Health Care

Why There Won’t Be an Ebola Outbreak in the United States

The circumstances that contributed to West Africa’s epidemic — and continue to plague efforts to contain it — do not exist in the U.S.

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Marina Koren
Oct. 1, 2014, 1 a.m.

Re­mem­ber Out­break?

Good. Now for­get about it, be­cause, con­trary to pop­u­lar — and pan­icky — be­lief, what happened in the 1995 dis­aster film won’t hap­pen in the United States now that the na­tion has its first-ever case of the Ebola vir­us.

The in­fec­ted pa­tient, who has not been iden­ti­fied, is be­ing treated at a Dal­las hos­pit­al, 11 days after he ar­rived in the U.S. on a com­mer­cial flight from Liber­ia. That coun­try is at the heart of an Ebola out­break in West Africa, the dead­li­est since the vir­us was dis­covered in 1976. More than 6,200 people have been in­fec­ted this year, and at least 2,917 of them have died, ac­cord­ing to the latest num­bers from the World Health Or­gan­iz­a­tion.

Yes, the vir­us it­self is scary. There’s no vac­cine for it. There’s no cure. It’s fatal in pa­tients 60 per­cent of the time when it’s caught early, and 90 per­cent when it’s dis­covered too late. An out­break of the size and scope as the one in West Africa is a real­ity for the cit­izens of the af­fected coun­tries. For Amer­ic­ans, it’s fic­tion.

Aside from a pos­sible “hand­ful” who came in con­tact with the pa­tient in Dal­las, people in the U.S. have not come in­to con­tact with the blood, vomit, sweat, fe­ces, or any oth­er bod­ily flu­ids of a per­son in­fec­ted with Ebola, which is how the vir­us spreads. Nor do the con­di­tions that con­trib­uted to the spread of West Africa’s out­break ex­ist to a ser­i­ous de­gree in the U.S. Here are some of those cir­cum­stances.

Many people in West Africa don’t un­der­stand the Ebola vir­us and how it spreads. Sci­ent­ists know little about where Ebola ori­gin­ates and how ex­actly it spreads, and the av­er­age cit­izen in West Africa knows even less. Some people have avoided seek­ing treat­ment, fear­ing that med­ic­al work­ers are the ones spread­ing the vir­us. Phys­i­cians and oth­er health care pro­fes­sion­als have been threatened with knives and stones, and some vil­la­gers have at­temp­ted to block nearby roads to keep med­ic­al teams out. In some parts of the re­gion, people think that just say­ing “Ebola” aloud makes the dis­ease ap­pear, ac­cord­ing to The New York Times.

Liber­ia, Guinea, and Si­erra Le­one had nev­er seen a case of Ebola un­til this year. Whatever in­struct­ive ma­ter­i­als their gov­ern­ments draf­ted to edu­cate their people about the vir­us, they made com­pletely from scratch.

Stateside, the Cen­ters for Dis­ease Con­trol and Pre­ven­tion and oth­er health agen­cies have re­peatedly ex­plained Ebola and how it spreads, even though the risk that any­one here will con­tract the dis­ease is ex­tremely small.

Some West Afric­an buri­al prac­tices are not like those in the U.S. When someone sick with Ebola dies in West Africa, his or her body is not taken to a fu­ner­al home, placed in a coffin, and bur­ied six feet un­der. Loc­al tra­di­tion of­ten calls for fam­ily mem­bers to wash, touch, and kiss the bod­ies of their loved ones. Some­times, the buri­al mats they use are saved for fu­ture buri­als. People in­fec­ted with Ebola are most con­ta­gious when they’re dead, which means the healthy people dis­pos­ing of their bod­ies are at ser­i­ous risk of ex­pos­ure.

The af­fected West Afric­an na­tions don’t have the kind of pub­lic health edu­ca­tion re­sources the U.S. does. Nearly every pub­lic re­stroom in Amer­ica bears a sign that warns cus­tom­ers and em­ploy­ees alike to wash their hands be­fore ex­it­ing. But many hy­giene meas­ures deemed stand­ard here are not com­mon in the re­mote vil­lages of the na­tions at the heart of the Ebola out­break. To teach loc­als about prac­ti­cing good hy­giene, vo­lun­teers have gone door-to-door and handed out in­form­a­tion­al pamph­lets and fly­ers, re­ports IR­IN, a United Na­tions hu­man­it­ari­an news ser­vice. They’ve pos­ted help­ful in­form­a­tion on Face­book and Twit­ter, and have worked with cell-phone com­pan­ies to send text mes­sages in loc­al lan­guages.

The af­fected na­tions lack the ba­sic health care in­fra­struc­ture needed to treat pa­tients, let alone con­tain the vir­us. There’s not much doc­tors can do for Ebola pa­tients aside from al­le­vi­at­ing their symp­toms, provid­ing in­tra­ven­ous flu­ids, main­tain­ing their blood pres­sure, and treat­ing oth­er in­fec­tions if they arise. But even such care, con­sidered routine in U.S. hos­pit­als, is dif­fi­cult to provide in West Africa. The af­fected coun­tries simply don’t have the med­ic­al sup­plies and per­son­nel to stop the vir­us. Many health cen­ters there don’t have enough beds for pa­tients, let alone high-tech isol­a­tion wards and pro­tect­ive gear for their em­ploy­ees.

Any po­ten­tial Ebola cases in the U.S. should be taken ser­i­ously. And they are, by the CDC and oth­er well-re­sourced or­gan­iz­a­tions, which have, more so than oth­ers, what it takes to cur­tail an out­break.


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