"I favor it, because it's not entirely clear that they can't transmit the disease," Beutler said.... "It may not be absolutely true that those without symptoms can't transmit the disease, because we don't have the numbers to back that up," said Beutler, "It could be people develop significant viremia [where viruses enter the bloodstream and gain access to the rest of the body], and become able to transmit the disease before they have a fever, even. People may have said that without symptoms you can't transmit Ebola. I'm not sure about that being 100 percent true. There's a lot of variation with viruses." In fact, in a study published online in late September by the New England Journal of Medicine and backed by the World Health Organization, 3,343 confirmed and 667 probable cases of Ebola were analyzed, and nearly 13 percent of the time, those infected with Ebola exhibited no fever at all.
New Jersey Gov. Chris Christie's (R) handling of the Kaci Hickox incident, and the Ebola threat in general, has drawn quite a bit of criticism, but the Republican governor believes he has a trump card. In several recent interviews, Christie has emphasized that his policy obviously has some merit, since it's been endorsed by Dr. Bruce Beutler, who won the Nobel Prize for Medicine and Physiology in 2011.
A local report out of the Garden State today noted Beutler's thinking on the subject (thanks to my colleague Tricia McKinney for the heads-up).
As it turns out, that may not be quite right. In fact, the New England Journal of Medicine has actually said largely the opposite. As we noted yesterday, the NEJM, arguably the nation's premier medical journal took the unusual step of intervening in a political debate, questioning the value of Christie's policy, and specifically concluding, "an asymptomatic health care worker returning from treating patients with Ebola, even if he or she were infected, would not be contagious."
But about that "nearly 13 percent" figure?
My colleague Will Femia tracked down the original study, and this appears to be the relevant reference: "The most common symptoms reported between symptom onset and case detection included fever (87.1%), fatigue (76.4%), loss of appetite (64.5%), vomiting (67.6%), diarrhea (65.6%), headache (53.4%), and abdominal pain (44.3%)."
So, as my colleague Will Femia explained, the New England Journal of Medicine found "some people may not initially have a fever among their symptoms, but asymptomatic people, even if infected, are not contagious."
That's not quite what nj.com readers were told this morning.
For more along these lines, Stephen Goldstein has a worthwhile piece yesterday, noting that the available research on infections is "not as ambiguous as debates in media have made them seem."