Tuesday, September 30th, the Centers for Disease Control and Prevention (CDC) confirmed reports of the first case of Ebola ever diagnosed in the United States. The patient in question is a male who on September 20 arrived by plane in Dallas, Texas via Monrovia, Liberia. The man became ill on the 24th and was checked into Texas Health Presbyterian, where the hospital’s infectious disease specialist Edward Goodman states, “He was evaluated for his illness, which was very nondescript. He had some laboratory tests, which were not very impressive, and he was dismissed with some antibiotics.” On the 28th, the mystery patient was returned by ambulance in a considerably worse condition where he is being held in isolation at the hospital’s Intensive Care Unit where he is reported to be critically ill.
While it may be tempting to cast Dr. Goodman as incompetent for letting a man with Ebola back into the public, there is no evidence to suggest that he or his staff was negligent in performing their duties. In fact, Ebola is relatively difficult to pass on to another person. According to the CDC, “Ebola is spread through direct contact (through broken skin or mucous membranes). This means that a healthy person must physically come into contact with the blood or bodily fluids of someone with the virus. It is thus impossible for airborne transmission to occur.
The reason it has become an epidemic in Western Africa is due to a culture of poor hygiene as well as a distrust of western medicine itself. A prime example is the tragic event that occurred in Guinea on September 18, where villagers attacked an outreach delegation of doctors and journalists. The group was trying to educate the village residents on the virus and how best to avoid it. They were, however, violently rebuffed as the locals began to throw stones and beat the outreach members with clubs. A resident police officer explained that the villagers believe Ebola “is nothing more than an invention of white people to kill black people.” Eight delegation members were killed and another 21 were injured.
Another incident, occurring in August provides another example of the mistrust of western medicine and governmental outreach. It occurred in Monrovia, the city from which the Dallas hospital’s mystery patient flew into Texas from. An isolation center was ransacked by a club wielding mob and 17 patients were whisked away, never to be seen again. There have also been stories of people stealing bloody bed mattresses and bed sheets of Ebola victims from hospitals and isolation centers. In Africa, it is customary to wash the bodies of the deceased before burial. This of course, places those still uninfected into direct physical contact with the virus. These factors, among others, provide a perfect breeding ground for the virus to quickly spread throughout communities, cities and countries in the region. The World Health Organization has that the death toll in Africa has surpassed 3,000 with reported cases reaching the 6,500 mark.
While the US has exponentially better personal health practices and services on hand, it is natural for people to be concerned. The fact remains that a person infected with the deadly virus flew to the US from an African country in the center of the outbreak. Naturally, questions have arisen as to how this was possible, and how many more potential cases will begin to arise. Fortunately for those on board the Liberia to Dallas flight, the virus is not contagious until the infected has displayed the requisite symptoms (a fever greater than 101.5 F, severe headache, muscle pain, weakness, and diarrhea, vomiting, and hemorrhaging). Passengers of the flight had their temperatures taken at the gate in before boarding with none showing a fever. In a press conference on Tuesday, CDC director Thomas Friedman went as far as to say that “there is zero risk of transmission on the flight [the patient was on].”
No details have been released as to whether or not the patient is a US citizen. While he is the first person to be diagnosed with Ebola inside the United States, he is not the first confirmed Ebola patient to arrive in the country. There have been four people who have contracted the disease in Africa and have subsequently been flown back into the states. Three have been treated successfully; two by Emory University in Atlanta, and one in a Nebraska medical center. The fourth person, whose health status and identity remain unknown to the public, is also being treated at Emory. The patients were treated with an experimental drug named ZMapp, but it is inconclusive how much of a role it played in their respective recoveries.
Dallas County Health and Human Services Director Zachary Thompson acknowledged that residents’ concerns but insisted that they have nothing to worry about. He went on to say that the people who have come in to contact with the infected man are being closely monitored. Health officials stated that the children who may have been in physical contact with him have been kept home and logistics are being worked on with school officials. In a time where international air travel is becoming increasingly ubiquitous, a case such as this was bound to occur.
That the virus has found its way onto America soil will no doubt change the calculus regarding people’s awareness of a danger that seemed to something a world away. It is somewhat reassuring to learn that the CDC has reported that Nigeria, the continent’s most populous country, has contained their own outbreak. If a country not considered first world is able to control a large outbreak, certainly the United States can too. After all, in his attempt to quell any panic, Director Friedman, told reporters, “I have no doubt that we will control this case of Ebola so that it does not spread widely in this country.” Let’s hope he’s right.