[Jim Noble]

I think the epidemiological data support the concept of transcutaneous infection. Whether this mechanism involves follicular dendritic cells, epithelial cells or others is unknown at present and will be for some time.

I work with PPE every day. One of my favorite observations is "for VRE, nobody does it right. For meningococcal meningitis, everybody does it right".

Even given the catastrophic conditions in West Africa, the attack rate among HCWs with access to PPE is extraordinary. I think this is most consistent with transcutaneous (intact skin) infection with an extremely low ID₅₀.

Scary stuff.

[ElenaM]

Transcutaneous transmission would explain the multiple times I’ve heard physicians on the ground insist that not a single square millimeter of skin can be exposed in the treatment wards.

What a nightmare scenario.