A reality check on the Ebola crisis
    Photo by Flood G. on Flickr / Creative Commons

    When writing about their work, scientists rarely feel the need to appeal to readers’ emotions. In fact, they’re not supposed to: Emotional logic leaves bad impacts on good science. Emotions are for sci-fi movies, like Armageddon and Moon.

    For instance, this paper about the near mass extinction of honey bees in the United States has the not-so-dramatic title, “Sub lethal exposure to neonicotinoids impaired honey bees winterization before proceeding to colony collapse disorder.” Even my favorite episode of Bill Nye the Science Guy is just blandly called “Volcanoes.”

    So when a highly respected scientist publishes an editorial with the purposely–ominous name "Ebola’s perfect storm," we should pay attention. We should educate ourselves about the disease and support those fighting for the lives of the 7,500 patients in western Africa. But we should not panic nor worry nor fear when a single Ebola patient pops up in a hospital in Dallas.

    Here’s the deal

    Ebola virus is a filovirus, a family known for their iconic looping shape and penchant for inducing hemorrhagic fevers. All human Ebola outbreaks have begun in rural Africa, most resulting from a hunter butchering an infected monkey or bat, maybe after he uses a bloody hand to wipe the sweat from his forehead or if he nips his finger with a knife. It can take as little 400 plaque-forming units to infect an individual, an amount well able to fit in a 0.8 micrometer water droplet, which is one tenth the size of a red blood cell. Ebola is hard to contract because you have to touch infected fluid, but once you have its very good at infecting you.

    Once an ebolavirus is in a primate, it is exceedingly good at infecting and reproducing in the host’s cells, especially the immune and blood vessel cells it targets. This leaves the unfortunate infected individual with a severely weakened immune system and a, well, “leaky” circulatory system. A sick person is extremely susceptible to other infections, and every fluid their body produces, even sweat, is able to infect others. Only after symptoms appear, usually within 1 to 21 days, is an individual contagious.

    In a region like West Africa with prime conditions for the spread of disease (there is only one doctor per 3,000 citizens and regional funeral rituals involve massive family gatherings and caressing the deceased), it’s no wonder one of the most virile agents in the world is able to double the number of infected every 20 days. At this rate, 21,000 people in West Africa will be infected by November.

    When these infected patients are discovered (many are reluctant to come forward after their sick relatives leave with aid workers and are never seen again), they are taken to makeshift hospitals with almost none of the modern tools doctors use to combat severe infections. There is no patient ventilation nor oxygenation, no way to test for vital electrolyte balance, a lack of important medicines and often barely detectable malaria outbreaks among already sick patients. It is sad but unsurprising that these conditions lead to Ebola’s panic-inducing 60 to 80 percent mortality rate in West Africa.

    Health care in the United States isn’t like Sierra Leone or Liberia. Access to experimental drugs aside, we have a $3 trillion healthcare industry. The United States is extremely well prepared to handle numerous outbreaks of the disease, and we’ve already proven it.

    Welcome to the U.S.

    During his recent trip to West Africa, a Liberian man helped take a feverish pregnant woman to a hospital, where it was confirmed she had Ebola. Soon after, he returned to his home in Dallas. Five days later he started vomiting and went to the hospital. The hospital messed up big time when, knowing full well he had been in Ebola infected regions, they sent the feverish man home with antibiotics, which are useless against viruses. Two days later he was back in the hospital, this time placed in isolation.

    The day after that, he was diagnosed with Ebola virus. Over the following 48 hours, health care officials systematically identified and began monitoring every single one of the 80 persons the Ebola patient encountered while contagious. Even with a huge blunder, the Ebola situation in Dallas is under control.

    What people need to know is that the United States’ unparalleled ability to root out, monitor and isolate infected individuals is how we will nip Ebola in the bud every time it pops up in our borders. The virus can’t spread when every infected person is stuck in a hospital quarantine.

    But what happens in the very rare case officials miss someone, and it spreads? That last time a filovirus found itself free in a developed country was the Marburg virus, which infected 31 people in Germany during the 1960s. Even back then, with an effective and supportive healthcare system the virus only killed 25 percent of the infected. One death in four is a harsh price to pay, but compared to the seven deaths in 10 in Africa today it seems like a godsend. With 50 years of advancement in critical care medicine since Marburg, the mortality rate would likely be lower.

    The only pitfall that lies before us is the supposed lack of protocols on how to deal with an Ebola patient. Since the early symptoms of Ebola look similar to influenza, should every person that looks like they have the flu be quarantined and have their blood tested? What happens if you accidentally walk a patient that does have Ebola all around the hospital? Even nurses say they are unsure what to do.

    The simplest remedy is two words: travel history.

    If hospitals nationwide learn from the Dallas mistake and pay attention when a sick patient tells them they were in West Africa, many of the scary what-ifs disappear. Ebola immediately becomes a suspect, and the patient can be succinctly placed in isolation until clear. Thankfully, hospitals are already doing this.

    Northwestern deals with Ebola

    Many universities, Northwestern included, seem to have adopted a similar plan that focuses on identifying students and faculty that have been to Ebola-affected regions. Enrollment and study abroad data made it easy enough for NU to find out which students are from or have recently been to affected countries. The number of those students was so low that Northwestern University Health Services contacted them personally.

    In all, only three persons affiliated with Northwestern needed to be under watch, and all they have to do is use a thermometer twice daily.

    Beyond monitoring and educating students, NUHS has already devised a plan to deal with a suspected Ebola patient. In the highly unlikely event that Ebola is suspected, the patient is politely encouraged to come to Searle, through the back door of course, where they’re met by a medical staff member in full protective "space suit." From there, it’s off to NorthShore Evanston Hospital, who has been working with NUHS. After that, Evanston health officials are contacted, and they begin the arduous task of investigating which people our imaginary patient came into contact with.

    For now, Ebola remains a daily scourge in Africa. If we feel scared with our single patient, imagine the emotions running wild in Sierra Leone and Liberia as the virus burns through their populace. This is why President Obama is sending 3,000 military personnel – and hopefully $1 billion in aid – to West Africa, and not to hospitals in the US. For now and the foreseeable future, Ebola will not be a problem in the United States.

    Knock on wood.


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