Ebola – A Wake Up Call?

A continually morphing virus is an unknown, so any information that the government gives us today, may be dead wrong tomorrow. The contradictory statements coming out of the government agencies about ebola is both inappropriate and counter-productive. They are caught between a rock and a hard place because they don’t know exactly what they are dealing with. They don’t want to choose between telling the American people the truth and facing the possibility of causing a panic, so they lie. Too bad. All Americans lose.

For myself, I have great faith in the American people. Behind closed doors, the government anticipates that as many as 30% of Americans will be affected by ebola. Yet we are sending up to 3900 of our finest young men and women into the cauldron of ebola-infested West Africa on a ‘mercy’ mission. Really? Where is the mercy for our sons and daughters, and how will they be protected?

The failure of our government to deal honestly with us and their decision to send the best of America knowingly into harm’s way are both criminal.

————–  Ilana Freedman, Editor

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Imagine the following scenario: A man in Liberia helps a pregnant woman, who is dying of the Ebola virus, in an attempt to get her medical attention. All the hospitals turn her away as she is in the late stage of the virus.

Having come in contact with a person infected with Ebola, the man gets on a plane without telling authorities he has been exposed to the virus, and flies on a United Airways flight to Brussels in Belgium. There he transfers to a flight to Washington’s Dulles Airport, where he again transfers and flies to Dallas-Fort Worth. He is not showing signs of symptoms until he arrives at his family’s apartment.

Suffering with a fever and flu like symptoms, his family takes him to the hospital where he is examined by nurses whom he tells that he has been in Liberia. This travel information never makes it to the doctors, who give the man some antibiotics and release him.

The man continues to become increasingly ill, and so three days later he is transported by ambulance back to the hospital. Before getting in the ambulance, he vomits in the apartment parking lot.

He is diagnosed with the deadly Ebola virus and placed in isolation in the hospital, and his family is placed in enforced quarantine in their apartment. Within a few days of being admitted, the man dies of the Ebola virus.

If you think this sounds like the plot from one of the numerous Hollywood outbreak type movies, you’d be right. Only this isn’t Hollywood, this is real life. The first person to be diagnosed with the Ebola virus on US soil, Thomas Eric Duncan, is believed to have made exactly those flights with stopovers at multiple locations, before arriving in Dallas Texas. C.D.C. director Tom Frieden said the Dallas patient who has Ebola was “critically ill,” and said he believes “a handful” of family members may have been exposed, though no further cases had been immediately confirmed. Mr. Duncan is now dead.

This series of events begs several major questions. Why are we allowing people to fly from known infected countries to the United States? How many people in Belgium and in DC did Duncan come into contact with during those transfers? Where did those people go? How many are potentially infected?

Before we tackle these questions let’s take a look at the nature of the Ebola virus, it symptoms and its means of transmission.

Ebola is deadly virus for which there is currently no proven cure. It is transmitted to humans from wild animals and is then spread through direct contact with the blood, secretions, organs or other bodily fluids of those who are already infected.

Symptoms, which can begin between two to 21 days after infection, include fever, muscle pain, headache and a sore throat followed by vomiting, diarrhea, rash, impaired kidney and liver function and in some cases both internal and external bleeding. To date, there have been almost 6,000 cases of Ebola diagnosed in the current outbreak. Experts from the WHO and Imperial College, London predict numbers will continue to climb and more than 20,000 people will have been infected by early November.

While there is no current cure for Ebola, patients can survive if they are rehydrated and treated for their symptoms in a hospital. Ebola is one of the world’s deadliest diseases, carrying a mortality rate of 90 per cent if left untreated. The current outbreak, however, has so far had a fatality rate of 70 per cent. With good medical treatment, survival rates can be around the 50 per cent range – still a daunting fatality rate by any standards.

Mr. Duncan’s story may not be a unique one, with many people making the trip from infected areas in West Africa to Europe and beyond. There have been many voices demanding that we ban direct flights from Liberia and surrounding countries to the United States, but as we see with with Mr. Duncan he didn’t fly directly from Liberia, but flew into Europe and then to the United States.

That said, shutting down an obvious conduit for travelers infected with Ebola virus makes good common sense. Both Britain and France have made that move in an effort to reduce the number of travelers who may attempt to fly directly to Europe from Liberia and the surrounding areas.

British Airways has suspended all of its flights between London and two West African nations for the rest of the year as the region struggles to contain the worst ever outbreak of the deadly Ebola virus. The airline initially said it was halting its service between Heathrow Airport and Liberia and Sierra Leone until the end of August due to ‘the deteriorating public health situation in both countries’, but it confirmed that it is extending the suspension until 31 December. The decision was announced by the Foreign & Commonwealth Office in an updated travel advisory for Britons

Air France has also suspended its flights to and from Sierra Leone, and the French government has urged French nationals to leave Sierra Leone amid concerns about the epidemic in four West African countries.

Several airlines have stopped flying into and out of Guinea, Liberia, Sierra Leone and Nigeria as they grapple with the worst outbreak since the virus was first detected in 1976. British Airways followed the lead of Emirates, which became the first major international airline to cancel flights, and African carriers Arik and ASKY.

Given the transmission mode of the Ebola virus, in terms of being in contact with bodily fluids including sweat, tears, vomit and excrement, we have to ask the question in terms of how many people did Mr. Duncan come in contact with during the three flights he made and his presence in four airports. From a virus distributions standpoint, airports are a nightmare in terms of the concentration of people in a given area and a wide variety of destinations those people may be flying to. Once in contact with the Ebola virus, the incubation period will allow these travelers to arrive at their final destinations and then start exhibiting symptoms of the virus and becoming sick, as with Mr. Duncan.

When we look at Mr. Duncan and how he was being treated in a Dallas hospital, and the quarantine conditions his family being held in, we have to ask the question regarding is this approach scalable? The authorities went into the Duncan apartment to remove soiled bedclothes and other contaminated items while decontaminating the apartment. This is one isolated case. What if it were 10 cases, or 100 or thousands? Will we have the infrastructure to support the isolation of the patients and the associated quarantine of their families?

Treatment of Ebola patients in American hospitals requires specific isolation techniques. Infected tissue and blood samples need to be handled in such a way as to avoid further contamination, which again requires manpower and space. I am left to ask the question if this virus did spread beyond a handful of cases, will our system be able to cope with the load required of it?

We now hear that an NBC news photographer has been infected with Ebola in Liberia. The NBC crew has voluntarily put themselves into isolation to determine if they have also been infected. There are plans to fly the infected cameraman back the United States for treatment, which in of itself in some respects is cause for concern. If we’re looking at testing and keeping out air travelers that are infected, while knowingly flying back infected individuals for treatment, this could be argued to be a contradictory policy. With all the opportunities for things that could go wrong with the infected patient is this analogous to bringing back an unexploded bomb to base to diffuse it?

There is also the issue of the virus itself and its potential to mutate into something that can be transmitted via the air. Mr. Anthony Banbury, the UN Secretary General’s Special Representative, told the UK’s Daily Telegraph that aid workers were fighting a race against time amid fears the virus will continue to mutate. He said: ‘The longer it moves around in human hosts in the virulent melting pot that is West Africa, the more chances increase that it could mutate. It is a nightmare scenario, and unlikely, but it can’t be ruled out.’ His comments come as organizations battling the crisis in West Africa warn that the international community has just four weeks to stop it before it spirals ‘completely out of control.’

To have the virus mutate to be transmitted via aerosol droplets would indeed be a nightmare scenario. We, as a nation, need to shut down travel from the West coast of Africa and do it now. Action need to be taken to protect the American homeland, rather than the politically correct sensibilities in Africa.

We have to remember that the now deceased Mr. Duncan was not exhibiting any symptoms when he arrived at the Dallas Fort Worth. So while we now have the Department of Homeland Security has ordered agents at airports and other ports to “observe” arrivals for potential signs of Ebola infection, chances are that Mr. Duncan, and others like him incubating the illness, may have not been detected. With a belated sense of urgency this past Monday, President Obama announced the upcoming airport screening plans, saying “we don’t have a lot of margin of error” in containing the spread of the deadly virus.

With American lives and infrastructure at stake, there is no margin of error.

- See more at: http://americainformed.org/health/ebola-a-wake-up-call/#sthash.NJ7MqQVS.DTkKSuKS.dpuf

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