Saturday, October 04, 2014

Ebola Containment Improbability

The current Ebola outbreak in West Africa is much more of a big deal than previous outbreaks.  Ebola was first identified in 1976 and is named after the Ebola River in the Democratic Republic of the Congo which was recognized as Zaire at that time.  Ebola likely circulated in primates and occasionally infected humans who handled and consumed wild primate and other bush meat.  However, the sporatic Ebola outbreaks usually burned themselves out because 1. the virus was 90% lethal 2. poor medical care 3. no easy travel 4. easier to quarantine small remote tribes and villages.

The current Ebola epidemic is a much different thing all together.  The current Ebola strain is much more dangerous because it is actually less lethal.  With a 50-60% mortality rate, and longer incubation time of up to 21 days, the infection is not burning itself out but has spread into the larger towns and cities in Liberia and Sierra Leone. More survivors means more chance to expose others.  

The 1918 Spanish Flu pandemic only had a 3-5% mortality, 500 million were sickened, and 50-100 million died.  Ebola isn't as easily transmissible as flu, but with the vomiting, diarhea, and bleeding associated with end-stage Ebola; it is not surprising that Ebola is spreading among healthcare workers and close contacts.

It is estimated that over 1 million people are currently in quarantine in West Africa. With ten thousand passengers leaving West Africa every single day; It is only a matter of time before this disease is carried to every corner of the world.  The Ebola cluster in Dallas will likely be cleared up, but it is only a matter of time before more clusters break out.  Eventually, we could see the level of outbreak clusters exceed our public health resources.

West Africa has miles and miles of shanty towns filled with millions of people who likely have no government documentation that they even exist or that even have an address.  This makes quarantine measures nearly impossible.  These poor area could serve as a reservior for Ebola infection that just continues to burn and smolder for years.

West Africa needs our help in terms of money, and resources, etc.  However, in addition to money, the US needs to be working on a vaccine, and putting all of West Africa on quarantine.  No US airline should be permitted to travel to or from West Africa.  Also, the US doesn't need to be approving any travel visas from anyone who originates or has traveled through West Africa.  American citizens returning from West Africa should be quarantined 31 days.  At the least, if Liberians are permitted to travel to the US, then require that they be quarantined for 31 days.

But even if the US implements all these measures, US measures won't stop spread to South and Central America.  If Ebola takes hold in the Americas, thennit is only a matter of time before it crosses the US border.  Accordingly, I think all the US military be brought home from Syria and wherever else and put in the US border to secure it.

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