CDC Removed Info On Coughing And Sneezing From Ebola Q&A (UPDATE)

WASHINGTON -- The Centers for Disease Control and Prevention has quietly removed some Ebola information from its website. The changes follow claims from news outlets and conservative blogs that the agency hasn't been forthcoming about how the virus spreads, but it was not clear on Thursday afternoon whether the removal was related to the reports.

The New York Post reported Tuesday that the agency "admitted" Ebola can be contracted through casual contact with a doorknob, seemingly contrary to the CDC's insistence that Ebola is only transmissible through direct contact with bodily fluids from a person sick with the disease. The Post cited a page on the CDC's website that said Ebola spreads through droplets that can travel short distances when a sick person coughs or sneezes.

Meryl Nass, an internal medicine physician in Ellsworth, Maine, first highlighted the page on her own blogover the weekend.

The page was a PDF document that explained the difference between infections spread through the air or by droplets. The PDF had been taken down as of Thursday afternoon, with this message in its place: "The What’s the difference between infections spread through air or by droplets?Fact sheet is being updated and is currently unavailable. Please visit cdc.gov/Ebola for up-to-date information on Ebola."

An earlier version of the page is still available in Google's cache. It said that while Ebola is not "airborne" like chickenpox or tuberculosis, it can travel a few feet in the air inside droplets emitted when someone coughs or sneezes.

"A person might also get infected by touching a surface or object that has germs on it and then touching their mouth or nose," the document said.

The CDC has also changed an Ebola Q&A, deleting the below question about coughing and sneezing (which are not typical Ebola symptoms):

Can Ebola spread by coughing? By sneezing?

Unlike respiratory illnesses like measles or chickenpox, which can be transmitted by virus particles that remain suspended in the air after an infected person coughs or sneezes, Ebola is transmitted by direct contact with body fluids of a person who has symptoms of Ebola disease. Although coughing and sneezing are not common symptoms of Ebola, if a symptomatic patient with Ebola coughs or sneezes on someone, and saliva or mucus come into contact with that person’s eyes, nose or mouth, these fluids may transmit the disease.

The version of the Q&A still online notes that Ebola can survive on doorknobs for several hours. The removed question is available in Google's cache from Oct. 29.

What's strange about removing the coughing-and-sneezing question is that it has been reposted all over the internet, including at news outlets like the Washington Post in early October, on state public health agency websites, and on blogs like Democratic Underground and Daily Kos.

A CDC official said the agency is continually updating its website. "This particular Q&A is being updated to ensure people understand that Ebola is not an airborne virus like the flu and will be reposted soon," the official said in an email.

Asked about the possibility of Ebola becoming airborne at an Oct. 7 press conference, CDC Director Tom Frieden said Ebola hasn't spread that way before and is unlikely to mutate into an airborne form.

"Ebola spreads by direct contact with someone who is sick or with the body fluids of someone who is sick or died from it," Frieden said. "We do not see airborne transmission in the outbreak in Africa. We don’t see it elsewhere in what we’ve seen so far."

UPDATE: 10/31/14, 7:41 a.m. -- The CDC has added a new answer about coughing and sneezing to its Ebola Q&A. The new answer emphasizes that the virus doesn't spread that way:

Can Ebola be spread by coughing or sneezing?

There is no evidence indicating that Ebola virus is spread by coughing or sneezing. Ebola virus is transmitted through direct contact with the blood or body fluids of a person who is sick with Ebola; the virus is not transmitted through the air (like measles virus). However, droplets (e.g., splashes or sprays) of respiratory or other secretions from a person who is sick with Ebola could be infectious, and therefore certain precautions (called standard, contact, and droplet precautions) are recommended for use in healthcare settings to prevent the transmission of Ebola virus from patients sick with Ebola to healthcare personnel and other patients or family members.

UPDATE: 10/31/14 2:00 p.m. -- The CDC has replaced the document describing the difference between airborne infections and ones that spread via droplet. A key change is that the airborne section stresses that airborne germs "can be inhaled even after the original person is no longer nearby." Droplet germs, by contrast, "travel shorter distances, less than about 6 feet from a source patient." Ebola is the latter type of germ.

This article has been updated to include the CDC's response.