Ebola Makes Its American Debut

by, Christine Coe

The first case of Ebola in the United States, was officially confirmed yesterday, September 30th by the Center of Disease Control in a widely televised press conference.  According to Thomas Freidan, director of the CDC, the patient identified as Thomas Eric Duncan, was admitted to Texas Health Presbyterian Hospital in Dallas, Texas on September 28th where he is conscious and able to communicate ,but in critical condition.    The patient has been carefully isolated behind glass in what a hospital spokesperson described Tuesday as “a robust infection control system” assuring the public that hospital officials have been meeting for weeks in careful anticipation and planning for what Barack Obama told the country just two weeks ago was very unlikely.

International Traveler 

How unlikely was Ebola’s debut on American soil, and now that it has arrived on a direct flight from Liberia, via a Liberian national, and through the very airports Obama promised would never allow it to “get on a plane” how unlikely is Ebola to breach the carefully constructed confines of its technological glass chamber?   After all, Friedman insisted only yesterday that, “no doubt that we will control this case of Ebola so that is does not spread,” yet today he has reluctantly had to admit that a second possible Ebola patient is being monitored who had shared close contact with Duncan.

Who Are They?

The Center for Disease control is now tasked with the complicated mission of identifying and locating all those whom might have come in contact with Duncan since he crossed the Atlantic.   Because the virus is spread through direct contact with bodily fluids and blood only during the infectious stage at which victims elicit symptoms, the CDC is only concerned with those people who shared contact with him after the onset of illness.

Contagion

Duncan, we are told, was asymptomatic when he boarded his flight on September 19th and reports feeling ill on September 24th.   Though he visited a hospital emergency room on the 26th, antibiotics were administered and he was promptly released.    He was only admitted after arriving by ambulance Sunday, September 28th.    If we are to accept that Duncan was asymptomatic and not contagious on his transatlantic journey, we are left with a timeline that allows for upward of five days in which he may have infected countless people around him including the ambulance transit team whom are not being monitored.

Contact With Children

Indeed, the NY Times today reports that Duncan came into contact with five school age children who attend four different schools: Hotchkiss Elementary, Dan D. Rogers Elementary, Tasby Middle School and Conrad High School.   A fifth school, Jack Lowe Elementary is also being watched because it’s close proximity to Tasby.   Each possible contact broadens the prospect of Ebola taking up new residence in the United States, but swift containment and monitoring of all individuals is key to containment and the prevention of mass outbreak.

Secondary Infections?

It is the unknown secondary infections that are most disconcerting to those tracking the disease and not all will agree on the ease at which Ebola may be contained.   According to researchers Gerardo Chowell-Puente, associate professor of Arizona State University’s School of Human Evolution and Social Change in the College of Liberal Arts and Sciences, and Hiroshi Nishiura at the University of Tokyo, each new incidence of Ebola infection yields another 1 – 2 new infections.

 “Our analysis of the reproduction numbers of Ebola cases shows continuous growth from June to August 2014 that signaled a major epidemic,” Nishiura said. “Uncontrolled cross-border transmission could fuel a major epidemic to take off in new geographical areas, as was seen in Liberia.”   In fact, from June to July, both in Sierra Leone and Liberia, transmission rates average between 1.4 and 1.7 for each case of infection.

Analysis

Researchers analyzed case counts of Ebola virus disease by the World Health Organization as of Aug. 26, 2014. Two groups of data were used: confirmed and probable cases; and the total number of reported cases (confirmed, probable and suspected cases).

Given these current rates of infection, the disease begins to spread at exponential proportions markedly increasing the risk of a pandemic.   Friedman himself recently returned from a trip to West Africa in which he stated on a CNN interview that the outbreak in Africa is “completely out of control” adding that “it will get worse in the future and our window of opportunity to turn it around is closing.”

And, also given that Ebola has just arrived, that window of opportunity is wide open for America, and containment is not only possible, it is probable if approached with extreme vigilance.  There is no cause for hysteria and reactionary measures, but caution must prevail and the risk is very real.

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