Ebola rears ugly head in America

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ebolaEbola Comes To America: First U.S. Case Just Diagnosed In Dallas

Ebola has arrived in America. A patient in Texas has been diagnosed with the deadly disease, the CDC confirmed on Tuesday.

It is the first case of Ebola diagnosed in the United States. That?s an important distinction because ? unlike the medical workers who contracted Ebola in Africa and were flown back to the United States for treatment ? the new Ebola patient could?ve been circulating in the general U.S. population, potentially spreading the disease.

From Last Week: Is Ebola Coming To America? Experts Ponder As Ebola Epidemic Rages In Africa

However, experts have stressed that Ebola does not transmit easily, but instead requires ?intimate? contact with someone who?s infected. ?Ebola poses no substantial risk to the U.S. general population,? CDC said earlier this month.

The U.S. patient diagnosed with Ebola is a man who was traveling in Liberia, and he started showing Ebola symptoms four days after returning. The man has been placed in ?strict isolation,? according to a statement from Texas Health Presbyterian Hospital of Dallas.

In a briefing on Tuesday, CDC officials stressed that because the man was not symptomatic with Ebola while flying, there was ?zero risk? of transmission for other passengers on the plane. They also vowed that public health officials ?would stop [Ebola] in its tracks in the U.S.?

Outbreak Currently Raging In Africa

As I wrote about for Forbes last week, the current Ebola outbreak in West Africa is already the worst on record. And it?s only gotten worse.

More than 3,000 people have died, and CDC estimated that as many as 1.4 million people in Liberia and Sierra Leone could contract Ebola by January 20. That?s about one in seven members of the population.

(For a sense of perspective on CDC?s worst-case scenario for West Africa: If a similarly sized outbreak happened in the United States, more than 45 million Americans would contract Ebola.)

Ebola has hit doctors and nurses especially hard: More than 200 health care workers have already died from the current Ebola outbreak in Africa.

And that?s a reminder that the Americans who initially treated the Texas patient diagnosed with Ebola might be at elevated risk. ?What wasn?t said in the CDC Ebola briefing,? reporter Helen Branswell pointed out on Twitter. ?Where did the patient seek care on Sept. 26? Did his visit lead to [health care worker] exposures??

The longer the Ebola outbreak goes on, the greater the chance that the disease could mutate, too. Scott Gottlieb, who served as a top FDA official under President George W. Bush, has warned that there?s even a chance that Ebola could go airborne, although other experts are pessimistic.

The World Health Organization also warned that given the scale of the outbreak, there?s a possibility that Ebola will go from epidemic to ?endemic? in West Africa ? essentially, the disease won?t go away, but continue to afflict the local population. That?s ?a prospect that has never previously been contemplated,? WHO researchers wrote in the New England Journal of Medicine.

Writing in the Washington Post on Monday, epidemiologist Gerardo Chowell-Puente noted that each case of Ebola in the current outbreak is producing about 1.3 to 1.8 secondary cases, on average. And that pace of transmission is especially troubling given Africa?s weak public health response, Chowell-Puente writes:

To break the chain of the current Ebola epidemic, our numbers show that health-care workers need to stop about 50 percent of infectious contacts by effectively isolating people who are infectious?

The trouble is that the countries suffering from outbreaks have weak health-care systems ? perhaps too weak to halve the number of infectious contacts.

These countries lack gloves, gowns, face masks and other essential supplies to protect nurses and doctors from infection, and they don?t have an adequate surveillance system to catch and identify Ebola cases in a timely way. The number of doctors and health centers is small as well.

There are signs for hope, however. In Africa, Nigerian public officials have successfully ?broken the chain? of Ebola transmission. And the U.S. public health response is considerably more organized and stronger than the public health framework in Africa.

Also See: Nearly 40% Of Americans Fear An Ebola Outbreak

Emory Healthcare in Atlanta has already treated three victims of the current Ebola outbreak. Two of those patients ? Kent Brantly and Nancy Writebol, who were doing missionary work in Africa ? have since been discharged.

Why did Emory take on those patients? How did staff respond?

I spoke with John Fox, CEO of Emory Healthcare, in an interview for the Advisory Board Daily Briefing ? and he stressed that he would do it again. ?This is our mission. This is the reason we exist,? Fox said.

Every Emory patient who treated the Ebola patients volunteered to do so.
Emory staff care for an American missionary who contracted Ebola in Africa. (Graphic via Los Angeles Times.)

Emory staff care for an American missionary who contracted Ebola in Africa. (Graphic via Los Angeles Times.)

How Ebola Kills You

Ebola?s initial symptoms include fever, headache, diarrhea, and vomiting ? all of which sound misleadingly common and relatively treatable. But the disease can quickly progress, with mortality rates of upward of 70%.

?At the end stage of the disease, you have small leaks in blood vessels,? Thomas Geisbert, an immunologist at the University of Texas Medical Branch at Galveston, told NPR in August. ?You end up with essentially no blood pressure. Your body temperature drops and you go into shock.?

That?s largely because Ebola can provoke a ?cytokine storm? in the body, as the immune system launches an all-out response to fight off the disease ? which simultaneously ravages a human body, damages blood vessels, and further lowers blood pressure to dangerous levels.

Ebola is terrifying.?But it’s not likely to kill you, or to spread widely in the United States. What’s scary ? and hyped ? about Ebola isn’t what makes it dangerous.

Ebola is a hemorrhagic fever. It kills about half of those who contract it. It sometimes, though not always, leads to uncontrollable bleeding. But it’s?difficult to contract. The only way to catch Ebola is to have direct contact with the bodily fluids ? vomit, sweat, blood, feces, urine or saliva ? of someone who has Ebola and has begun showing symptoms.

The problem with Ebola is stopping it in Africa, where cases continue to rise exponentially, and where health systems are already overwhelmed. The CDC estimates that 1.4 million people could be infected by January if swift action isn’t taken to scale up the response. The medical and political consequences of that would be vast. “This is more than a health crisis. This is a growing threat to regional and global security,” President Obama said at the United Nations.

while there can and will be cases of Ebola in the United States, the disease will be stopped

That said, while there can and will be cases of Ebola in the United States, the disease will be stopped here. Ebola is dangerous when it can overwhelm a health-care system, but it’s nowhere close to being able to overwhelm the US health-care system. So if you live in America, worry about heart disease, or traffic accidents, or gun violence instead. Ebola is terrifying, but it’s not likely to kill you.

Source-Forbes/Vox

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