Ebola In the United States

The inevitable has occurred. While there have been four patients with Ebola physically present somewhere in the United States at some point this summer, today it has been announced that for the first time, a patient has been diagnosed with Ebola in the country.

This is an announcement of historical proportions. Never before has Ebola viral disease been diagnosed in a patient outside of the African continent. Granted, the report states the patient left Liberia, not sick, to visit family in Texas, then started to get sick on his fourth day in the country. So, he clearly acquired the infection in Liberia.

I listened to the CDC press briefing this evening. I heard the questions asked over and over again. I made the mistake of reading reader comments on the CDC Facebook page. Ignorance is deadly. I already knew that. Ignorance has contributed in part to the current epidemic in West Africa after all.

I recall a saying that I first heard in my early teens.

He who knows not and knows not that he knows not is a fool, avoid him
He who knows not and knows he knows not is simple, teach him
He who knows and knows not he knows is asleep, wake him
He who knows and knows he knows is wise, follow him

Simply put, the Ebola virus, while capable of causing an infection with a high mortality rate, is not easily spread like norovirus or influenza. Once infected, it can take anywhere from a couple of days to three weeks for the person to show symptoms. Symptoms that start as non-specific as fever, headache, body pains (which could be anything) to later nausea, vomiting, diarrhea, before the characteristic hemorrhagic shock at which point the patient is clearly critically ill.

But, an infected yet asymptomatic patient is not contagious. A patient who has fully recovered is not contagious. It’s only a symptomatically sick person that can spread disease and to do so one would need direct contact with bodily fluids or exposure to contaminated objects like needles. Not by breathing the same air. Not through casual contact.

We know this because there are scientists who have studied the virus and doctors who have observed patients in earlier outbreaks.

So it’s disturbing to hear the media press on and on for details about the flight this person in Texas took from Liberia to the United State to be released. It serves no purpose but fear-mongering. No-one on that flight is at risk. It’s heart-wrenching to read on the CDC Facebook page, reader comments such as “Way to go CDC, you morons”, and “CDC=Morons. Zero confidence here”. I know I’m not supposed to be reading internet comments, but wow, people have watched one too many Hollywood movies and have warped their high school science into amazing junk science and conspiracy theories.

You know why Ebola in West Africa is an epidemic now? Because neither one of the countries initially involved, Guinea, Sierra Leone, and Liberia, has anything close to a CDC to boast of. Early recognition and detection of an outbreak, dissemination of information, contact tracing, public health and infection control methods all are extremely effective. Of course, it would help if there was clean water, good roads, reliable electricity, doctors and nurses en mass, and other basic infrastructure. After all, these hard hit countries are either extremely poor or trying to recover from recent civil war or both. Look at Nigeria and Senegal that have subsequently recorded Ebola infections in their countries. Contained!

Americans should be proud of their Centers for Disease Control and Prevention rather than spitting vitriol at it and cutting its funds. I really am disgusted that anyone can think ill of them. But then again, I should not be surprised. The reader comments to the CDC statements are akin to the treatment I get from some patients I’m trying to help.

A little knowledge is a dangerous thing.

Meanwhile, let’s hope that the patient in Texas recovers. Let’s hope that none of his close contacts since the time he became symptomatic get infected. Let’s hope that the health care staff on the frontline of his care don’t get infected. I would love a peek at the records though to see why anyone seeing an ill recent traveler from Liberia would send him home.

I for one am glad that there is a department of health in Texas and that there is a Centers for Disease Control and Prevention in the United States even if no-one else is grateful they exist and no-one else seems to realize how much worse things would be if they were not doing their job.