Epidemic

An Ebola Epidemic Will Not Happen in the U.S.

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Ebola
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USA Today features a slightly alarming headline: Ebola Only an Plane Ride Away from USA. Of course that is true, but that does presage the possibililty of a widespread epidemic here? No. Why not? Because my fellow Americans would go seek treatment when they feel ill and would submit to quarantine if diagnosed with the disease. Contrast this with how the New York Times reported some West Africans are sadly confusing correlation with causation:

Eight youths, some armed with slingshots and machetes, stood warily alongside a rutted dirt road at an opening in the high reeds, the path to the village of Kolo Bengou. The deadly Ebola virus is believed to have infected several people in the village, and the youths were blocking the path to prevent health workers from entering.

"We don't want any visitors," said their leader, Faya Iroundouno, 17, president of Kolo Bengou's youth league. "We don't want any contact with anyone." The others nodded in agreement and fiddled with their slingshots.

Singling out the international aid group Doctors Without Borders, Mr. Iroundouno continued, "Wherever those people have passed, the communities have been hit by illness."

Health workers here say they are now battling two enemies: the unprecedented Ebola epidemic, which has killed more than 660 people in four countries since it was first detected in March, and fear, which has produced growing hostility toward outside help. On Friday alone, health authorities in Guinea confirmed 14 new cases of the disease.

Workers and officials, blamed by panicked populations for spreading the virus, have been threatened with knives, stones and machetes, their vehicles sometimes surrounded by hostile mobs. Log barriers across narrow dirt roads block medical teams from reaching villages where the virus is suspected. Sick and dead villagers, cut off from help, are infecting others.

"This is very unusual, that we are not trusted," said Marc Poncin, the emergency coordinator in Guinea for Doctors Without Borders, the main group fighting the disease here. "We're not stopping the epidemic."

Efforts to monitor it are grinding to a halt because of "intimidation," he said. People appear to have more confidence in witch doctors.

Despite the scary headline, the USA Today article does note:

Yet while Ebola is a fearsome disease, the virus "would not pose a major public health risk" in the USA, [Michael] Osterholm, [director of the Center for Infectious Disease Research and Policy at the University of Minnesota] says.

That's because people need to be in intimate contact to spread the virus, Osterholm says.

Ebola is actually much harder to spread than respiratory infections, such as influenza or measles. Those viruses pose a much greater threat on a plane or in any confined space, says Osterholm, who notes that people cannot spread the Ebola virus simply by sneezing or coughing.

Ebola also can only be spread by people with active symptoms, [Stephan] Monroe, [deputy director of the CDC's national center for emerging and zoonotic infectious diseases] says.

"No Ebola cases have been reported in the United States and the likelihood of this outbreak spreading outside of West Africa is very low," says Monroe, who says that the CDC has sent 12 experts to Africa to help with the crisis. "While it's possible that someone could become infected with Ebola in Africa" before boarding a plane to the USA, "it's very unlikely that they would spread it to other passengers."

Ebola does spread readily through body fluids, such as blood and saliva, Osterholm says. On a plane, a sick person could potentially contaminate the bathroom if he or she vomits or has diarrhea…

Hospitals in the USA are on high alert for Ebola, however, and would quickly isolate anyone with suspicious symptoms who has recently returned from Africa, Osterholm says.

"Right now, we'd have to assume every case is an Ebola case," in people with suspicious symptoms, Osterholm says.

In a worst-case scenario, Osterholm says, a handful of emergency room workers could be exposed before a sick person is diagnosed.

That being said, if you've traveled to West Africa recently and begin to experience fever, muscle aches, chills, sore throat, vomiting and diarrhea, a rash and start bleeding all over the place—go see a doctor.

For more background, see my 2003 column, "Disease, Public Health, and Liberty," analyzing when quarantine is appropriate.

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  1. And people doubt survival of the fittest…

    1. Fittest for what?

  2. Way back in the post 9-11 days, there was a lot of modeling done on smallpox used as a bio-weapon.

    It would be stupidly easy to start a wide-spread infection, if you had the virus and especially if you had a few “suicide infectors”. Because highly infectious diseases spread geometrically, shit can get out of hand muy rapido. Especially since these diseases hit health care workers early and hard.

    And here in the United States of Pussies, you wouldn’t even need much of an “epidemic” to set off utter panic and overreaction.

    1. Ebola isn’t airborne though, so smallpox is a lousy analog. If you look at waterborne viruses like Hepatitis A or SARS, they just don’t spread very well in developed countries.

      1. Ebola isn’t airborne though, so smallpox is a lousy analog.

        As I recall, the “best” method for starting a smallpox epidemic was through contaminated clothing, etc.

        Ebola may be a different animal, even for a scenario like that.

  3. MM: Some of us are vaccinated against smallpox. Just saying.

    1. That was taken into account. The point of the modeling was to figure out who, and in what order, people who aren’t vaccinated should get vaccinated.

    2. Ugh, that vaccine is a bitch. Nothing like getting lanced several times with a needle and being asked to let it fester.

      Still, if the CDC screws up or some wackos end up contaminating the populace, it’ll be worth it. Maybe.

  4. …”This is very unusual, that we are not trusted,” said Marc Poncin, the emergency coordinator in Guinea for Doctors Without Borders,”…

    I’m not sure; polio vaccinations were a tough sell in SE Asia.
    There seems to be a limit on how far you can push a population with regard to ‘improvements’. Beyond those limits, even really bad outcomes are seen as preferable to the unknown.

    1. It certainly doesn’t help when the CIA uses vaccination efforts to disguise their operations.

      1. Yeah, but well prior to that, there was real resistance.

      2. Aw, come on man= you really think people in a village in ‘Kolo Bengou’ were all tweeting each other how they read on Facebook about the CIA vaccinating people in Pakistan….?

        or that maybe they’re just *fucking superstitious*?

        Not that your point is *wrong*, just that in this case it has no bearing.

        FWIW, my ex-gf did aid work in Africa about a decade ago, and she summarized problems with tribal villagers being, “they generally suspicious of anyone claiming to want to ‘help’ anyone without getting something in return. It makes no sense to them.”

        at which point i would tease her about how we’re all evolutionarily ‘selfish capitalists’

        1. No I don’t. But I do think the Muslim populations spread the rumors around.

          In uneducated tribes, I imagine ignorance of microbiology and belief in witch doctors doesn’t help either.

          1. *But I do think the Muslim populations spread the rumors around.*

            Yup, right after they got done warning everyone that the Jews put poison in Pepsi, they went to work on the polio vaccine scare.

        2. Just explain that, in return, you want them to dedicate their eternal soul to the one true God. Then they’ll get it.

    2. If the village has Ebola and the locals bar the medical team, back off, call in an air strike (daisy cutter) and move on to the next village. Eventually they’ll get the message.

  5. As I said….

    (luckily I’m teleworking two of those days and won’t have to but up with any bullshit surrounding this event)

    1. hahaha, the timing couldn’t be more perfect.

    2. “I do not see the countries and peoples of Africa as a world apart; I see Africa as a fundamental part of our interconnected world ? partners with America on behalf of the future we want for all of our children. That partnership must be grounded in mutual responsibility and mutual respect.”

      “Africans are humans!”

      Way to take a stand there, President Courage.

      1. Empty platitudes are empty.

        People appear to have more confidence in witch doctors.

        Quarentine the assholes and let nature take its natural, and merciless, course.

        1. Yep. “Let us in now or we won’t let you out. Your choice.”

  6. To stop the spread we could always nuke the region from orbit, it’s the only way to be sure.

    1. you forget the fuel-air bomb from Outbreak

      1. I want a more accurate weapon, that one couldn’t even hit a town.

        1. Doesn’t need to.

    2. Okay, I know this is an emotional moment for all of us. I know that. But let’s not make snap judgments, please. This is clearly an important virus we’re dealing with and I don’t think that you or I, or *anybody*, has the right to arbitrarily exterminate them.

      1. They could be intelligent. Better send a Wiggin to investigate.

  7. Ugh, Bailey and his damn pictures.

    Ebola also can only be spread by people with active symptoms

    Not quite true. Ebola is an STD-males who get it and survive can transmit it sexually for up to two months after symptoms subside.

    1. Wouldn’t the remnants of all those healing blisters (or whatever those are in that pic) sort of keep a guy from transmitting the virus via sex?

      This is like when I heard a story on NPR about how thalidomide had been found to be very helpful in treating leprosy, but all sorts of pearl clutchers were worried about the lepers having flipper babies. Huh? How many lepers are in danger of getting knocked up?

    2. From the CDC:

      Once the virus has been transmitted to a human, it can then be spread through person-to-person contact. People can be exposed to Ebola and Marburg viruses from direct contact with the blood or secretions of an infected person.

      Nosocomial transmission, or the spread of disease within a healthcare setting, also occurs, making the use of protective clothing and the disposal of needles and syringes crucial to preventing the spread of infection.

      http://www.niaid.nih.gov/topic…..ssion.aspx

      1. *Once the virus has been transmitted to a human, it can then be spread through person-to-person contact*

        Oddly coincidental that at the very same time this is going on, the medical community would be encouraging everyone to fist-bump instead of shaking hands, eh?

    3. so don’t try and join the mile high club on the plane back from Africa and you’ll be fine

  8. Government should enforce quarantine with lethal force.

  9. An Ebola epidemic will not happen in the U.S. with the current known strains of the virus. If the virus mutates into a form that shows symptoms more slowly, then it could easily get here.

    1. I am not an Ebola but I know just enough to know that if Ebola mutates this way, it will lose all of its deadliness.

      The Ebola virus is a replication monster. It replicates way too fast for the innate immune system to restrain it and there is no chance the adaptive immune system will kick in before you’re too far gone or dead. I’m pretty sure that rapid replication is the cause of all those symptoms.

  10. Ebola Only an Plane Ride Away from USA.

    What a bunch of pointless, stupid fear-mongering. Everything on this planet is “only a plane ride away from the USA”. So what.

    If Ebola were any good at causing pandemics it would have done so already, like influenza or duckface.

  11. Is that alt txt suppose to be funny?

  12. I think we’ve inadvertently discovered the way to affordable health care for all – Witch Doctors! Their educational credentials are much lower, so there won’t be any shortage of health care professionals.

  13. Note what happened the last time there was a viral hemorrhagic fever outbreak in the US:

    http://en.wikipedia.org/wiki/Sin_Nombre_virus

    It did not lead to a nation wide epidemic.

    Our society does just does not transmit this sort of virus very well compared to developing countries, both for technological and social reasons.

    1. Yeah, I’m not too worried about an “organic” epidemic in the US. This just reminded me of some very interesting presentations from back in the day on terrorist bio-weapon attacks.

    2. I couldn’t see for sure but I don’t think that one transmits from person to person.

      1. Ebola doesn’t causally transmit human to human either. If you’re been following the news, the transmission is two main causes:

        1. Waste from an infected person gets into a water supply. This is blocked technologically by modern water sanitaion
        2. Funeral rights involving communal washing of corpses. This is blocked socially; most of us would be reluctant to touch a healthy corpse, let alone one we knew to be infected with a deadly diesease.

        1. Then how are doctors and nurses getting it? I’ve read it’s spread by “close contact.”

          1. Hence my qualifier “casually”.

            1. For all I know, “close contact” could mean a sneeze or a touch. That seems pretty “casual” to me.

  14. There goes a man tyhat knows what time it is.

    http://www.WentAnon.Tk

  15. Sounds like the villages are quarantining themselves.

  16. Ebola epidemic WILL NOT happen in the U.S….and the Titanic WILL NOT sink!

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