and body aches. If you are having trouble breathing, it’s important to schedule a consultation with your physician.

At present, the Enterovirus spread in the United States is the biggest outbreak of EV-D68 that has ever happened. More than 600 cases have already been reported in the United States.

Treatment Options

There’s no specific treatment or cure out there for Enterovirus at this time. Symptom management, however, is an option. Although there are no antiviral medications available for patients infected with Enterovirus, hospitalization can be a measure recommended for patients with more severe respiratory infections.

Risk Evaluation

If you suspect that you or your child is infected with Enterovirus 68, getting medical attention in important, but you are not facing as high of a risk as a patient suffering from the flu or from Ebola. Take care to prevent the spread of the virus to other people who implementing rest and nutritional guidelines recommended by your physician.

The Flu

A yearly occurrence, flu season generates concern across the country, with everyone from parents of small children to elderly individuals wondering how to prevent it. The flu has already been documented as deadly in past seasons, even though Enterovirus and Ebola are garnering more headlines in the last few months.

According to the Centers for Disease Control and Prevention, between 1976 and 2007 the average annual deaths from the flu alone hovered above the 23,000 mark. Although certainly cases of Ebola and Enterorvirus have spiked fear as a result of deadly symptoms and painful suffering, flu spread should be a greater concern at the present time in the United States.

How Infection Happens

Influenza is known for being highly contagious, especially for any individuals who don’t have the pre-existing antibodies that help to protect against flu (like younger children). Spotting symptoms of flu can be difficult, since up to 50 percent of all infections don’t have symptoms. Children are the most likely to have asymptomatic flu. Symptoms that you have been impacted by the flu include a fever of 100 degrees Fahrenheit or higher, a runny nose, chills, fatigue, nausea, headaches, body aches, vomiting,  and nausea.

The flu is primarily transmitted through direct contact by and droplets (like coughs or sneezes of an infected person). Indirect contact, like touching an inanimate object also touched by an infected person, is another way that you can contract the flu.

Treatment Options

The flu, unlike Ebola and Enterovirus 68, can be prevented. Your chances of contracting the flu can be significantly reduced by getting a flu shot. You can visit your doctor, but most people who contract the flu “ride it out” by staying home, drinking plenty of liquids, and focusing on rest. If your symptoms start to worsen or seem severe from the outset, make sure to get medical attention. The flu can be fatal, especially in vulnerable populations.

Risk Evaluation

Although those who suspect Enterovirus should take their symptoms seriously the likelihood of death is much lower with this virus than the flu or Ebola. Ebola’s high mortality rate in West Africa is worth considering, and the fact that so many people in the U.S. pass away from the flu every single year is also important to remember.

Death By Virus

As the chart above indicates, while Ebola has a high death rate since the outbreak began, annual flu deaths are also still disturbing in the U.S. The public should be aware of the dangers associated with both.

Final Thoughts

All three of these viruses carry some risk, and experiencing any of the symptoms associated with them should be taken seriously. Attempting to compare flu to Enterovirus 68 to Ebola is like evaluating apples versus oranges: the ability to treat the viruses, the amount of information that is known about them, and the environmental factors that influence populations affected by the viruses all vary. Flu can be quite deadly based on reported deaths alone in the U.S., but it also infects many more people, making the mortality rate for flu lower. It’s impossible to know just how quickly Ebola might spread if it became a rampant issue in the United States simply because of the differences in medical treatment along between West Africa and North America. Simply by the fact that it has such a high death rate in West Africa, Ebola could be considered the deadliest of the three, but this fails to capture the many people who pass away from the flu.

Citizens would do well to continue educating themselves about these viruses, washing their hands and taking other spread prevention tips under advisement, and reporting any potential symptoms to their medical professionals.

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