There are several infections that I am naturally scared of. One of these is Ebola virus disease (Ebola hemorrhagic fever) caused by one of several strains of an Ebola virus. It isn’t the only virus capable of causing a hemorrhagic fever however. Lassa fever, Marburg virus fever, yellow fever, which used to cause epidemics in the US, and even dengue, which has found its way to the United States, cause hemorrhagic fevers too.
These viral hemorrhagic fevers are found worldwide. They are zoonotic which means they live naturally in an animal host or arthropod vector. Sporadically they cause human infection. Some like Ebola can be transmitted from person-to-person.
Initial symptoms of most viral hemorrhagic fevers are vague including fatigue, muscle aches, and fevers. Sounds like many other viral infections such as influenza and malaria right? Severe cases explain the name “viral hemorrhagic fever” as these patients have both internal and external bleeding leading to shock which means their organs start to shut down and eventually death.
Like many viral infections out there, we do not have specific treatment nor vaccines. All we can offer is supportive care, that is fluids, painkillers, and rest. That’s what makes them scary. You just have to wait it out and see whether you will be a survivor or a victim. Ebola in the past has killed over ninety percent of those infected. Yikes! Therefore, prevention is of foremost importance. Vaccinations if available, like it is for yellow fever; controlling and avoiding contact with host species like bats and rodents and their habitats and droppings; controlling arthropod vectors like ticks and mosquitoes through infrastructure and public health measures but also through personal use of insect repellant and bed nets are some of the prevention methods we can undertake.
But am I currently scared of the ongoing Ebola crisis in Liberia, Guinea, and Sierra Leone? Rather simply, the answer is no. Don’t get me wrong. It is a scary situation. These countries have not seen an Ebola outbreak like this before. In fact, the world has never seen an Ebola outbreak like this ever. Already more than 700 dead and no clear end in sight. It’s unprecedented. I’m concerned and saddened. I worry about when and how this current outbreak will end, because end it will. But I’m not personally scared and most people in the world should not be either.
It’s easy for me not to be scared really. After all I live in the United States and I don’t plan to travel to one of those countries affected anytime soon. If Ebola does make it into the United States, which it could since we live in a global world, we have the capabilities to quarantine people effectively. On a personal level, if I get called to the emergency room to see a patient with a flu-like illness or a gastroenteritis-like illness who has recently been in West Africa I know I have easy and reliable access to protective gear.
I say all this because despite this current Ebola outbreak being ongoing since at least February of this year, it’s as if “shit just hit the fan” this past week with the death of Mr. Patrick Sawyer, and with the announcement that an American doctor and an American hygienist in Liberia have also been infected. Mr. Sawyer, a Liberian-American fell ill on a flight from Monrovia, Liberia to Lagos, Nigeria, with a stop in Lome, Togo, and collapsed upon arrival in Nigeria. The American health care workers are currently quarantined in Liberia and I’m sure will soon be airlifted to the US.
I do remember about three weeks ago when a sick American was quarantined in Ghana for concern of Ebola. Luckily, that person did not have Ebola. My heart did skip a beat and I prayed and hoped that the illness would not be Ebola because that’s how little faith I have in the Ghanaian health care infrastructure. I remind myself of the lack of facilities at the premier teaching hospital of Korle-Bu. I can only imagine that other hospitals in the public sector have it worse.
For some odd reason though, with this Ebola death in Lagos, Nigeria, I trust that Nigeria will be effective in not having this virus run amok in that country. At least, unlike the rural areas of Liberia, Guinea, and Sierra Leone that have been hardest hit, Lagos is a city and Nigeria a rich country. I would hope that people there are more educated and motivated to take their sick ones to the hospital. Willing to isolate and quarantine them without stealing them back from the hospital to take them to a witch doctor or to take care of them themselves at home. Willing to have the dead bodies of their loved ones disposed of quickly and safely without insisting on all the protracted customary rites that only expose them to infected fluids.
On the flip-side I would hope that Nigeria would try to remove whatever barriers that might prevent a sick person from seeking care; barriers such as the fee-for-service system which requires health care to be paid for up-front. I would hope that people are being educated not to automatically assume that a febrile illness is malaria and try to self-treat at home. I would hope that the Nigerian doctors and nurses don’t run away from the hospitals en masse afraid for their own lives. But maybe I have too much faith in Nigeria. This is the same country which did not care to retrieve over 200 kidnapped girls after-all. Hmmm! By, the way, Ghana too says it’s ready. Okay, if they say so.
The bottom line is that though the epidemic is worsening in West Africa, there is little risk of an epidemic across the US or even Europe. But you wouldn’t know it from all the speculation on the airwaves these past few days. Even if a person infected with the virus is able to board a plane and arrive in the US, like Mr. Sawyer would have eventually done if the timing had been right so to speak, there is actually little risk of transmission. This is because transmission requires contact with bodily fluids. It doesn’t happen via breathing the same air. But let’s assume a transmission does occur in the US. A country such as this has the infrastructure to test and quarantine thereby stemming the infection before it becomes an epidemic.
I think if Western countries are truly concerned then they should offer help. Offer to screen passengers at airports in the affected countries so as sick people do not leave the country. Offer the necessary personal protective gear for the medical workers in those countries. Offer supportive intravenous fluids to the sick. Offer improved and faster diagnostics so it’s easier to discriminate between those who actually have Ebola from all the other feverish, achy people who have malaria or another illness.
Staying tuned to this one.
Leave a Reply