American physician Dr. Kent Brantly, infected with the Ebola virus, recently returned to the United States for treatment. While he is improving, according to the director of the Centers of Disease control Dr. Tom Frieden, it is too soon to know whether he will survive this devastating infection. Nancy Writebol, a coworker of Dr. Brantly, also infected with Ebola, will be transported to the U.S. later this week. Should we be worried? Is this a real life version of the new TV series “The Strain“?
CDC boss Dr. Frieden reassures us that while Ebola is a big problem in Africa, “It’s not going to be a huge risk in the US.” Is that so? In July 1981, the same CDC, discussing a new disease originally named “gay-related immune deficiency,” now called AIDS told us, “There was no apparent danger to non-homosexuals from contagion.” Two years later is was clear that AIDS was much more than a “gay disease,” transmitted also through heterosexual sex, blood transfusions, and IV drug use. Granted, AIDS was a new disease at the time, while Ebola is not, but even the experts can make erroneous predictions.
The same CDC mishandled another deadly contagion anthrax as they “failed to inactivate the dangerous bacteria before transferring it to a lower lab” according to Dr. Frieden last month. In fact there were “5 incidents in which deadly pathogens were mishandled” by the CDC. Why couldn’t Ebola mishandling make a sixth incident?
Ebola is transmitted via, “direct contact with the blood or secretions of an infected individual” or through infected needles, according to the CDC. Much the same way AIDS is transmitted. Ebola symptoms typically manifest within a week or two of exposure. But sometimes symptoms can be delayed for up to three weeks, with early symptoms similar to the common cold or flu. How many travelers return home from abroad and soon develop a cold, from a virus caught in a busy airport or the close confines of a transoceanic flight?
Researchers at Tulane discovered that Ebola virus was found in saliva, stool, semen, breast milk, tears, and nasal blood. That doesn’t mean contact with these fluids will cause infection, but it might. OSHA implemented “Universal Precautions” in the workplace to prevent infection through contact with blood and bodily fluids. Infections such as HIV, hepatitis, staph and strep infections, gastroenteritis, pneumonia, tuberculosis, and herpes can be transmitted in this fashion, hence healthcare facility precautions of mask and gloves, even for a routine teeth cleaning.
Brantly and Writebol were caring for Ebola patients in Liberia. It is safe to assume that they were taking appropriate precautions, yet they caught the deadly virus. What about healthcare workers or first responders in the U.S., ones managing a sick patient who might or might not have mentioned their recent trip to Africa?
What about hospital workers at Emory? Who removes and cleans linens, utensils, bedpans, and handles the trash? What if just one person makes a mistake or doesn’t follow proper protocols?
A passenger recently arriving in London from Sierra Leone collapsed and died after getting off the plane, but not before vomiting and sweating. Ebola or simply a heart attack? Fortunately she tested negative for Ebola, but what if she didn’t? How many fellow passengers, flight crew, or emergency personnel could have been exposed and potentially infected? What if it was one of many flights originating in Sierra Leone ending up in New York City, with multiple stops along the way?
Perhaps I’m a chicken little for raising these issues. After all, our government assured us that all is well and that we are safe. Our government leaders also told us the attacks in Benghazi were due to a video and there was, “not even a smidgen of corruption” at the IRS. Last week the president signed an executive order allowing, “The apprehension, detention, or conditional release” of certain individuals with acute respiratory disease. Seems a bit extreme if we are safe from Ebola. Unless the administration is hoping to catch Rush Limbaugh or Sean Hannity sneezing or coughing on air.
Dr. Joondeph is a retina surgeon at Colorado Retina Associates and serves on the faculty of Rocky Vista University School of Medicine. Twitter @retinaldoctor.