Ebola: How Afraid Should We Really Be of an Outbreak in America?

When it comes to Ebola, have Americans lost their minds?

Despite just three confirmed cases — that of Thomas Eric Duncan, a Liberian man who died from the virus in a Dallas hospital, and of two nurses who treated him — the airwaves are buzzing with constant alerts of one person or another who may be experiencing “Ebola-like symptoms,” or perhaps just the flu.

• In New Haven, a medical student who had recently returned from Liberia was admitted to the hospital with symptoms of the virus, although the patient was tested and found Ebola-free.

• In San Diego, students at Southwestern College were afraid the virus had reached campus when one of their peers was hospitalized with flu-like symptoms and allegedly said he or she had shared a flight with a nurse who was diagnosed with Ebola the next day. The school’s officials said the incident is not Ebola-related.
• On Friday morning, health officials in HazMat suits swarmed a woman suffering from Ebola-like symptoms in a parking lot at the Pentagon, who was also not diagnosed with the virus.
• Two students in DeKalb were blocked from enrolling in school after their family returned from Sierra Leone, despite having waited the appropriate quarantine period.

In fact, at least seven people have died from complications related to the recent outbreak of enterovirus D68 (EV-D68), as opposed to the one U.S. death resulting from Ebola.

So how afraid should we really be? And could alarm over the relatively remote threat of Ebola infection cause its own problems for hospitals and doctors?

According to Dr. Whit Fisher, attending physician of emergency medicine in New York and Rhode Island, the chance of widespread Ebola cases in the country are unlikely, and people should not jump to conclusions when exhibiting flu-like symptoms.

“The absolute worst thing people can do is run to the hospital the moment they get a fever and chills,” said. “That will clog up the hospital system, cost them a fortune, and quite frankly put them near other sick patients.

“The only time that you should consider Ebola as a cause of symptoms,” he added, “is if you have had close contact with a person who has a confirmed diagnosis, or with an ill person who has come from the affected regions of West Africa.”

The affected African countries include Liberia, Sierra Leone and Guinea, which make up only a fraction of the continent.

Ebola can spread only through direct contact with an infected person’s bodily fluids — including sneezes, coughing and other methods of spreading mucus — or exposure to a contaminated object, such as a used needle.

• See: Ebola In Your Town: What’s The Plan?

Until recently, to most Americans Ebola was a remote threat and the stuff of medical thrillers like Richard Preston’s “The Hot Zone.” That changed in September when Duncan, who had direct contact with an Ebola patient in his home country, showed up Texas Health Presbyterian Hospital with a fever. The hospital sent him home, and when he returned three days later, he was diagnosed and admitted for treatment.

Although the medical staff at Texas Health Presbyterian Hospital said they followed the Centers for Disease Control and Prevention’s guidelines to contain the virus, that quickly was found to be untrue, and the virus spread.

A Texas nurse named Nina Pham was infected after treating Duncan. Pham was transferred to an isolated facility at the National Institutes of Health in Maryland for treatment, and has since asked that an emotional video shot in her isolated unit of doctors thanking her for her work be shared with the public. Shortly after Pham became ill, a second health care official who worked near Duncan was diagnosed with Ebola.

The virus has remained a primary topic of the discussion after making its way to the United States in September. Only a few cases have been confirmed — which hasn’t stopped people from joking that they have it while onboard planes — and concern about the possibility of widespread infection has spread across the country.

Fisher said that the stage of the virus is important in regard to treatment, as patients in earlier stages of infection have a better chance of responding to medicine.

A forerunner treatment for Ebola is a drug called ZMapp, a mixture of three antibodies that is produced by Mapp Biopharmaceutical in San Diego and has been used treat infected patients successfully.

Although officials are working on a method of producing more of the drug, Fisher said experimental treatments like ZMapp are more difficult to obtain. Since the medicines are not approved by the Food and Drug Administration and are usually manufactured in smaller labs, producing and shipping in mass numbers is not feasible.

The FDA could streamline approval for certain drugs, Fisher said, or at least make it a priority to expedite the approval process.

Another issue is that increased awareness of Ebola has coincided with flu season. With winter coming, Fisher said, many people across the country will develop standard cold symptoms of fever and body aches, and many “will overreact” and wonder if they have a deadly disease that claims the lives of half or more people who get it.

Fisher said initial procedure has been to transfer Ebola patients to “level-one academic center” hospitals, such as Yale-New Haven and Emory, although the specific hospitals designated to accept Ebola patients will likely change over time. Fisher also said that although he doesn’t think the virus will be widespread in the United States, he does believe there will be more fatal cases with health care workers who are around infected patients.

“The key thing to remember is that even Duncan’s family members who were in the apartment with him for several days while he was ill show no symptoms,” Fisher said. “It seems that it is only when patients are very, very ill that they become more and more infectious.”

Fisher said this observation explains why officials treating Duncan became infected through brief contact and with protective gear, while his own family members who shared close contact days before were not.

• What do you think about the Ebola scare? Is the U.S. at serious risk for a widespread infection? Tell us in the comments section below.

Image via Wikimedia Commons