A few weeks ago, as the Ebola epidemic was unfolding, we discussed the pros and cons of bringing patients back to the U.S. for treatment, versus sending medical professionals and resources abroad to provide treatment at the source of infection. Clearly, there are arguments on both sides.
But that issue may be secondary, when you consider our global community, how interconnected the world is now, and how borders are only a partial barrier to stopping the spread of disease.
This comes with news of a case of Ebola in Dallas after the patient allegedly fabricated a story to be allowed onto a plane from Liberia to the US, then showed symptoms of the disease once here. And there was a report today of a nurse in Spain who has tested positive for the disease—the first case of Ebola with an origin outside Africa.
The interconnected nature of our world makes it exceeding difficult to fully contain a disease to a region, especially in countries where security and travel restrictions cannot be fully managed. And even with expanded efforts with greater security—and even troops—a case like the one in Dallas shows how these measures can be circumvented.
So containment can only be part of the strategy for stopping an epidemic like Ebola.
Medications Are Still In The Development Stage
There is no vaccination against the Ebola virus right now, and medications that can treat the disease are in the development stages. One medication, ZMapp, has shown promise, and it was used to treat a couple of American healthcare workers who contracted the virus and who were returned to the U.S. for care. Use of the drug was arranged privately by Samaritan’s Purse, the humanitarian organization that employed one of the American workers. Samaritan’s Purse worked with the private company that developed the drug to provide it.
But ZMapp supplies are extremely limited, and no clinical trials have been conducted yet. So the drug won’t be available for widespread use until sometime in the future—if it proves effective. The same holds true for other treatments. The National Institute of Health is beginning Phase 1 of trials on a potential vaccine, and trials are also planned with a Canadian drug and a UK vaccine possibility.
One Of The Best Strategies At This Point: Education
This however, doesn’t mean that effective action can’t be taken now. In fact, one of the strongest tools for managing and stopping the Ebola outbreak is simple: Knowledge.
The Ebola virus is a terrifying disease that, if untreated, has a mortality rate of greater than 90%. With supportive care (re-hydration and other therapies to counteract its effects), the morality rate can drop significantly—to around 50%. While still high, this is a marked difference. And it could potentially be enhanced if people exposed to the virus knew to seek treatment early.
We know that the virus is only contagious if an individual is exhibiting symptoms, and that it takes contact with bodily fluids or items that have contacted bodily fluids (like clothing) of someone infected to transmit the disease. We also know that there’s a 21-day window between contact and infection if it occurs. That’s very specific information, and we have the tools available to communicate this information to the majority of the U.S. population in a matter of days, if not hours.
This is a major change than, say, from the 1980s where Surgeon General C. Everett Koop had to spend months engineering the largest mailing in U.S. history to 107 million households in an attempt to stem the HIV epidemic.
But the power to reach people quickly comes with the responsibility to do it accurately. A frightening and emotional issue like Ebola can spark panic, and without accurate information being distributed to alleviate the fears, misinformation can fill the vacuum. This could actually create situations for the virus to spread further, or distract from work that could develop effective treatments. If you’ve watched the news, you’ve seen the risks of this already. That’s another aspect of the double-edged sword of our global connections.
The CDC and others have been proactive in communicating to the public, and explaining the risks. Other professionals are taking similar action. Even lay people who have proper knowledge of Ebola should impart that to others in conversations about the virus—social media can pass information at the grassroots level rapidly.
There have been four other instances of hemorrhagic viruses reaching the United States (one Marburg, four Lassa). None resulted in any transmission in the U.S. Responsible action can yield similar results with this new threat.
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