Since Sept. 29, when a man in Texas tested positive for Ebola, federal and state officials have identified more than 100 people who may have come in direct or indirect contact with him. They are being monitored for fever, and four individuals are quarantined for 21 days in an apartment for a more controlled monitoring. None have symptoms so far.
Dr. Thomas R. Frieden
“We remain confident that we can contain the spread of Ebola in the U.S.,” Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention (CDC), said during a press briefing. “There could be additional cases, and if that occurs, there are systems in place to prevent the spread.”
The sick man, who has been identified in the media as Thomas Eric Duncan, first visited the emergency department at Texas Health Presbyterian Hospital in Dallas on Sept. 26, a week after he left Liberia. He was sent home, only to be brought back 2 days later by an ambulance. He is still in serious condition and remains the only case of Ebola to be diagnosed in the United States.
Texas officials said they are investigating why he was sent home at his first visit.
“The lesson from all of this for the hospitals across the nation is that they really have to take the travel history,” Dr. Frieden said. “Ask if they’ve been in these areas where there’s Ebola, and if so, they have to put Ebola on the differential diagnosis.” He stressed the importance of hospitals working and collaborating with public health officials.
“Any hospital in the country can safely take care of Ebola patients,” he said, as long as they have a room with its own bathroom. “But you need rigorous, meticulous training, and you need to make sure that the care is done well.”
There are currently 12 laboratories around the nation prepared to test for the Ebola virus, according to officials. As of Oct. 2, there have been 100 inquiries from hospitals in 34 states about the possibility of having a patient infected with Ebola. So far 15 cases have been tested for Ebola, and the only positive case so far is the man in Texas.
Staff trained by the CDC took the Texas patient’s temperature when he was boarding the plane in Liberia, which is the current protocol, and his temperature was 97.3° F, officials said. The status of his exposure in Liberia is now being investigated.
“The broader issue is, can we make the risk zero,” Dr. Frieden said. “And the bottom line, the plain truth, is that we can’t make the risk zero until the outbreak is controlled in West Africa.” Until then, officials will do what they can to minimize the risk of spread, he said. “It’s not impossible that we’ll have other individuals coming to the country that have Ebola.”
Based on the most recent data, there have been more than 6,500 cases of Ebola in West Africa, and more than 3,000 of those patients have died. Liberia has had the highest number of Ebola cases, followed by Sierra Leone, Guinea, and Nigeria. There has been one travel-reported case in Senegal.
Whether the affected countries should be isolated is a tough question, Dr. Frieden said, because isolating the countries will make it more difficult to deliver help, which in turn will enable the disease to spread more widely.
“The best way is not to seal off those countries, but to provide the services needed” and identify any [infected] individual who may be leaving those countries.
Ebola outbreaks have been recorded since 1976, but none has been as large as the current epidemic in West Africa, which was first identified on March 23 as an outbreak in Guinea.
In a study published in the New England Journal of Medicine on Sept. 23, the World Health Organization Ebola Response Team predicted that by Nov. 2, 2014, the cumulative reported numbers of confirmed and probable cases in the affected West African countries will exceed 20,000 in total.
“These data indicate that without drastic improvements in control measures, the numbers of cases of and deaths from [Ebola virus disease] are expected to continue increasing from hundreds to thousands per week in the coming months,” the team wrote.
Helpful links
Hospital checklist: http://www.cdc.gov/vhf/ebola/pdf/hospital-checklist-ebola-preparedness.pdf
Information for health care workers: http://www.cdc.gov/vhf/ebola/hcp/index.html
Latest outbreak information in West Africa:
http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/index.html
History of Ebola outbreaks: http://www.cdc.gov/vhf/ebola/outbreaks/history/distribution-map.html
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