Officials with the Centers for Disease Control have confirmed that a person in Dallas definitely has the Ebola virus. Tuesday’s official determination makes the Dallas patient the first diagnosed Ebola case in the United States.
Officials with the Centers for Disease Control and Prevention are holding a press conference at 4:30 p.m.
I surely hope and pray people in the US don’t panic over this. Take deep breaths, pray, and let’s review some perspective.
1) There have been 5 Ebola cases treated in the US so far. Three have recovered & released. AFAIK, 2 are still in treatment (Emory and NIH patients). There has been no spread of Ebola when adequate precautions are taken.
2) Ebola has been SUCCESSFULLY CONTAINED (PTL!) in two African countries: Nigeria (where there were cases in Lagos & Port Harcourt) and Senegal. Both countries are now basically “Ebola Free” (no contacts remaining under surveillance) after travelers brought in the disease. In Nigeria 21 people were infected and 8 died. However at least 600+ people came into contact of the initial patient and those he infected, so only 21 cases is low. In Senegal, even more amazingly, NO ONE was infected by the Guinean student who brought the disease to Dakar and then lived in an extremely crowded apartment building and went to a local clinic while ill (symptomatic) with Ebola. 73 contacts were followed up and released. None of them became ill. No one died. The Guinean student has recovered and been released. If Nigeria and Senegal can contain the spread of Ebola, so can the US.
3) Ebola is much less contagious than airborne diseases like the flu or TB. As is the common refrain, you have to be exposed to body fluids (blood, vomit, feces, sweat…). You don’t get Ebola from casual contact, and it can only be spread while someone is actively symptomatic (fever, vomiting, etc…) But, some people may mistake the statement that “you need to be exposed to body fluids” to be like how one gets AIDS or other STDs (e.g. blood transfusion, needle stick, sexual intimacy…) Unlike AIDS, Ebola CAN be spread by touch. Touching the sweat, blood or vomit of a patient with Ebola can infect a person. (A huge problem in W. Africa has been people touching dead bodies, which are highly infectious.) That is why Ebola patients are treated in isolation units by people in full protective gear, unlike AIDS patients. So, here’s a little equation. In terms of “how contagious is this disease” (how easy it is to catch): AIDS < EBOLA < Flu Does that make sense? I truly hope and pray the brouhaha over this Ebola case in Dallas does not in anyway detract from continuing to mobilize a massive response to help those so ravaged by the epidemic in W. Africa. In terms of perspective, please think and pray of the thousands of health workers on the frontlines of this disease (MSF has over 3000 staff in W. Africa, I read today). They are the ones most at risk of catching this disease as they serve others. Please don't be selfish and self-centered America. One case is not a cause for panic. 6000+ cases in W. Africa, ravaged economies, hundreds of Ebola orphans, etc. etc.... is a totally different story. As the news from Nigeria & Senegal shows, Ebola CAN be stopped. By God's mercy and as His servants pour themselves out to respond, we can hope for the containment of this epidemic. Please join in prayer as Christians around the world this week #PraytoendEbola!!! Don't let fear rob us of love and compassion.
One other comment I meant to include under point 1 in my comment above: there have also been Ebola cases treated in England, Spain and France (and I think Germany too? I probably should double check), with no spread of the disease. Of course, these cases like the 5 prior cases in the U.S. have all been evacuated health workers, brought to the US or Europe under strict isolation standards.
So, of course, it’s not like a patient with Ebola getting on a plane and walking into an ER in Dallas. I get that… but still, it does go to show that the disease can be successfully and safely managed in Western countries.
I watched part of the CDC press conference this evening about the Dallas Ebola case. The official was very calm and made many of the points you make, Karen B., about transmission. I have no doubt that this disease can be controlled here in the US even if people fly in from west Africa with it. Really, if an outbreak in Lagos, Nigeria, can be controlled, people have little to fear here. And with good quality medical support the patient in Dallas is likely to do better than he (?) would have in Liberia. Adequate IV fluids and breathing assistance make a huge difference.
Thanks be to God for the good outcomes in Senegal and Nigeria!
The CDC statement on the Ebola case in Texas is here:
http://www.cdc.gov/media/releases/2014/s930-ebola-confirmed-case.html
Very well done. I think they strike just the right note between real honesty (there is SOME risk of more cases) – acknowledging that fear is NORMAL! – and seeking to calm fears through accurate and careful info. It’s not at all patronizing, which is very refreshing. Here’s the section I found best:
[blockquote]Ebola can be scary. But there’s all the difference in the world between the U.S. and parts of Africa where Ebola is spreading. The United States has a strong health care system and public health professionals who will make sure this case does not threaten our communities,†said CDC Director, Dr. Tom Frieden, M.D., M.P.H. “While it is not impossible that there could be additional cases associated with this patient in the coming weeks, I have no doubt that we will contain this.â€
The ill person did not exhibit symptoms of Ebola during the flights from West Africa and CDC does not recommend that people on the same commercial airline flights undergo monitoring, as Ebola is only contagious if the person is experiencing active symptoms. The person reported developing symptoms several days after the return flight. Anyone concerned about possible exposure may call CDC-Info at 800-CDC-INFO for more information.
CDC recognizes that even a single case of Ebola diagnosed in the United States raises concerns. Knowing the possibility exists, medical and public health professionals across the country have been preparing to respond. CDC and public health officials in Texas are taking precautions to identify people who have had close personal contact with the ill person and health care professionals have been reminded to use meticulous infection control at all times.
We do know how to stop Ebola’s further spread: thorough case finding, isolation of ill people, contacting people exposed to the ill person, and further isolation of contacts if they develop symptoms. The U.S. public health and medical systems have had prior experience with sporadic cases of diseases such as Ebola. In the past decade, the United States had 5 imported cases of Viral Hemorrhagic Fever (VHF) diseases similar to Ebola (1 Marburg, 4 Lassa). None resulted in any transmission in the U.S.[/blockquote]
Yes, I heard Dr. Frieden making the point about the previous VHF experiences. My husband was in an emergency room and then emergency surgery four weeks ago in an American hospital. (He did well and is fine.) We had the opportunity to chat with various medical professionals while there. The hospital has done training and has disseminated information about Ebola, symptoms, and precautions. No doubt this hospital in Dallas had also made some preparations. The extreme isolation unit like the one at Emory in Atlanta is not essential to safe treatment, since this infection is not spread by air. It’s a worry, but not a reason for panic. CDC has dispatched four experts to Dallas to assist.
Katherine, I’m struck by your comment… 4 CDC workers to Dallas to assist with managing 1 patient. Think about that for a minute, compared with the situation in Africa where there is such a shortage of medical personnel compared with the need.
In no way am I complaining. Sending the CDC group to Dallas is good and right to make sure there is adequate training, aggressive contact tracing and management, etc. but it does make my heart sad (as Kendall would say) to see a world with such inequalities in resources and care. The more I read my heart is just breaking for what’s happening in Liberia, Sierra Leone and Guinea.
Folks I am currently in South Africa. When we arrived at Johannesburg airport those coming from non-visa countries had to stand in front of a Fever Screen which instantly assessed their temperature. I would suggest that both the U.S. and U.K. need to consider such a measure.
Terry Tee, it’s a good idea, although it won’t absolutely keep the Ebola virus out. The Dallas patient reportedly began to feel ill four days after arrival. There’s a 21-day incubation period.
I went through a fever screening on arrival in Cairo in the middle of the 2009 swine flu panic. Fever screening at least tells whether other people on the plane might be at risk.
CNN reported that the Dallas Ebola patient was not asked, when he visited the emergency room on Sept. 24 and was sent home, whether he had recently been out of the country. If this is true, the hospital was not following what has been recommended for some time. When my husband went to an ER last month he was asked if he’d traveled domestically or internationally, and where.
I’m not panicked.
I am appalled and disgusted at the laissez-faire and casual behavior of our country’s leaders. We should not be accepting people into the country from the three African countries in question and should not have been for some months now. Reasonable people have been pointing this out for ages — and this reality has been casually ignored.
It was, of course, inevitable that allowing thousands upon thousands of people into the country from, say, Liberia, would produce an outbreak right here in the US — the *first case of Ebola* on US shores [not deliberately imported] in history.
So congratulations, dear leaders. Ebola is now here, rather like smallpox when it was introduced into the country by us hundreds of years ago — it is an historic introduction, and since the symptoms are not necessarily active for up to 21 days, people are allowed to wander shopping malls and trains, coming into contact with dozens of people before they are quarantined.
Anybody I know recognizes ebola is not airborne. What we also recognize is that it takes contact with a micron and less of human sweat, or tears, or blood to transmit the virus.
I expect it’s a combination of the vast clueless incompetence of our current leaders, and utter medical arrogance imagining that we can somehow manage this disease that causes us to behave with such casual indifference and without the most basic of safeguards [no travel to the affected countries, no entrance from those countries]. It is a death-dealer. And the fact that our leaders have, through their own incompetence, hastened and aided its arrival to deal death and horror just sickens me beyond words.
Sarah, re: panic, I have it on good authority from the NY Daily News that America is panicking 😉
‘A plague like no other’: Americans panic over first U.S.-diagnosed Ebola patient
New York Daily News – ‎4 hours ago‎
Ebola is here – and so is the mass hysteria. Public fear about the deadly virus boiled over Tuesday after the Centers for Disease Control and Prevention confirmed the first U.S.
Twitter Users, including Donald Trump, fearfully predicted a dire, deadly outbreak.
http://www.nydailynews.com/life-style/health/americans-panic-u-s-diagnosed-ebola-patient-article-1.1959147
[of course if you believe everything printed in the NY Daily News, I have some beachfront property in Kansas to sell you…]
I am in agreement that it is not sensible, given the risks, to be allowing pretty much unregulated entrance to people who have been in Liberia, Guinea or Sierra Leone within three weeks of their wishing to enter the US. This case in Dallas (and what may become a cluster) shows us that this is dangerous — and this is quite different from the very careful isolation evacuations of the SIM/Samaritan health care workers. Since the incubation period is, as I understand it, 14-21 days before symptoms appear, we should be closing entry during that time period. I do not understand why this patient was allowed transit through Brussels, either. If the traveler’s passport stamps show he left Liberia four weeks ago, and he is not ill, then in he comes.
Fortunately, contact tracing and public awareness should keep the Dallas outbreak under control. But if repeated over and over, eventually some selfish person or persons are going to spread this and create a larger problem.
Actually, a look at the timeline on the Dallas patient discloses that he was exposed to a dying Ebola patient on Sept. 15. He left Liberia on the 19th and arrived in Dallas on the 20th (via Brussels and Washington). By Sept. 24 he was in the ER with symptoms. That’s nine days. The twenty-one days is the outside limit for incubation.
Not the same disease, but a friend of mine is the mother of a child with severe asthma. She is very concerned about the Enterovirus 68 which is spreading and seems to have been brought by the illegal alien children from Central America who have not been properly screened and immunized prior to dispersion to locations all over the country. The illness in endemic in their home areas. This virus is not the same level of threat as Ebola, but nonetheless a child in Rhode Island has died of it.
I was listening to a summary of what was done on Ellis Island when immigrants arrived — screening and quarantine for fear of smallpox and other diseases. They actually took that stuff, you know, seriously — because people *die*. We were able to allow people in — but only with rigorous screening and evaluation by a horde of physicians and nurses on the island. My understanding is that even the examining healthcare people were also *placed in quarantine* so that they had shifts of 30-60 days *on the island* and then time at home. They weren’t allowed to casually trot home after dealing all day with immigrants.
Oh how far and how arrogantly we have descended.
Oh yeh . . . this:
[blockquote]The New York Times said that Duncan, in his mid-40s, helped transport a pregnant woman suffering from Ebola to a hospital in Liberia, where she was turned away for lack of space. Duncan helped bring the woman back to her family’s home and carried her into the house, where she later died, the newspaper reported. Four days later Duncan left for the United States, the Times said, citing the woman’s parents and neighbors.
Texas health officials said that up to 18 people, including five children, had contact with the Ebola patient after he traveled to the United States from Liberia in late September. The children had gone to school early this week but have since been sent home and are being monitored for symptoms.[/blockquote]
So the guy *knew* he’d been in *close contact* with a person with ebola and *chose* to get on a plane to the US [i]four days later.[/i]
This is why the whole “hey, man, relax, ebola’s not contagious until there are symptoms” is such pathetic rhetoric [the CDC didn’t cover itself in glory with its recent interview either — not reassuring when the man is nonplussed by a question about sneezing within 3 feet of another person, seeing as how yes it’s not “airborne” but that is a bodily fluid]. Because . . . [i]when does somebody know that they themselves are “exhibiting symptoms”[/i]? Is it when they get a fever, [i]and know that they have a fever[/i]? Or is it when they have a fever but haven’t quite yet realized it?
Obviously it’s the latter.
And we know that he wasn’t symptomatic — not even the remotest touch — four days later when he boarded a plane with hundreds of people on it . . . [i]how[/i]?
So how many more Thomas Eric Duncan’s will be arriving here?
In other news:
[blockquote]The White House said Wednesday it will not impose travel restrictions or introduce new airport screenings to prevent additional cases of Ebola from entering the United States.
Spokesman Josh Earnest said that current anti-Ebola measures, which include screenings in West African airports and observation of passengers in the United States, will be sufficient to prevent the “wide spread” of the virus.
The chances of a U.S. epidemic are “incredibly low,” he said.[/blockquote]
Right. I for one completely trust the people staffing the West African airports in the three affected countries that have been unable to beat back the outbreak to do a competent and excellent job. And our own “observation” of passengers will do the trick on the other end.
Sarah, that description of Ellis Island procedures is consistent with my husband’s grandparents’ recollections of coming through there.
In this case, Ebola, we are sending aid there, both government and private charity aid, and numerous medical missionaries are risking their lives over there. It doesn’t make sense to allow casual travel here from those areas. The White House assertion that they can prevent “wide spread” is not too comforting to the Liberian community in Dallas, eighteen of whom are now under observation.
Sarah, sorry I couldn’t continue our discussion from the #PraytoendEbola thread above last night. Time got away from me…
Let me just say I do understand and share a lot of your concerns. I’ve not seen evidence of panic or unreasonable fear here on T19.
Nor did I deliberately go seeking it out. But since I’ve been voraciously reading about Ebola in recent weeks for 2 reasons:
1) because of my work responsibilities and contingency planning here in Africa (far too close to the hot zone for comfort, in a place whose health system is not too much better than Liberia’s…) and
2) since I’m helping lead the Lent&Beyond; #praytoendEbola prayer effort this week.
It’s that latter role that had me on Twitter promoting #praytoendEbola and being exposed to panic and lies being spread and much venom being spewed. And so that’s the context that prompted my earlier remarks. I was venting a bit…
I think I’ll leave it at that for now. I’m praying fir the situation in Dallas, and for wisdom and good sense for officials re: how to properly limit air travel / screen & quarantine passengers. I too think some limits are needed!
Thankfully, our ultimate trust in these matters is not in the CDC, the WHO, the UN, the US gov’t, but in God. I am confident that as we cry out to Him He can and will raise up leaders with wisdom to effectively battle this outbreak.
[blockquote]Health officials are reaching out to as many as 100 people who may have had contact with the first Ebola patient diagnosed in the U.S., a spokeswoman with the Texas Department of State Health Services said Thursday.[/blockquote]
According to a (conservative) policy group, current US law gives the executive branch the authority to declare a disease a public health hazard and this designation would enable the State Department to limit incoming travelers from affected areas. This should be done, and it should not be a matter of politics. It’s purely common sense.
Areas in Africa surrounding the three afflicted countries have closed their borders to anyone from those areas, and it is my understanding that Nigeria no longer allows flights in from those countries. This has stopped the spread of the virus outside of Liberia, Guinea, and Sierra Leone — except to countries farther distant who are still allowing possible infections in.
The Dallas patient suddenly left his job on Sept. 4, according to reports, and flew out on Sept. 19, and sought medical care on Sept. 24, which is just inside the three-week period assuming an exposure on Sept. 4, in addition to the reported exposure to a critically ill woman on Sept. 15. It does make one wonder.
[blockquote]Also Wednesday, customs workers at Hartsfield started handing out Ebola information leaflets to passengers holding passports from West African countries such as Guinea, Liberia and Sierra Leone.[/blockquote]
That is, of course, a great relief. Leaflets will do the trick.
Sarah, I think ignorance is a large factor, and yes, leaflets may not help much. Here is [url=http://news.sciencemag.org/africa/2014/09/confronting-ebola-virologist-liberias-hot-zone]an interview with a leading virologist[/url] who came back from three weeks in Liberia in mid-September. He describes the airport outgoing screening in Monrovia as perhaps worse than useless. It’s crowded and workers don’t understand how to measure temperatures correctly. He said that outside of the MSF Ebola clinics the airport felt to him like the least safe place in the country.